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Bodily Injury Settlement Process

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mistaP

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


Hi, all. I'm looking for someone to advise me on the likely course of the negotiations involved in reaching a settlement. Here's the background: On Nov. 1 2008, I was hit head-on (55 mph) by a sleeping driver who was found at-fault. My truck rolled over twice and my head and left arm went through the driver's-side window. I was taken 21 miles by ambulance to ER. My neck was immobilized and head strapped down... with much glass still there imbedded. Medical treatment included x-rays and CT scans, glass had to be dug out, 40 staples in my head, 11stitches in my elbow. Was prescribed narcotics and muscle relaxers. One month, and much agony, later I had to have a minor surgery to remove glass that was left in my arm.

My insurer paid my bills--$4500. I missed a total of three weeks of work for a total of $14,800.

Lingering effects: shards of glass of festered out of my scalp three times, I cut my self on scar tissue while cutting my hair four times, anxiety when driving at night, and worst of all, I have to wear a hard hat, at work, which rubs on the scars and keeps the area very sensitive.

So far: A snafu caused the adjuster to think that I had only $2200 in med and $5000 in lost wages. He offered me $11,500. After correcting the snafu, I asked the adjuster if he would like me to make a demand for settlement. He did. I said $135,000. Three days later I get email rejecting my demand.

That brings me to now. It's been almost a week and I have not heard back from the adjuster. What is the next move? Do I wait for him to counter? Any other information would also help. Thanks.
 


ecmst12

Senior Member
Your demand was too ridiculous to merit a response. Come back with something more reasonable then 30x medical bills and you might get a dialogue going.

For your missed work, did you receive vacation or disability pay for that time, or were you completely unpaid for those 3 weeks? You can't claim lost wages unless you were actually unpaid. Lost vacation time isn't compensated dollar-for-dollar as lost wages would be, it's considered part of your "general damages" (pain and suffering).

You can only receive compensation for anxiety if it was severe enough that you have sought treatment for it. If you weren't treated for it, it doesn't exist as far as the adjuster is concerned.
 

AngloAustrian

Junior Member
I am handling my own claim right now.
The person who responded to your question is an adjuster and therefore on the side of the insurance companies.
Call your adjustor and ask them for the REASONS they are denying your demand and ask them if they are making you a counter offer?
Then, take those reasons and write a rebuttal lettter reminding them of the reasons why your demand is reasonable and fair.
A good book to get from the library is HOW TO WIN YOUR PERSONAL INJURY CLAIM from NOLO Press. It has really helped me so far.
I don't think your demand is ridiculous considering what you went through, and neither will a jury. Negotiations will take time, and the insurance adjustor will never offer you the amount they are actually willing to pay. You have to be patient. Follow instructions in the book and good luck.
 

ecmst12

Senior Member
I'm not an adjuster anymore, and I don't "side with insurance companies", I tell it like it is. I have no dog in this fight - I think people should get fair compensation for injuries. But I do NOT think people should be greedy or treat auto injuries like the lottery. Which is what OP is trying to do.

You can't litigate a lawsuit for that kind of money without a lawyer. OP doesn't have a lawyer, so a demand like that is a joke. His injuries don't warrent it and if he wants to be taken seriously, he needs to make a REASONABLE demand.

I think he can get more then a token settlement, he is probably going to have glass coming out of his skin every so often for the rest of his life and the scars are documentable permanent damage. BUT, he didn't lose a limb, he hasn't lost any ability to work as he did before (he has some discomfort but can still do the same job, same hours etc as before), he can walk, he can participate in all the same activities he did before. So some perspective is definitely needed. People who get $100k+ settlements are a LOT more injured then this guy.
 

mistaP

Member
After much thought on the matter, I asked myself how much would it cost for me to be willing to go through the wreck again. Not already knowing the outcome would be the same as it was, I wouldn't go through it again for anything. My wife had a baby to be born in three weeks, I thought I was going to die. I said my last prayer in those million seconds. However, if I knew how the events would unfold, I would go through it all again for a year's wages--which over the last three years has averaged $135,000.

Thanks so much for the advice and the book information.

I will read the book, but at what point do I "lawyer-up"? Thanks, John
 

ecmst12

Senior Member
Your thought process makes no legal sense. If you can't come up with a more reasonable settlement figure on your own, you should talk to a lawyer now.
 

mistaP

Member
I appreciate your opinions. In fact, I seek ones such as your's so as to improve my negotiating abilities... with someone who has no bearing on the outcome of the settlement. I cannot well practice with the adjuster.

Explain to me if you can the concept that equates "legal sense" with what a jury might award in a civil suit.

To answer my original question, what can I expect next in this process? I will settle for less than my original demand, maybe 50%, but I am not in the habit of bidding against myself. Should I wait for a counter-offer, or should I ask for one?

Also, is it unheard of for me to contact the at-fault driver directly, and ask him what his policy limit on bodily injury is? I cannot see where it would hurt anything.

Thanks for your attention. Please give me some more ideas or things to consider.
 

ecmst12

Senior Member
Even 50% of your original demand is FAR more then your injuries are worth. 25% is still high but at least you won't get laughed at.

You also didn't answer my questions about your "lost wages".

You could contact the driver but he has no reason to speak to you or answer your question and hopefully (for his sake) he will tell you to pound sand. Minimum coverage in your state is $25k per person.

At this point, you are a year away from the SOL running. The adjuster is NOT required to make a counter offer and may just wait to see what you do next. If you decide to get a lawyer, don't wait until the last minute or you may not be able to find one who will take your case.

