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  1. #1
    Hit From Behind is offline Junior Member
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    Rear-Ended 3/08, Nearing Settlement

    What is the name of your state (only U.S. law)? WI

    I had posted about my accident when it first happened, as I had some questions. The other driver rear-ended me (I was stopped at a red light) during a snow storm in late March of this year. No police at the scene (it was on the freeway, and he WAS an off-duty PO). I filed a self-report with the State afterwards (as it was too late to file a police report). I had almost immediate neck and upper back pain and went to the ER later that morning (did not continue to work that day). He and his insurance co. admitted his 100% liability, and insurance has been following up with me pretty much monthly to "see how I'm doing." I've been treating with my chiropracter, and finished about 6 weeks ago. Other insurance is aware that I had a prior accident in 10/06 (also rear-ended at that time by a drunk driver--same type injury, soft tissue/whiplash). But I was DONE treating about a year before my most recent accident.

    I have about $4000 in med bills (including ER, ER dr. and chiro treatments). Other's insurance is still gathering med bills, but we're nearing them offering me a settlement (per them--I'm patiently waiting). My question is this (because last time I had a lawyer, and this time, so far, I do not): Other insurance DOES need to pay all of my med bills at the very least, correct? My husband's health insurance covered all the chiro bills, and our auto insurance covered the ER and ER dr. Both are subrogated (meaning I need to pay them back). I want to be sure that they don't try to offer less than full med bills ($4000) because the health insurance (obviously) paid less because alot of the chiro bills were "provider discounts/written off." The ER and ER dr. were paid at 100% (by our auto insurance med pay), so that's not up for debate ... the other insurance will have to pay them back (or I will from the settlement).

    Don't know about the P&S amount here ... I can deal with that on my own ... just wanting to ask about what the other insured's liability is on paying back ALL of the medical bills (meaning $4000, not a lesser amount based on health insurance provider discounts).

    By the way, it's a big name insurance co. here (didn't know if I should mention it). No policy limits or anything like that to deal with--it's not that large of an accident.

    Thanks for any replies!
  2. #2
    ecmst12 is offline Senior Member
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    You shouldn't be waiting for them to make you an offer, you should be submitting a demand to them. If you have fully recovered with no permanent damage, you shouldn't expect a windfall for pain and suffering, but feel free to start high and negotiate from there.

    Your medical bills is the amount paid out on your behalf and which you have to pay back out of your settlement. Those are your actual damages. Anything more then that is pain and suffering (general damages).
  3. #3
    ReformedMan is offline Member
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    While nobody here can give you a definitive answer one way or the other, I would worry that the insurance company might try to deny part of the medical bills based on the previous injury. If you can get the previous treating physician to attest to the fact that you were COMPLETELY done with treatment and that the pain would NOT reoccur for any reason, you might have a solid defense. However, the insurance companies know that such a defense in court (should it ever come to that) is very expensive.

    I would consider at least consulting with a PI lawyer to see what difficulties you may be facing in the near future. The rest of your questions I will have to defer to the more knowledgeable members here.
  4. #4
    Hit From Behind is offline Junior Member
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    Thanks. To ecmst12 ... so what I could "expect" to receive from the other driver's insurance would not be the actual amount of my medical bills (which is $4000), but a lesser amount based on what was ACTUALLY paid out by both the health insurance and the auto insurance? That's what I was trying to clarify.

    When my accident from 2006 was settled (using an attorney), it was based on the total amount of my medical bills (which were $6000 at the time), plus an amount for P&S. Ended up settling for $8900, the atty. got her 3rd, and then I paid the subrogated medical amounts (which were far less than the $6000).
  5. #5
    ecmst12 is offline Senior Member
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    You can ask for the full billed amount if you like. And different states/courts have different opinions on this matter. But at least IMO, your out of pocket expenses are only the actual dollars coming out of your pocket.
  6. #6
    Hit From Behind is offline Junior Member
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    OK, thanks. That's helpful.

    It seems as if on my last accident, it was totally based on the TOTAL amount of the bills (not the subrogated portion). And like you say, I can ask for (in my demand) what I feel is fair.

    I just spoke with my chiropracter for the 2nd time this week and he is sending me all my medical records tomorrow (I already have those from the ER & ER dr.), and I'm fairly confident about drafting the demand letter.

    Just have to get to the nuts & bolts of an actual amount ... my chiro did also state (and this will be in writing as well) that I was done treating from my prior accident well before this accident occurred (no dr. visits at all for that injury for one year prior to 3/08 accident).

    Thanks again!

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