Questionthank you for the quick reply, I will rate the answer as high as possible.
The full settlement offer is for $2500, my medical bill total is $2924.94.
They believe soft tissue damage is minimal and would not require
excessive treatment. My CA insurance company that paid Medical pay
has not put a lean on the settlement. Do you repay medical pay? Thank
you again.
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The text above is a follow-up to ...
-----Question-----
I was hit from behind and suffered soft tissue damage in my neck and
back. The insurance company is offering $2500, I feel it should be a
little more. Any suggestions?
-----Answer-----
Hi Kelly,
Thank you for not asking me to value your claim, since there is
absolutely nothing here to fix valuation. What you did ask is what steps
you can take next in order to get the adjuster to increase your offer.
One would like to know whether or not the offer includes the medical
expenses to date. In other words, do you have $2,000 in medical
expenses and he is offering $500 in general damages (pain and
suffering)?
Or do you have $500 in medical expenses and he is offering $2,000 in
general damages?
Or do you have $3,000 in medical expenses and he is only offering
$2,500 TOTAL, including both special damages and general damages?
Knowing the answer to that question would have helped to figure out the
next best step.
Just for your information, be SURE to ask what his offer consists of.
What is he planning to do for payment of your medical expenses? Is he
planning to pay you the full $2,500 and at the same time to pay your
own insurer who paid your doctors to date? Or, as is often the case, is
he talking $2,500 total settlement and from that he will deduct $2,200
in medical bills, leaving $300 for you?
Usually the settlement amount will include all medical expenses,
although during negotiations the adjusters may only mention "new"
money inasmuch as the subrogation lien is paid directly to the claimant's
insurer that has paid the medical bills to date. So the first thing to do is
for you to find out what it is that he is offering.
At the same time, find out how your insurer that paid your doctors will
be reimbursed if your state gives it subrogation rights.
Next, get the total of the medical bills and compare that total to what
the adjuster has and provide him any missing billings.
Then you also have to make sure that he does have all of the medical
records that your doctors have maintained regarding your injury and
treatment.
A final thing on medical records is to review them and make sure that
what your doctor has written makes sense in terms of your condition,
your injuries, your condition, and your prognosis. If there is not a full
discussion of these topics, but only a bare minimal hen-scratched note
of treatment history, then you may wish to consider making a request
for a narrative letter.
The narrative report will help to "sell" your claim to the adjuster by
putting in plain English all of the facts and medical opinions needed to
support your claim. Expect to pay for that letter, but maybe you can talk
to the office manager at your doctor's office and try to get the price and
payment terms for the narrative letter a bit more to your liking.
Then, I would respond only in writing. That shows serious purpose, as
opposed to the minimal effort to just pick up the phone.
Effective communication with insurance claims adjusters. Establish Firm,
Professional, and Positive Relationships With the Insurance Injury Claims
Adjuster http://www.settlementcentral.com/page0059.htm
Always communicate with the adjuster in writing, showing your own
analysis of value. It is OK I guess to have one call or so, but no more.
Always have your information and ammunition in writing to give to the
adjuster.
Let him know that you are FIRM IN YOUR RESOLVE to get what you are
demanding (NOT "asking", since that invites a counter-offer, but instead
"demanding" as fair and reasonable compensation) by asking him what
the options are to resolve the matter fairly should he not agree to a
reasonable claim value. In other words, let him know that you will go
through with a court filing if need be.
Remember these tips, do your homework, print out your evidence, show
resolve to get your fair settlement, and you will DO JUST FINE.
I trust that my extra time here has produced some information that has
been of value to you, and thus I would respectfully request that you take
the time to locate the FEEDBACK FORM on this site and leave some
feedback for me.
Best Wishes,
Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com
AnswerHello again, Kelly,
I am going to put your new question in this answer so we do not have to scroll up to see what you asked. Here it is.
"thank you for the quick reply, I will rate the answer as high as possible. The full settlement offer is for $2500, my medical bill total is $2924.94. They believe soft tissue damage is minimal and would not require
excessive treatment. My CA insurance company that paid Medical pay has not put a lean on the settlement. Do you repay medical pay? Thank you again."
I will give you thee answers:
1) one that says they are WAAAAY to low in their assessment;
2) second that says if you do not have any medical lien this is within the ballpark;
3) third that suggests some ideas for increasing the offer.
