QuestionA couple weeks ago my boyfriend and I were rear ended. We were in my 2002 Honda Odyssey. I was not driving, it was my boyfriend. We were dead stopped on the freeway but the car behind us was still going at speed 50+mph. She totaled her car and deployed her airbag. The CHP report states that she was 100% at fault. I suffered a concussion and whiplash and my boyfriend with his back. I didn't have insurance. But my boyfriend does, will that make a difference? Should I get insurance now while my car is still in the shop or should I wait? The car hit us is insured by AllState. The Body shop that we are dealing with has been very helpful with all this. The body shop was able to help us get a car rental Hertz and is handling the billing directly with AllState insurance.
We now have the car rental and found out that it will take 15 days to repair my van and the property damage has reached to $6,000. My boyfriend and I are now trying to gather all our document and information together and write a demand letter for our pain and suffering. We’ve been off a week now and still not in full recovery, but we’re running out of sick leave and vacation. And, we both just got referred to see a Physical Therapy, don’t know how long that will last. We both can’t afford to be off work because we have bills to pay. My boyfriend and I don’t live together, but we share a 3 year old together and we’ve been together for 8 years.
So, when should we submit the claim? And should we do it first or wait for them to make an offer? And what is a good settlement to demand? We would like to settle this quick, but I’m not sure if that’s good. We’re both doing modified work. Will my claim be deny if I didn’t have insurance? Do you have a sample of a Demand letter I can follow as a guideline? Sorry for all the questions! I just need some kind of answers without calling an attorney.
Thank you for your advice,
Jennelle
AnswerHi Jennelle,
We are going to REALLY DIFFER on our approaches to this case, Jennelle. I am going to suggest that you take a lot of time on this claim because I believe you have a very serious and long term injury. Hence, I am going to put in a very long time in making a long and thorough answer for you. I want you to read what I am giving you and I want you to think about getting a loan via one of those "insurance settlement" loan companies. Watch out for the high interest rate they will charge you. But that terrible interest is A LOT LESS than the amount of settlement you will lose if you were to settle without going through some of what I am suggesting.
You have suffered a serious injury, and from your description, you are going to also suffer financially because you "have bills to pay". It appears that you are headed for a minimal settlement because of your rush to settle too soon and your passive role in the process. This will take a lot of my time, but it is worth putting down a lot of information for you since I do believe that you were hurt a lot more that you think at this point. If I am going to put in the time for you, I hope you will take the time to read and to understand how to proceed to make a winning insurance settlement.
Let me go through your questions to see where that leads, and then I will have some comments for you on how to settle a claim.
#1. I didn't have insurance. But my boyfriend does, will that make a difference?
ANSWER: It will make no difference in your claim versus the tortfeasor. Your boyfriend should open a claim with his own insurance and let them pay for his medical bills. You can ask if you are covered under his insurance, but since he was not at fault, I suspect you will not be included as an insured.
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#2. Should I get insurance now while my car is still in the shop or should I wait?
ANSWER: Who is covering you and your child now against uninsured motorist accidents? I would buy insurance now, and make sure you include all first party coverage for injuries, such as Personal Injury Protection (PIP)—also known as Med/Pay—and uninsured motorist coverage (UIM).
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#3. So, when should we submit the claim? And should we do it first or wait for them to make an offer? And what is a good settlement to demand? We would like to settle this quick, but I’m not sure if that’s good.
ANSWER: Your last comment is RIGHT: a quick settlement of a serious injury IS NOT A GOOD IDEA. As for who should make an offer first, YOU should take the initiative.
Take the initiative and DO NOT LET THE ADJUSTER DICTATE THE SIZE OF THE BALLPARK you are going to play in: Get your demand letter out there.
You asked: “What can I expect for a settlement?”" Unless you take the initiative in this claim, what you "can expect" is to become another success story for an adjuster who has run over uninformed claimants and denied them a fair settlement award.
You should be commended for having the initiative to seek out a website such as this and to ask for help, but the most important part of achieving a successful personal injury claim HAS TO START WITH YOU, NOT THE ADJUSTER. Do NOT let the adjuster set the parameters of the negotiation: get your demand letter out there FIRST, but ONLY after you have reached maximum medical improvement. It is not all that hard or mysterious to put together an Effective Personal Injury Insurance Demand Letter http://www.settlementcentral.com/page0170.htm It does not have to be "fancy" or complex; just hit the main points and get it out to the adjuster soon.
