Insurance Settlement Help

[nocluesue7717]

What is the name of your state?Calif.
My 16 year old was a passenger in a car that was involved in an auto accident almost a year ago. The driver of the car he was in was not at fault. The driver of the other car was. The at fault driver's insurance is accepting responsibility and now wants to settle our bodily injury claim. The medical bills for my child came to a total of $1055.00. My private insurance was billed and they ended up paying a total of $590.07. I paid a total of $85.01 out of my pocket. The remaining $379.92 was written off because the doctors and hospital were contracting with my private health insurance company plan. First Question: Shouldn't the at fault auto insurance pay the total $1055.00 so I can then pay back my private insurance company? I don't feel my health insurance should be responsible for these charges. They are only offering to pay us the $590.07 + $ 85.01 or $675.08. This is confusing to me. Second Question: My son has a facial scar as a direct result to this accident. It is small in size, located on his upper eye lid. The insurance is offering $2000.00 for "General Damages". Is this a fair amount? I don't want to make money off of this accident. We're lucky we have our son alive after this head on collision but I would like to make sure that this amount seems fair and resonable. He will have this scar for the rest of his life. Any advice or input from those who have had experience with this issues will be greatly appreciated. Thank you, nocluesue7717.

 

[moburkes]

According to you the bills total:
$590.07 paid by private insurance.
$85.01 paid by nocluesue7717.
======
$675.08 the total paid out by all parties.

$379.92 was a negotiated discount. Your health insurance company actually "saved" this amount by having a negotiated rate with the hospital. No one paid this. No one is eligible for "reimbursment" for a payment that was not made. Who will you turn the $ over to? No one, right? Sometimes the insurance company will pay the health insurance company directly, so there would be no need for them to give to you then have you maybe or maybe not turn over to the health insurance company. This really shouldn't be confusing. Let's say that they did give you the whole amount. You will have received $379.92 "extra", plus, you may not turn over to the health insurance what you agreed is rightfully theirs. You will "profit" from the claim.

What should you accept for the small scar? I have no idea. Hope that I've answered your first question.

 

[seniorjudge]

According to you the bills total:
$590.07 paid by private insurance.
$85.01 paid by nocluesue7717.
======
$675.08 the total paid out by all parties.

$379.92 was a negotiated discount. Your health insurance company actually "saved" this amount by having a negotiated rate with the hospital. No one paid this. No one is eligible for "reimbursment" for a payment that was not made. Who will you turn the $ over to? No one, right? Sometimes the insurance company will pay the health insurance company directly, so there would be no need for them to give to you then have you maybe or maybe not turn over to the health insurance company. This really shouldn't be confusing. Let's say that they did give you the whole amount. You will have received $379.92 "extra", plus, you may not turn over to the health insurance what you agreed is rightfully theirs. You will "profit" from the claim.

What should you accept for the small scar? I have no idea. Hope that I've answered your first question.

Good one....

 

[moburkes]

Senior, I can't tell if you're being sarcastic or agreeing....

 

[seniorjudge]

Senior, I can't tell if you're being sarcastic or agreeing....

I was complimenting you. Good explanation.