QuestionHello,
Recently my Wife was in a No-Fault auto accident here in Salem Oregon. Some background on the actual accident is as fallows. She was driving east on a 4 lane roadway in the outside lane. The speed limit was 45, of which she was traveling lawfully. While traveling a Chevrolet Silverado HD(huge truck) was traveling in the opposite direction (west) when he made the decision to do an illegal U-turn. As he made the U-turn he said he knew that he would not make it so he "gunned," it. While making the U-turn he crossed into my wifes path, at which point he hit the guard rail and my wife hit him. My wife said she had no way of stopping before he was in front of her.
As for the damage to the car, we were given 1100$. Now the damage was minor but the accident was enough to break her seat and ruin the entire left fender. The Driver at fault, admitted to being at fault and his insurance has placed it 100% on him.
Since the accident my Wife ended up going to the hospital where she was prescribed pain medication and muscle relaxers. She was told to take some time of work, and then to see a doctor before her return to work. She went to see the doctor today and he stated that it could take 1 week to 2 months to heal, and if she went to work it could take twice that or more as she is a CNA and she depends on her back to be healthy to adequately do her job. She was also told that she needed to attend Physical Therapy for 2 weeks (4-6 appointments) and see him again when finished.
This accident has also caused our family some problems. My Wife has also not been able to care for my 4 yr old son adequately as he is 50 pounds, and she is limited to lifting 35 lbs. Another that issue is that we recently had started trying to have another baby and this is going to halt that. She has had allot of pain, a lack of sleep, and is very uneasy due to sitting around the home.
My question is how do I go about calculating a demand? I want to be fair as possible and that is why I am on here. I want to settle quick but I am not sure how. Our insurance is covering the Health insurance (only to be reimbursed) so do I calculate that into the equation? She has missed work so that needs to be included. I know this could be a fight as the adjuster came to my home and tried to throw a low ball 500$, which was before the doctors appointment.
If you could help I would greatly appreciate it.
Thank You,
Chris Valentine
AnswerHi Chris,
I'm sorry to learn of the injuries to your wife and do wish her a full recovery.
First of all, you must understand that I am a retired insurance broker, not an Attorney. My statements can not be construed as free legal advice, only opinions and observations that I have gained from 44 years in the insurance industry.
The true value of your wife's claim is based on many factors. The total of all her 'specials' which are a total of all her medical bills including prescriptions and physical therapy, the cost of each trip for treatment or to pick up a prescription @ $0.46 per mile, the total of her documented wage losses and the severity of her injuries.
Will she be able to recover 100% or will there be lasting injuries that will entail future treatment or a change in lifestyle.
Oregon has a two year statue of limitations in which this claim must be settled or hire an attorney to file suit to extend the time limit, or forever lose any right of collecting.
If your wife makes a 100% recovery, this can be settled without need of an attorney. If she will suffer future problems or a change in lifestyle or career, you need to at least schedule a consultation with an attorney to review your options.
Although insurance companies DO NOT have any kind of formula used to settle claims, as you said, you do need to use some kind of an equation to determine a demand in cases where your wife will be making a full recovery and you desire to settle without an attorney.
I have had many clients tell me that the following equation worked for them.
Once you have totaled all your wife's 'specials', make a demand for 3.2 times that amount.
The insurance company will then usually make a low counter-offer of about 2 times the specials. Clients tell me that they are able to negotiate with the insurance company and receive a settlement of between 2.5-2.75 times their 'specials' for pain and suffering. This is the total amount received and they have to pay back their health insurance company out of that amount or the health insurance has already filed a lien against the claim and will be paid by the insurance from the settlement amount and the balance forwarded to you.
I hope that my opinions and observations have been of help to you.
Please feel free to write me again if you feel that I can be of more assistance. Please check any future correspondence as PRIVATE.
Your feedback by rating my answer will be appreciated.
Sincerely,
Bennie
San Francisco Bay Area