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On this first topic, it is inane that your offer does not even come up to the amount of your medicals UNLESS there is some weakness about your case that you are not aware of.
California DOES ALLOW SUBROGATION, so I would be darn sure that your own insurer is not going to come in and try to snatch away part or all of your settlement.
We do not give valuation of claims for reasons too numerous to go into here. But if in fact you had no prior treatments ongoing of the same area that you are now treating for injury, and if your doctor bills were all reasonable and necessary, then their offer is WAAAAY far too low.
See below for ideas of how to fight it without starting a lawsuit.
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On this second topic, if in fact you can be absolutely assured that no one is going to swoop in and seize part of your award, then their offer, as distasteful as it is, will yield a net result the same as a "normal" subrogation case handled by an attorney and she achieved an award of $6,675. How is that?
Well, in a "normal" subrogation case, the medical lien would come off the top, so if you deduct $2,925 in medicals from a gross award of $6,675, and then you find that the net award would be $3,750.
The attorney's fee would be one-third of that, or $1,250, leaving you with a net award of $2,500. That would not be all that bad, given that you have done nothing at all to achieve it.
BUT this still could stand some improvement, so read on about some ideas.
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If you have the time and patience and perhaps a hundred bucks or so, then you can get your doctors to attack their assumption that the medical (chiropractic) treatments were not reasonable or necessary.
THAT is the standard that your doctor has to meet in order to get your treatments to be admitted into evidence at a trial, and THAT is the standard they are saying you failed to prove.
Thus, this is simply a matter of lack of proof on your part. Did you even write a demand letter, or did you just let the adjuster take control of the claim? I think that you need to exercise some power here and organize and present your claim in better fashion. It will take some effort on your part, unless you want to hire an attorney. Here are some pages to read for your homework! You can just pick and choose what makes sense to you and don’t worry about the rest.
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TAKE THE INITIATIVE in personal injury insurance claims—don't wait for the adjuster to suggest the first settlement figure—SEND IN YOUR DEMAND LETTER FIRST.
Unless you take the initiative in this claim, what you "can expect" is to become another success story for an adjuster who has run over uninformed claimants and denied them a fair settlement award.
You should be commended for having the initiative to seek out a website such as this and to ask for help, but the most important part of achieving a successful personal injury claim HAS TO START WITH YOU, NOT THE ADJUSTER. Do NOT let the adjuster set the parameters of the negotiation: get your demand letter out there RIGHT NOW. It is not all that hard or mysterious to put together an Effective Personal Injury Insurance Demand Letter http://www.settlementcentral.com/page0170.htm. It does not have to be "fancy" or complex; just hit the main points and get it out to the adjuster soon.
It is not too late for you to take the initiative, and I will explain how below. But just for a second, put yourself in the shoes of the adjuster and see what you have done by letting her have all the control of the claim. As an adjuster, she is trained by her company to reassure the injured party that she is acting in THEIR behalf, as opposed to the interests of her company—sort of like a car salesman who convinces a customer that he will fight for them versus the auto store manager. Sure.
But both of those are relationships are to the disadvantage of the consumer, aren't they? We would like to trust people who are in the position of the adjuster to act at least nominally in our behalf. But it is just as much as a mistake to take a passive role here as in buying a car: you have to get up and make something happen yourself.
If I were you, what I would do right now is to become as fully informed about the insurance injury claims process as I can, with the objective of seizing the initiative in prosecuting my claim, instead of taking a passive, reactive role. Can you see the difference in postures and how one works to your advantage and the other to your disadvantage?
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Learn how to submit and settle your own personal injury insurance claims—DO IT YOURSELF SETTLEMENTS. Here is a series of pages that you can review. Take what makes sense to you and don't worry about the rest. Just get a flavor of how the system works without spending a ton of time right now. DO NOT BECOME A MEMBER OF MY SITE IF YOU ARE JUST GOING TO MAKE SOME SMALL INCREASE IN YOUR CLAIM VALUE. YOU CAN DO THAT BY YOURSELF SIMPLY BY READING SOME OF THESE BUSINESS IDEAS.
