QuestionHi--first let me apologize for the length of the question. I'll try to be brief, but it is involved.
On an early West Virginia evening in Sept. 2005, I was t-boned by a 20-year-old (very) drunk & speeding driver who ran a light as she chatted on her phone and smoked pot (yes, seriously). She was taken from the scene in handcuffs. I was utterly dazed and confused at the scene, and refused treatment because I had to arrange for child-care pickupand didn't realized my injuries required attention.
An hour or so later, I went to the ER with shortness of breath and neck pain, and was immediately transferred by ambulance to a trauma center in another local ER. I had CT scans and I think x-rays at both hospitals, was admitted overnight, and was discharged the next day with a neckbrace, a possible hairline rib fracture, a mild concussion, and lots of bruises. That first week, I returned to the ER twice: once for an unrelenting headache and the second time for kidney-type pain (each involved another CT scan and ended with a prescription for painkillers). The initial hospital bills total about $10,000
Her insurance company accepted 100% liability and they paid for a rental car for THREE days after I was released from the hospital. They offered $4800 for my VERY low mileage 1997 Ford Malibu. However, although they took possession of my car, payment was delayed until mid-December due to difficulty obtaining a copy of my clear title from the state in which I bought the car new. During this time, I ran up over 200 in cell phone bills related to the accident, had to take the bus to and from work (I was in my 4th year as a PhD grad student and was paid a stipend). I have five kids and that was our only transportation, so it inconvienence them as well. Transportation issues, in addition to the time required on the phone, led to spotty attendance in the lab (ie: work) and a formal note from my department telling me my tardies and early departures (to get kids from day care via bus) were unacceptable. The insurance company provided me with a rental car again for 3 days in late November to take care of the title issues. The vehicle loss claim is now paid and I have a used car.
Two laptop computers were damaged as well--one significantly and the other slightly.It looks like they're going to take care of them--although I've already replaced the one that had my dissertation on it. This property claim is being handled seperately from the personal injury.
My shoulder (and to a lesser degree, my neck and upper back) still hurts, significantly. I have a first visit with an Orthoped. Dr soon, although it was delayed because I didn't have PID through my own policy and the other insurance won't pay the bills until we've settled. My health insurance is primary, although the orthopedic Dr. wanted a cash deposit from me. Significantly: In December I was asked to and did withdrawal from Graduate school due to my attendance. I haven't told the insurance adjuster this peice of information. Also, although my husband and I had separated in August, we were working on reconciliation. The stress of this accident has been very real, and has added more stress to our relationship.
The insurance company has offered $3000 for pain and suffering, with an agreement that they'll pay for up to $7,000 in medical treatment for the next six months. It seems unreasonable to me despite that my injuries (thankfully) aren't terrible--no permanent disability resulted...yet the $3000 offer is almost a laughable joke considering the very real pain and suffering, physically, emotionally and mentally.
Given all of that, I find the adjustor to be friendly and seemingly above-board. He's not offering lost wages because I was paid a stipend and no wages were lost, but should I mention that I dropped out of my PhD program? Long ago, he agreed to reimburse me for the cell phone bills-do you think he really is including this in his $3000 offer? Please tell me he EXPECTS me to respond by saying that's too low.
My biggest question is the hardest to answer: what would a reasonable offer would be?
Thank you,
K. Nichols
Answer
Dear K. Nichols,
I am sorry to hear of all your injuries, and also the way the accident impacted your life.
NO "INCONVENIENCE" MONEY: Since our statehouses are usually more friendly to insurance companies than to trial attorneys, you will find that most all of your inconviences suffered are not compensable. They COULD be considered, but statutes would have to be ammended, and there is not incentive in this country now to pay injured people more money.
Now, off the soap box and on to other aspects of your claim.
BRAIN INJURY: First, what about your concussion? Did you strike your head on the side window? How hard did you strike your head? What medical treatment have you had for it? Have you had a psychological assessment done?
I wanted to hit that first because concussions are nothing to be dismissed just becasue you feel better and appear to be functioning better. Brain injury is serious business that one would like to attend to as soon as possible. But in this case, better late than never.