Finally, do not be concerned with "jury awards". Almost NO auto accident cases actually go to trial. It just isn't cost effective (trials are VERY VERY VERY expensive) unless there are very severe injuries (much worse then yours), million dollar coverage, or the at-fault party is independently wealthy and could pay an award beyond the policy limits. None of those are likely to apply in your case.
 

ats2009

Junior Member
get yourself a good lawyer.
your request is not crazy. I'll tell you what is nuts.

Someone cut in front of me and stopped short. I hit her at about 10 mph.
there was no damage to her car but she claimed 3,300. she was from out of state but had a lawyer write papers 8 days after accident and filed 15 days after. My insurance company's lawyer got these two weeks before me.
she was going to doctors 2 to 3 times a week for six months (except for 2, two week periods where she did'nt go. She then had surgery on her knee. According to my insurance company lawyer all these were degeneritive in nature. But my claims adjuster settled with her for 75,000 knowing that she did this in 2004 in my same (no-fault) state which is 600 miles from where
she is supposed to live. Even thou someone else at my insurance company said something was fishy and the lawyer said that it looked like i was only 50% at fault the adjusted did not consult the lawyer. She said she did'nt have to and, that the other accident with injuries were different injuries.
Because of her action this person was able to again commit insurance fraud and will mostly likely do it again, and put me at 100% at fault which will of course raise my rates
DO YOURSELF A FAVOR--- FIND A GOOD LAWYER LIKE THIS LADY DID
 

mistaP

Member
You also didn't answer my questions about your "lost wages".

Adjuster has accepted verification of these lost wages from my employer and has, in writing, agreed that I am due recompense that I chose to use personal leave during that period notwithstanding.

You could contact the driver but he has no reason to speak to you or answer your question and hopefully (for his sake) he will tell you to pound sand.

Truly, is this your hope?

An arrogant lot, these adjusters.

The adjuster knows that I make $5000/wk for 6 months out of the year and $700/wk for the other 6 months that I don't work. He knows that I can afford to hire an attorney or split my settlement with one. He knows that I'm not going to roll over, and I believe that I will get the 50%.

When we settled for the property damage, he made me an obligatory insultingly low offer which I, in a heated exchange, not so politely rejected. The next day he asked me how much I wanted. My demand was 1.5 times what he offered, and he paid it without hesitating.

But, thanks for the advice as far as not waiting until the last minute. My plan was to wait one year to make a demand for settlement, which I did. My thought being that if I was not too anxious to initiate the negotiating, I would be in a stronger (or perhaps less weak) position. Any thoughts? Thanks.
 

ecmst12

Senior Member
Yes, I truly hope the person who hit you doesn't help you take advantage of his insurance company.

You are due compensation for the leave time that you used. However, you are not due the full amount of your salary for that time period. It's not the same as if you'd been unpaid for 3 weeks, that would be an objective loss, not a subjective loss. Vacation time is a subjective loss. This is what a lawyer will tell you. The reason I know this is not because I used to be an adjuster, it's because I was injured in an accident a long time ago and that is what MY lawyer told me about my "lost wages". I missed 6 weeks of work, but I had a very good STD policy at the time and so received my full salary for that time, and lost only a week or so of my vacation time. Even the week of vacation time was not compensated dollar for dollar.

Your injuries are NOT worth $70k and it is greedy of you to ask. The standard that people think is a formula is 3x medical bills, which is not actually accurate at all and in many cases is way too high, but in your case is probably fair or maybe even a little low. If you'd received only soft tissue injuries with no permanent damage, your case would not be worth even that.

You need to wait until your treatment is complete before you start thinking about settling - you could have probably started sooner. If you are going to get a lawyer, now is the time to start looking. Expect to pay between 30 and 40% of your settlement to the lawyer.
 

tammy8

Senior Member
With *all* that medical care, your bills were only $4500? And you make $4300 a week in wages?

Sorry about the accident, but gotta ask, what do you do to make that kind of money? I need a new career!


$11500 is a MORE than fair settlement with only $4500 in medical.

Basically what I am getting at is that these money amount seem really fishy**************..
 
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mistaP

Member
Seems odd that would question my figures, but if you really want to know. I am a Superintendent for a major industrial contractor that overhauls coal-fired boilers ( power plants). I have a contract that pays me $36 an hour that I actually work, 125/day per diem, $135/week truck allowance + fuel. When I work, usually 10 -12 weeks in spring and 10 -12 weeks in the fall, I work 7 days a week, 12 to 14 hours a day. Although I have a contract, I am paid hourly and receive OT after 40 hours. You do the math. When I am off, I have a "retainer clause" that pays me 1/2 of my hourly wage for 40 hours / week and I am free to work elsewhere until I am called back. It's good work... if you can get it. And it's a recession-proof industry.

It's odd that you suggest 3x meds. I've seen other threads where people are ridiculed for asking, "how much is my claim worth as a multiple of meds?"

The amount that I am demanding is not really the subject on which I am seeking guidance.

As far as the "lottery" comment earlier: I didn't purchase a ticket in hopes of winning something. I would be perfectly content to have my head scar-free as it was for 37 years and to still be driving my old truck.

How am I attempting to take advantage of his insurance company? In keeping with the gambling metaphor, the insurance company is betting that they will have to pay out less on their insured's behalf than they collect in premiums, no?
 

ecmst12

Senior Member
They know they are going to be paying out more for your injury then they're likely to make in 5-10 years of premiums off of this guy. Obviously they want to pay as little as possible. But there is fair and there is greedy. You are being greedy. The adjuster probably doesn't want to screw you, but he doesn't want to deal with an unreasonable claimant either.
 

mistaP

Member
You seem to use the word "greedy" very freely and authoritatively, as if it is an objective term that has some definite threshold. What, then, constitutes greed on the insurance company's part?
 
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