QuestionQUESTION: I was involved in an accident on 3/28/2010. I was rear ended and this resulted in my van being totaled. My son and I were transported to the ER.
I have pre-existing condition, fusion in cervical and lumbar spine. I have 33K in medical bills. This accident has exacerbated my condition. I submitted paperwork to State Farm in Oct. 2011. I found out in Jan. 2012 the claims adjustor had been changed.He told me my file was a mess and it was going to take time to get it straightened out. I began discussions my claim. He kept telling me over and over I will get to your case this week I am just buried. This past week he made an offer for my son's medical bills. We accepted the offer and are awaiting the documents to sign release.
He then told me he had to submit my case to his supervisor to make an offer because he was not authorized in that amount. I am waiting for his supervisor to authorize an offer.
I know I am being mislead and I am in big trouble right now. Is there anything that I can do at this time? I have called numerous attorneys and no one will take our case. I am just hoping what everyone is telling me is not true!!!
I am hopeful you can provide advise as to what steps to take next.
Pam
ANSWER: I'm not convinced you are being mislead. The insurance industry is cyclical in that work volume changes throughout the year. It is entirely possible the adjuster is behind on his work. If the statute runs on 3/28/12 in your state, then you will need to either complete the settlement or file a lawsuit before that date.
The insurer is well aware of the date it runs. I would be shocked if a major insurer was trying to trick you into missing it. This just does not happen, at least not with reputable insurers. I'm confident you will get an offer in time to settle before the statute.
Not that does not mean you will agree on the offer. If you do not, you'll need to file a lawsuit. I don't understand why you can't find an attorney to take your case - there are plenty of personal injury lawyers out there. It does not take more than an hour or two to file a lawsuit. What is the problem?
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QUESTION: The problem seems to be my pre-existing condition. The adjustor told me that it is going to be the main problem with my claim. They would have to look into my past and all the treatment over the past few years.
I am not looking for a huge settlement. I want my bills paid with an amount for future treatment.
They offered half of what my bills are this afternoon. I have a ER bill of 8,500 therapy of 5,000, Radiology and radiologist bills of 2,000, pain management and treatment for 23 months, medications too. Why they are not paying my bills? I have had an increase of medications, I have to wait now to get another epidermal because my health insurance deductions are too high. My condition had worsened since this accident.
Everyone I have talked with said it is because of pre existing condition. One person was very honest and said there was not enough money in it for him. This is totally a soft tissue claim and because there is no big money in this then no one is interested.
I am not looking for some stupid amount of a settlement. I just want to be able to get the care I need.
I let my emotions get the best of me because I know the person who hit me and I didn't look to get a lawyer and I waited too long. I honestly didn't want to sue them. I like them too much to do it to them. They are a family who barely make ends meet and the husband lost his job and has not been able to get a job to replace his income.
Thank you for your response.
AnswerIt appears that the insurer believes the treatment you received was either excessive or that much of it was needed because of your prior condition and not because of this accident. If their belief is correct, then they would not owe what you are asking. They would only owe for treatment needed because of this accident and nothing else.
If you believe they are wrong, then your only option is to file a lawsuit.
I have to say that it would be very unusual for someone to need the type of care you are describing for soft tissue injuries. Most medical experts agree that soft tissue injuries resolve anywhere from 72 hours to 4 months, depending on severity. 23 months of care would likely be for something else.
It sounds like the lawyers you have spoken to do not believe your case is very strong. They may believe the insurer is likely to win in court. If you find an attorney to take your case, he/she will sue the other driver and State Farm will defend him. You could set the family's mind at ease by assuring them that you will not take any more than the maximum of their State Farm policy. This way they would not lose any money if you get a large verdict in a trial. Just be sure to discuss this with your lawyer.
