Auto Insurance Claims: Future Medical, future medical costs


Question
Hi,

I am in a situation following a car accident where the other driver was at fault.  The insurance company is Allstate and they have accepted liability for the accident (their driver pulled out in front of me and I t-boned them), so no issues there.  I have incurred about $14K in medical expenses due to injuries to my knee and neck so far (ER visit, MRI of knee, PT for neck, etc).  Here is the issue - the doctor wants to do an arthroscopic surgery on my knee, but I need to wait 2-3 months to have this done (long story, but can't change this). I am also in a situation where I need to settle before the surgery due to my current financial situation.  

Here is my question (finally) - the Allstate adjuster is stating that future medical will not be considered since a claim can stay open for 3 years.  Essentially, she is saying they wont take the future knee surgery into account when settling.  Does this sound right?  How do I counter this argument?  

Thanks in advance for your help!

Answer
Good question.

It is true that there is nothing I am aware of which would bar the insurance company from maintaining their position on waiting for the surgery to happen or a lawsuit to be filed.  The reason for the delay of the surgery and the duress you're under for getting a quick settlement are really very important things for me to know if I am to give you good insight, but anyway, just be advised that if you're not finished with your main treatment, then waiting on projected medical bills to happen is a common thing, and without really getting into the details of the exact rules and venue where this could be potentially litigated, I can't really get much more specific.

Basically, my answer is that there is not much of a counter argument to your situation as it stands.  The only thing I can think of is to make a creative settlement offer that indicates you would return any unused future medical cost if the surgery for some unforeseen reason never happens, but that's a stretch.  When I wss adjusting I never settled until I had a notice that medical treatment was complete, barring future medical followups needed at pre-scheduled increments in the future.

I hope this helps.