If I were you, what I would do right now is to become as fully informed about the insurance injury claims process as you can, with the objective of seizing the initiative in prosecuting my claim, instead of taking a passive, reactive role. Can you see the difference in postures and how one works to your advantage and the other to your disadvantage?
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#4. Continue Medical Treatment for Residual Injury Pains and do NOT Settle too Soon
If the crash was at 50 MPH and her vehicle was totaled, then you were in a crash hard enough to cause serious injuries. I am willing to bet that even after your treatments, once you start to get more active, you will notice pains once again. Mark my words that at first you will have a dull ache, and that ache will become a nagging pain with your increased physical activity if it is not treated.
Listen to your body and to get medical attention when you feel any aches or pains that continue for a day or more. GET MEDICAL CARE FOR YOUR INJURIES—if you have any aches, DO IT NOW. You were involved in an accident with a lot of impact. It is likely your body suffered trauma sufficient to cause injuries. And there is no reason why you should suffer.
It seems like you are trying to get a quick settlement, but that is instead the goal of the insurance adjuster. SHE wants the quick settlement, NOT you.
DO NOT SETTLE YOUR CLAIM UNLESS YOU ARE ABSOLUTELY CERTAIN THAT SOFT TISSUE INJURIES WILL NOT REAPPEAR ONCE YOU STRESS YOUR BODY WITH PHYSICAL ACTIVITIES OR JUST DAILY LIVING AND WORKING. That Plays Right Into an Insurance Tactic Regarding Inducing Early Settlement of Injury Claims.
Let's just finish up this topic of early settlements Jennelle, so you get the full picture of the advantage to them and the risks to you. Insurance companies like to settle early because the general damages—claims for pain and suffering—are always minimal, but continue to grow with continued medical/therapeutic care over the months. Therefore, the insurance adjuster will try to settle before the claim merits a larger pain and suffering element. This makes good sense for the insurance company. A claim that is still active after 12 months, with an injured claimant still undergoing treatment, will settle for a lot more pain and suffering money than a claim that is settled after two or three months of treatment.
In soft tissue cases such as this, the full extent of most injuries is not known immediately after finishing early rounds of treatment, because the injured person has to undergo some of the wear and tear of everyday life, including the pounding his body will receive from a day's work. Even jobs that appear not to be physically demanding can be hard on an injured body.
For example, have you ever stood all day with few breaks, as a store checkout clerk or a jewelry salesperson does? Or sat all day at a computer, as a secretary or phone service center employee does? Many jobs will interfere with healing, and you have no way to know how your body will respond until you have experienced sufficient physical exposure to load-test the ligamentous scar tissue as you heal.
Plus, who will pay for your medical care incurred AFTER you settle? What if you were to settle now and nine months later when you are suffering at work and the pain starts to become too much, and you go to a doctor only to discover that you can expect a course of treatment that will cost a lot of money? After you settle your claim, all further treatment is YOUR responsibility. Except in specific, unusual situations, you cannot go back and re-open a settlement.
Here is page from my website that shows in detail why you should never make an early personal injury insurance claims settlement http://www.settlementcentral.com/page0211.htm
And, of course, once you settle, THAT IS IT: you will never see another dime in pain and suffering money. By the way, did you know that getting an early settlement is a favorite trick of the insurance adjusters? Please see my website wherein we show Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm
I know that you think this is going on too far with this one topic, Jennelle, but I HAVE TO TELL YOU that this is a REAL danger that I have seen many times. So just have patience a bit longer and commit yourself to read the following:
There may be a dull ache at night following a day at work or some physical activity or pain the next morning. DO NOT LET LITTLE PAINS GO UNATTENDED SINCE YOU DO NOT KNOW WHETHER THEY WILL CONTINUE OR GO AWAY. We all hope and believe that such little pains will disappear soon. But on the other hand, we have no way of knowing since this is the way serious fractures and soft tissue injuries can behave.
So, when this happens, even if a couple months or more post-treatment, do not hesitate to SEE A DOCTOR AND ATTRIBUTE THE PAIN TO THE ACCIDENT WITHOUT EQUIVOCATION. It is NEVER TOO LATE TO REPORT PERSONAL INJURIES FROM A FALL ACCIDENT http://www.settlementcentral.com/page0104.htm
"No medicine: no money"; medical costs increase worth of personal injury insurance claims http://www.settlementcentral.com/page0045.htm
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5. WITHOUT FAIL I want you to get checked out for mild brain injury
How hard did you hit your head? It sounds like a pretty hard whack. So, let’s first address that topic of the most significant potential injury, your traumatic brain injury. Research that term, and especially post concussive syndrome and you will see some of the symptoms of that condition. My bet is that you DO HAVE A MILD BRAIN INJURY. It is untreated for two reasons.
