QuestionQUESTION: Say a person is involved in a auto accident. Calling this person bob. The other person is at fault and admitted it on a police report. Call this person Gene. There insurance carrier is agreeing to pay ALL medical bills and time off work and has already paid off bob's car loan. But now there not willing to make a pain and suffering offer until Bob's doctor is willing to release him.
the settlement to pay off his car loan was 11,500.00
So far his medical bills are
11,800.00 for er visit that lasted 6 hours on a BACKBOARD
500.00 ambulance ride
Unknown $ of doctor bills
Unknown $ of tests
tests performed were, x-rays, drug test, ct scan, and all other tests you'd expect from a car accident. Bob refused no medical treatments or tests. let them do whatever they felt needed to be done.
Bob has extreme bruising to chest and arm. Has been to his regular doctor after being sent home from hospital. And was prescribed pain medicine and told to come back in a week if headaches and chest pain doestn't subside.
Details of crash were: Bob was traveling at 30mph and was t-boned after the other person ran a stop sign. Bobs airbag deployed and took the skin off of forearm which hurts like heck, but bob lost steering and brakes and as a result ran into a tree. When he struck the tree the airbag had already deflated so bob took a steering wheel to the chest at about 25 mph. No surgery was required and x-rays and other tests found no internal injuries in a ct scan. Only a basic ct scan was able to be performed due to bob being allergic to the dye that they inject to see xtreme detail like organs and etc. All scan was able to see was bone. But after a week bob is suffering from constant headaches. Some times random but loud noises and everyday problems bring them on. Also bob gets tongue tied and forgets what he was saying. Seems to forget things but come back to him a few minutes after putting some real thought into the memory. Also bob doesn't seem as quick witted. Seems thought is a lil slower, notiably so but not extreme. Also suffering from chest pain that is so bad it brings him to the brink of tears.
Bob doesn't want to go through the whole lawyer thing since they are willing to pay ALL medical bills to the point of doctor release. Bob is just wanting to know what a fair and expecting pain and suffering offer he should accept.
Thanks, "bobs daughter"
ANSWER: Ok, you guys need to slow down a little bit. Don't be in such a rush to settle this claim.
The insurance adjuster is trying to do you a favor by telling you to wait. The insurance company could settle your claim today for your current medical bills but this would be unfair to you.
You have described some pretty serious injuries and ongoing symptoms. You definitely should not settle the injury claim until you know how serious this is. A rule of thumb is you should always wait until either the doctor has released the patient from care or at minimum given a clear opinion on what to expect in the future.
This may turn out to be soft tissue only and he may be fine in a couple weeks. But what if there is some serious problem that requires thousands of dollars of future care? What if he has trouble at work because of the mental issues you described, and can't keep his job? I don't want to scare you, but you need to be sure before you settle the claim.
The insurance company will ask you to sign a full and final release when you settle. Once this is signed, you cannot go back to them for more money. They do this to protect their insured from being sued by you in the future. Protecting their insured is and should be their main goal.
If you need help paying the bills now, they might agree to pay some medical bills in advance and deduct them from any future settlement. Most carriers will agree to this out of good will. Also, depending on the state you live in, your auto insurance company may pay some or all of the medical bills and lost wages. Or your health insurance company can cover medical bills. Another issue you need to consider is whether or not your auto insurance company or health insurance company will seek reimbursement for anything they pay out on medical bills from the settlement you get from Gene's company. This will depend on your state laws and is called a lien. You can call them and they should be able to explain this to you.
I understand and admire that your father does not want to involve lawyers, because they can make things worse on simple minor claims. But this is a pretty large claim and things can get very confusing, so you may want to consider hiring an attorney. Most will charge a contingency fee that is taken out of the settlement, so it costs you nothing up front.
In the meantime, if he has not done so yet, your dad needs to call his doctor to describe the current symptoms and find out what is going on. The mental issues you described concern me.
---------- FOLLOW-UP ----------
QUESTION: Thank you so much and after talking to him and showing him your message he is agreeing to wait atleast 6 months incase of future injuries. He went to the doctor the other day and his doctor doesn't recomment him being released. I called my dads insurance company (auto) and there going to pay 5,000 of his medical bills and his health insurance from work (blue cross and blue shield) are going to pay the rest and future medical bills. Both insurance companies are going to pay them as long as he pays the deductibles which are like 20 and 50 dollars. And they said they'd go after the other drivers insurance company to get reimbursement. My dads doctor at this point doesn't think there are any major medical problems. (at this point) He says it's a probable that he's just suffering from trauma and shock from the accident. like shell shock that soldiers have after coming home from the war. But he also adds that as time goes by new problems may show up. Now I did talk to gene's insurance company's adjuster/investigator. On the phone they admitted 100% fault. They have already agreed to pay off his car and are providing a rental. They have already sent us a release form saying they agree to pay 11k for his car. And on the phone they said after being released from his doctor to send all medical bills and they will pay them and then determine a pain and suffering ampt. Oh and you inquired to the state we live in. We live in Indiana. My dad is going to wait awhile before settling because he is having a bit of back pain. The headaches are still here as well as forgetting things. like conversations he had the day before. His long term memory is great but occasionaly he forgets conversations he had hours before and even a few times minutes before. My dad was just wondering as well as me that when he is released from the doctor what kind of a settlement offer would be acceptable. Assuming his pains go away and his mind is sharp as it was b4 the accident. My dad and me both aren't looking to be sue happy or money hungry. He as well as me dispise of ppl like that. We just want to get what's fair and common.
I very much appreciate you helping us!!!
P.S. he will consider a attorney if things get complicated or the insurance company starts getting nasty or if the settlement offer of pain and suffering isn't in the range of what u suggest is fair.
THX again!!!
AnswerI'm glad to hear that things are working out well and the doctor does not expect anything serious.
It is too early to give a range for pain and suffering. Why don't you send me another message when he is released from care and we know how much the bills are.
Their offer will be based on 2 kinds of damages:
special damages - things like medical bills, lost wages, etc - things that can be documented.
general damages - subjective items like pain and suffering, mental anguish, shell shock, etc. This part is very subjective and difficult to determine. The adjuster will basically try to decide what a judge or jury would likely award if the case went to court. But 3 people will probably come up with three different values. For this reason, it is best to work in ranges, like $1500-$2000 or $20,000-$30,000.
Their first offer will likely be in the low range and you typically will try to negotiate something higher.
An old school rule of thumb is general damages might be two times special damages. You add the special damages to the general damages for the entire settlement. But this is not always an accurate way of doing things because it really depends on the type of injury and treatment. Once he is released, I'll be able to help more.
One last thing - make sure the release for the car specifically says it is ONLY for the car and/or property damage, and that it does NOT cover injuries. You want to make sure you don't release all claims when you sign this.