If you have any history of follow-up on your head injury, try to get the doctor to discuss a psych evaluation for you. He or she may or may not agree, but at least it is worth covering that base NOW, before you settle this claim.
LOSS OF RELATIONSHIP: This CAN be a factor. It is called loss of relationship or loss of consortium, and it is sometimes alleged by the spouse who lost the companionship (read bedtime benefits) of the injured person.
But to the extent you can prove that this accident had a harmful impact on your relationship, you COULD claim it, BUT I WOULD BE CAREFUL. This can open up a lot of problem areas for you and in this instance -- just from the little you presented -- it sounds like there were other factors involved. Thus, think about your proof before making a claim on this issue.
PhD PROGRAM TERMINATION: This IS A COMPENSABLE item to the extent you can prove the accident WAS THE PRIMARY cause of your poor attendance and performance. Thus, you would want to be able to show good attendance and good solid performance in the program prior to the accident, and a significant deterioration of same afterward. This could also be combined as an element of the brain damage.
In truth, if the connection--the nexus, if you will--between the trauma and your being booted out of the program is strong, then this could be A BIG ITEM OF DAMAGES.
An attorney would be required for pursuing either or both the brain injury and the loss of your PhD program status.
ORTHOPEDIC DOCTOR CONSULT: Be sure to give an accurate history, including any prior traumas to the injured area, BUT ALSO STRESSING your very active lifestyle and the fact you had no pre-existing pain whatsoever.
IF A SURGERY IS RECOMMENDED, BE INTERESTED. That does NOT mean you have to go through with it. But orthopods typically don't go out of their way to support claimants who are not going to go under their knife. Thus, if you reject surgery out of hand, your office notes will be less favorable to your claim than if you are going to have a surgery. They will deny this, of course, but Dr. Settlement has seen it happen too many times in over a quarter of a century at this game!
Bottom line on this guy: take the surgery if it is recommended since this is the best time to have it, it is the best opportunity to get it paid for, and it will add a lot of value to your claim. You will get money if he recommmends surgery and you do not have it, but you will get a lot more if you go through with it.
VALUATION OF CLAIM: The offer is grossly unreasonable. REJECT IT IMMEDIATELY, in writing, even if you do not yet know the value of the claim. WRITING ONLY: http://www.settlementcentral.com/page0244.htm
What do you care whether or not the adjuster is friendly to you? Of course he is going to do that, since he uses that to pick people's pockets.
Your claim cannot be evaluated at this stage because we do not know the answers to the questions above. Moreover, valuation is an art, not a science, and ten adjsuters and ten attorneys would have twenty-two different values, with a wide range. But from what you have told me, this is $3,000 IS WAY OUT OF THE QUESTION.
GET AN ATTORNEY OR GO IT ALONE? You could see if your state bar association has a lawyer referral service that will afford you one hour of an attorney's time for a low fee of $50 to $75. But, again, that attorney may or may not know much about personal injury law.
Here is a link to state bar associations:
http://www.settlementcentral.com/links.php
You could go it alone just to get an offer and then take it to an attorney, thus exempting the amount of the offer from her fees.
http://www.settlementcentral.com/page0109.htm
Or, what if a young doper has just mimimal limits?? Your limits in West Virginia are only $20,000. It is likely that a doper is not going to insure for a lot. Thus, why hire an attorney at all? Learn how to handle policy limits claims so you can collect from both the tortfeasor and from your own UIM without your own insurance company penalizing you for failure to give them adequate notice of the policy limits settlement.
Dr. Settlement has a free tutorial on that here:
http://www.settlementcentral.com/page0451.htm
We teach our members at SCC to demand those policy limits, so it makes no difference what the value of the claim is, so long as it is well above the limits. From what you have told me, and especially if you are recommended for surgery, your claim should have a value well in excess of your state's minimum limits.
I trust that this answer has been of value to you, and I respectfully request that you find out how to leave feedback on this site and do so for me so we can see how we are helping people.
Best Wishes,
Dr. Settlement, J.D.
www.SettlementCentral.Com