First off, you most likely denied any loss of consciousness, right? Second, if there is no loss of consciousness and no complaints of the symptoms of brain injury, most doctors who are called upon to treat injuries will not make referrals to have the patient tested for brain injury.
Let’s first examine what is a concussion and what is a loss of consciousness. You DID HAVE A CONCUSSION, that much is for sure, since you hit your head. So traumatic brain injury is in play in your claim since you suffered a brain concussion.
Post-concussion syndrome, also known as post concussive syndrome or PCS, is a set of symptoms that a person may experience for weeks, months, or even years after a concussion, a mild form of traumatic brain injury. As many as 50% of patients who have experienced concussion have PCS, and some sources say as many as 90% of patients experience post concussion symptoms. People who have had concussions may experience physical, mental, or emotional symptoms. Symptoms can appear immediately or weeks to months after the initial injury.
Physical symptoms can include:
• headache
• dizziness
• impaired balance
• nausea and/or vomiting
• fatigue or sleepiness
• inability to sleep
• decreased libido
• sensitivity to noise or light
• ringing in the ears
• double or blurred vision
• decreased sense of taste, smell, or hearing
Emotional symptoms may include:
• irritability
• anxiety
• restlessness
• depression
• lack of emotion
• emotional lability or mood swings
• lack of ability to tolerate stress or alcohol
• aggression
Cognitive or mental symptoms can include:
• amnesia or difficulty remembering things
• confusion or impaired cognition
• impaired judgment
• slowed cognitive processing
• difficulty with abstract thinking
• difficulty concentrating
• decrease in work performance
• decrease in social skills
LOSS OF CONSCIOUSNESS—not essential to diagnosis of post concussive syndrome, but sometimes the length of time unconscious will be used to judge the degree of the brain injury.
The patient is typically the primary source who is asked the most significant question: Did you lose consciousness as a result of your injury? Most of my clients who actually later recalled that they did not remember moments just after being struck in the head, AT FIRST DENIED ANY LOSS OF CONSCIOUSNESS TO THE POLICE AND TO THE EMERGENCY ROOM.
WHY? First, most people equate loss of consciousness with being unconscious for some time. But in fact, “loss of consciousness” means loss of conscious awareness. Hence, loss of consciousness can range from being briefly dazed to several days of coma. In fact, in order for a brain injury victim to answer such a question, they would have to undergo extensive examination recollecting past events. Any change in mental state can be significant in understanding a patient's condition and if loss of memory (amnesia) occurred immediately before or after the trauma.
When you struck your head probably there was a brief loss of consciousness. Even if you never before reported it, now is the time to correct your records with a letter to your doctor explaining that you DID have a brief loss of consciousness.
Here are some ideas of how to work that fact into your records. I would insist upon seeing a neuropsychologist for testing. Yes, this is a delay and an expense, but I am willing to bet that you had more of those symptoms above than your general practitioner doctor knows about.
Here are some ideas of how to correct your medical records in case you recall some loss of consciousness.
Loss of Consciousness http://www.settlementcentral.com/page0134.htm After Accident or Injury
How do you correct records with the medical providers and the insurance adjusters? http://www.settlementcentral.com/page7004.htm Letters to insurance claim adjuster. While this is designed for self help claims, your attorney could write the same letter, even at this late date. Better now than at trial.
This page talks about how to confirm conversations with the insurance adjuster
http://www.settlementcentral.com/page0460.htm with loss of consciousness notify the insurance adjuster as soon as you recall it. Naturally I do NOT want to second-guess your attorney, but I would bring up to her the fact that you now recall loss of consciousness and lobby for her to let you write to correct your records.
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#6. I wonder if you have headaches that are associated with your head trauma. TMJ—temporomandibular joint syndrome: possible source for headaches.