Overview Tort Law Personal Injury Legal Claims http://www.settlementcentral.com/page3000.htm
Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.htm
Medical Care Documentation-the Key to Successful Personal Injury Insurance Claim Settlements http://www.settlementcentral.com/page0217.htm
Keys to a MAXIMUM INSURANCE INJURY CLAIM SETTLEMENT http://www.settlementcentral.com/page0089.htm
Outline of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0190.htm
Detailed listing of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0207.htm
By the way, did you know that getting an early settlement is a favorite trick of the insurance adjusters? Please see my website wherein we show Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm
Responding to Settlement Offer From Insurance Claims Adjuster http://www.settlementcentral.com/page0244.htm
Do It Yourself Advantages, or do these claims need an attorney? As for an ATTORNEY, this does not seem to be a case that involves any legal issues in dispute nor any large or complex damages. Why should you pay someone one-third to do what you can do yourself? Do-It-Yourself Personal Injury Claims; Eliminate Personal Injury Attorneys' Fees; Save Thousands of Dollars Settling Your Own Insurance Claim http://www.settlementcentral.com/page3011.htm
Without having to join my website, I have given a lot of free information on handling insurance claims without having to join as a member. Read the module at "5 Easy Steps to Do-it-Yourself Insurance Claim Settlement" http://www.settlementcentral.com/page0102.htm
This stuff is not rocket science, but it will take some effort on your part to read and cut and paste letter examples and to communicate. But hundreds of people are doing it each day, and they are getting good results.
What if you get only two-thirds the way to your settlement goal? Well, you can get as big a settlement as you can and then turn it over to an attorney and save a lot of fees. Thus, you could go it alone just to get an insurance settlement offer, and then take that insurance settlement offer to a personal injury attorney, thus exempting the amount of the offer from her fees. Do It Yourself Personal Injury Settlement Offer Reduces Personal Injury Attorney Fees http://www.settlementcentral.com/page0109.htm
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New topic: CONSIDER USING A DOCTOR'S NARRATIVE REPORT to assist in settling the insurance claims.
Have you seen any of the doctors' records that went to the insurance adjuster? If not, it is easy enough to get a copy so you can make sure that everything of importance you discussed is included therein IN READABLE FASHION.
Cryptic notes may be medically significant, but why make the insurance adjuster struggle to figure out the significance of the injuries? A narrative report or letter spells things out so the adjuster can see, read, and understand the doctor's diagnosis and prognosis and her record of the problems and pain and suffering you have endured.
Plus, narrative letters can tie together the trauma and its after-effects in a way that is authoritative.
We recommend that claimants almost always include some type of typewritten medical information to accompany to computer coded medical records and/or handwritten records. That is the first clue as to when to use the narrative report: if you are asking the adjuster to evaluate your claim on the basis of handwritten records and/or computer coded records that indicate diagnosis and treatment codes, then you need to supplement the record with a narrative report.
We have a lot of free legal tips on insurance claims settlements using doctor narrative reports http://www.settlementcentral.com/page8003.htm. You can get information there as to how to ask for a narrative letter and what it might cost. Talk to the doctor's office manager about it.
I would put the burden on the doctor by pointing out that her treatment costs were disallowed, and thus could she please write a brief letter to explain how the treatments and their costs were reasonable and necessary as a result of the trauma you suffered in the accident.
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That is about it, Kelley. Send a response letter telling the adjuster that while you appreciate her offer, it is insufficient in that it does not take into consideration all of the pain and suffering you have endured. Then you can get in your comments to support your claim and follow it up with a letter from your doctor.
DO NOT PROMISE HER THAT YOU ARE GETTING A LETTER FROM YOUR DOCTOR BECAUSE IT MIGHT NOT TURN OUT TO BE REAL FAVORABLE FOR YOU and since you have alerted her, she will be looking for it.
Better to work with your doctor quietly on the side. TELL HIM THAT HIS TREATMENTS WERE CONSIDERED TO BE DISQUALIFIED FOR THE CLAIM. Let your doctor feel the need to correct this himself since his records were not well enough put together. His treatments were not deemed to be reasonable or necessary.
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Here are some pages we made up just for chiropractors. Do a deep search thru these pages inasmuch as there are some letter formats that I will let you use at the end of each of the three topics we present on these pages. Go ahead and give this link to your doctor as well if you think it would help him.
http://www.settlementcentral.com/page0070.htm
Thanks for your kind proposed feedback forum remarks,
Best Wishes,
Dr. Settlement, J.D. (Juris Doctor)
Http://www.SettlementCentral.Com
