QuestionQUESTION: Have seen your previous posts indicating the average offer for the pain and suffering is about 2.5 to 2.75 times of the economic loss (medical bills and wage loss), but I recently saw some people reported the offer is about 1.5 times of the medical bills. What is the least offer for the pain and suffering you have ever seen if the injuries are in the soft tissue? Or, what does the insurance offer for the pain and suffering at least, 0, 0.5, 1, 1.5 times of the economic loss or what else? Thank you for your answer.
ANSWER: Hi Again Lou,
All experts at this site are volunteers. We attempt to use our knowledge and experience to help you and others with questions.
There is no kind of financial remuneration, all we ask is that you
follow the rules that you agreed to when you ask the question.....
which is to provide a fair rating for our answer.
On 3-8 and 3-9, I answered three questions for you regarding your accident and injuries, yet you have not had the courtesy to take 1 minute of your time to rate those answers.
When you are able to find 1 minute to rate my past answers, I will find 15 minutes to answer your question.
Sincerely,
Bennie
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QUESTION: Your previous answers have been rated after your request was received. Thank you again for your time.
ANSWER: Hi Lou,
In my posts, you will note that I always suggest that the injured party not use a Chiropractor for treatment because the insurance industry (auto, health and Medi-Care) is extremely anti-chiropractic.
Insurance company offers when Chiropractic treatment is involved is usually at least 50% less than when injuries are treated by a Medical Doctor and prescribed Physical Therapy.
I will break my answer into two parts. The worst (lowest) offer that I have seen is a person with soft tissue injuries that treated with a Chiropractor and incurred medical bills of $2,200. Her initial offer from the at fault insurance company was $1,800. This was the first offer made....she was able to negotiate with the insurance and eventually got a settlement of $2,400.
The worst settlement I have ever seen is from a gentleman who wrote after the case was settled because he was unhappy with the settlement.
His injury was all 'soft tissue' and he had retained an attorney. The attorney advised him to treat with a specific Chiropractor.
This man did not have Medical Payment coverage on his auto policy and had to process his bills through his health insurance which had a clause stating that if he recovered money from a 3rd party, he had to reimburse the health insurance company (almost 50% of the health insurance policies and all Medi-Care policies contain this clause).
His Chiropractor bills exceeded $12,500. The attorney settled the case for $15,000 and kept $5,000 as his fee (1/3) and the injured party got a check for $10,000. He owed the health insurance over $12,500. He was able to negotiate with them and settle for $10,000, leaving him exactly ZERO for his pain and suffering. Since the settlement by the attorney closed the case forever, he was unable to reopen it for any additional settlement.
Insurance companies DO NOT have any kind of FORMULA for settling an injury claim. Each one is judged on it's own merits based on the type and severity of the injury, whether there will be a long term disability or necessary change in lifestyle and other economic losses such as lost wages and the cost of travel to receive treatment.
The percentage figures that I allude to in my posts are based on actual settlements received by my clients since 1964 and the cases that I have dealt with on this insurance Q & A board.
I have spent 50 minutes preparing and writing this answer. I hope that you find the information to be of help.
Your feedback by rating my answer will be appreciated.
Sincerely,
Bennie
San Francisco Bay Area
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QUESTION: Thank you for your answer. From your answer, the lower offer for pain and suffering is mainly because of the chiropractic treatment. How about the physical therapy? What is the least offer for the pain and suffering that the insurance will likely consider, at least two times of the economic loss or less than that assuming no chiropractic treatment but physical therapy only, for example, medical bills $3000? In addition, if an attorney handles the personal injuries claim such as medical bills $3000, how much will the offer be likely increased, 3, 4, 5 times of the economic loss or more? I am talking about the soft tissue injuries only.
AnswerHi Lou,
You keep placing the emphasis of your question on first "offer". It's the desire of the insurance company and part of the job of the claims adjuster to settle the claim for the least possible amount which means that their first 'offer' is going to be so low as to sometimes be laughable.
Assuming that your injuries were 'soft tissue' only, you have fully recovered with no kind of permanent disability and the injuries will not cause a long term change in your life style, your treatment was by a licensed Medical Doctor and prescribed Physical Therapy, you suffered no wage loss and your total economic loss (medical bills) is $3,000, you can expect your first offer to be between $5,000 and $6,000 or less.
Before any offer is made, you should have first made a written demand, along with copies of all your medical bills. Most people would make the demand in the amount of $9,600.
Once you have made your demand and the insurance company makes it's first offer, a negotiation process begins between you and the claims adjuster which will last a period of many weeks to several months.
During this time, the adjuster will increase his offer while you slowly decrease your demand. In my opinion, a case such as this should eventually be settled for between $7,500 - $8,250.
An insurance company judges each case on it's own merit and the fact that an attorney is involved will not cause them to increase their initial offer nor their final settlement.
The latest statistics that I have read indicate that only 15% of the attorneys practicing personal injury law have ever actually taken a case to trial.
This means that the other 85% are sending 'boilerplate' demand letters to the insurance company which may look impressive to you, but are a joke to the insurance company because they see hundreds per day. Even an attorney with trial experience would not take a $3,000 'soft tissue' injury to trial. When the insurance company says "this is our final offer", the attorney settles and takes his 1/3 fee.
In most cases, that "final offer" is the same amount that you could have gotten by handling the case yourself.
Keep in mind that I am not an attorney and I am not giving you any legal advice, just my opinions and observations from 44 years in the Property and Casualty Insurance business.
Sincerely,
Bennie
San Francisco Bay Area