This is another term I want you to research, Jennelle. When an accident victim strikes her head, there is a good possibility that the disc in the condyle, or jaw joint disc, can be displaced. One of the consequences of jaw joint displacement is headaches. All too often in my practice, the doctors treated headaches as having originated from cervical problems, when in fact, they were due to a TMJ.
http://www.lectlaw.com/med/med04.htm
http://en.wikipedia.org/wiki/Temporomandibular_joint_disorder
http://www.tmjdoctorofmaryland.com/
There are two at-home ways to see if your jaw joint is moving. First, find the spot in front of the little lobes on the middle of your ears. These are called “tragus”: http://www.infovisual.info/03/048_en.html
Now, put your fingers just in front of the tragus and over the jaw joint and open and close your mouth. If the disc is far out of place, you will feel a click. Better is for someone to stand behind you as you are seated and perform the same test. That person can feel the click if your jaw joint disc is far out of place.
WHAT TO DO ABOUT REFERRALS: If you feel that you do have any of these symptoms and they are of some significance, I WOULD INSIST UPON TREATMENT for them ASAP. It is best to get your general practitioner to refer you, but you can self-refer if you have to. Your attorney can also be a source of information on good specialists. Here is what you would need: a neuropsychologist to test and to treat the mild brain injury. That is where the big mental help will come from, and of course that is where the BIG INSURANCE SETTLEMENT DOLLARS come from also.
As for the TMJ, a dentist who specializes in that field would be a lot better than an ordinary dentist. The TMJ specialist is adept at diagnosis and treatment, and of course, at making records that will help in making a good insurance settlement.
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#7. How to Make a Successful Insurance Injury Claim Settlement
OK, Jennelle—now it is to learn how to submit and settle your own personal injury insurance claims—DO IT YOURSELF SETTLEMENTS.
Here is a series of pages that you can review. Take what makes sense to you and don't worry about the rest. Just get a flavor of how the system works without spending a ton of time right now.
Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.htm
Medical Care Documentation-the Key to Successful Personal Injury Insurance Claim Settlements http://www.settlementcentral.com/page0217.htm
Keys to a MAXIMUM INSURANCE INJURY CLAIM SETTLEMENT http://www.settlementcentral.com/page0089.htm
Outline of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0190.htm
Detailed listing of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0207.htm
Overview Tort Law Personal Injury Legal Claims—boring and long, so just skip thru it http://www.settlementcentral.com/page3000.htm
By the way, did you know that getting an early settlement is a favorite trick of the insurance adjusters? Please see my website wherein we show Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm
Responding to Settlement Offer From Insurance Claims Adjuster http://www.settlementcentral.com/page0244.htm
Do It Yourself Advantages, or do these claims need an attorney? As for an ATTORNEY, this does not seem to be a case that involves any legal issues in dispute nor any large or complex damages. Why should you pay someone one-third to do what you can do yourself? Do-It-Yourself Personal Injury Claims; Eliminate Personal Injury Attorneys' Fees; Save Thousands of Dollars Settling Your Own Insurance Claim http://www.settlementcentral.com/page3011.htm
Without having to join my website, I have given a lot of free information on handling insurance claims without having to join as a member. Read the module at "5 Easy Steps to Do-it-Yourself Insurance Claim Settlement" http://www.settlementcentral.com/page0102.htm
This stuff is not rocket science, but it will take some effort on your part to read and cut and paste letter examples and to communicate. But hundreds of people are doing it each day, and they are getting good results.
What if you get only two-thirds the way to your settlement goal? Well, you can get as big a settlement as you can and then turn it over to an attorney and save a lot of fees. Thus, you could go it alone just to get an insurance settlement offer, and then take that insurance settlement offer to a personal injury attorney, thus exempting the amount of the offer from her fees. Do It Yourself Personal Injury Settlement Offer Reduces Personal Injury Attorney Fees http://www.settlementcentral.com/page0109.htm
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#8. FINAL TOPIC, Jennelle: Effective communication with insurance claims adjusters. Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm
Always communicate with the adjuster in writing, showing your own analysis of value. It is OK I guess to have one call or so, but no more. Always have your information and ammunition in writing to give to the adjuster.
Let him know that you are FIRM IN YOUR RESOLVE to get what you are demanding (NOT "asking", since that invites a counter-offer, but instead "demanding" as fair and reasonable compensation) by asking him what the options are to resolve the matter fairly should he not agree to a reasonable claim value. In other words, let him know that you will go through with a court filing if need be.
Remember these tips, do your homework, print out your evidence, show resolve to get your fair settlement, and you will DO JUST FINE.
I trust that my extra time here has produced some information that has been of value to you, and thus I would respectfully request that you take the time to locate the FEEDBACK FORM on this site and leave some feedback for me.
Best Wishes,
Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com
