Adjuster said Medical + Pain/Suffering = settlement

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

Hello - I was hit by a stop sign runner (he was 100% at fault) - pushed my car across three lanes of oncoming traffic and over a parking sign. My head hit the rearview mirror so hard, it was torn off the windshield. I had left to right neck whiplash, neck and shoulder pain, limited range of motion and right side extremity weakness, swollen area on head, headaches, CT scan, MRI, physical therapy, medication and ultrasound steriod therapy. I was discharged from PT to continue treatment at home. I am diabetic and a heart patient.

My husband who is 100% disabled had double bypass heart surgery shortly after my accident. Because of my injuries I could not assist him with daily activities, take him to appointments or bathe him. Home health care was assigned and required by his doctor to assist. I was limited in range of motion, the weakness in my right shoulder and arm were documented. I had difficulty driving, taking care of my home, myself; reaching and lifting or even doing my hair because of my injuries.

I documented the at-fault driver's breaches (failure to look out, avoid, stop, obey road signs, follow the rules of the road) and associated Missouri statutes. I documented that the negligence of the other driver caused my injuries, presented "but-for" causation, loss of essential services, loss of quality of life for myself and my husband and potential future medical treatment. All of the above was documented with medical reports/documentation.

The limits on the at-fault's policy is $25K. My car repairs were paid already
($6k). The adjuster is offering me $13K, but I have to pay my own medical out of that. Medical bills came to $6.3K, netting me $6.7K pain and suffering. He told me that he didn't value my pain and suffering at more than $6K. He told me that if he paid my medical he would cut me a check for what was left over ($6.7K). I asked for $38.5K but the limit is $25K. The adjuster wouldn't even go up to $17K.

Should (or can) my husband file a claim? What else can I say to this guy to make him compensate me fairly? I don't feel $6.7K is reasonable P/S for what I have gone through - not to mention my disabled spouse and my inability to care for him. I am trying not to do the lawyer dance because I need this settled shortly - my medical bills need to be paid before they come after me for payment. I threatened to go to the claims manager - the adjuster said he had more authority than the claims manager. The adjuster's job title is "Casualty Claim Desk Adjuster" (not even a senior). So how is that???
Can somebody help me? I need to deal with this guy so that I can get compensated fairly. Any ideas of what I can say to this guy to make him budge. Thanks, Moma G.

Do you have any proveable PERMANENT limitations due to your injuries? Not just lingering pain but actual limitation of function.

No, your husband was not injured so he has no standing to file a claim.

Hello ecmst12

I would need to go back for an MRI of my shoulder, because I still have limited range of motion (when I raise my right arm) and pain when resting on my right shoulder at night, also there is signifcant temperature difference in my right arm and hand at times (right hand/arm is cold - which can be felt). I am concerned about developing arthritis in this shoulder and/or frozen shoulder - something that affects diabetics (their shoulder joint). The adjuster tried to tell me that since my therapy stopped on 8/27 I had not gone back for more treatment so they had the option to deny any further claims because it had been more than 3 months (but I was discharged to continue therapy at home) - I am still authorized 12 sessions of PT.

You stopped treatment before you were better and waited several months. You will now have to jump through hoops and prove to the insurance company that any treatment you get now is directly related to the accident and NOT to any of your other health conditions. You really would do well to consult a lawyer and not rush to settlement. With the treatment you received, $6k sounds pretty generous, but you stopped treatment before you should have.

I have been continuing my exercise program at home on the strenghtening regimen I was given (along with medication) as prescribed by the physical therapist - medication prescribed by the doctor. This is what I was discharged from treatment to do.

6.7k doesnt sound bad at all. If you get a lawyer i bet you end up with less. It sounds like the claims adj wont budge. Just hold off for awhile & maybe the adj will increase his offer. I wish i got 6k for my pain/suffering. I only got half of that & my treatment lasted 7 months. yep...i negotiated badly.

Even though you are continuing your exercises at home, you haven't followed up with your doctor for more then 3 months, which means according to your documentation, your treatment has stopped. And it only counts if you can document it.

If the policy limit is $25k, getting a lawyer to negotiate will likely end up costing you money unless the attorney is able to get the full policy. Given the current state of injuries, I don't see that as particularly likely, so best bet may be to keep pushing the adjuster yourself.

How did you get the adjuster to divulge the policy limit? Just ask, or did he offer it? verbal or written?

It's a lot easier to find out the limit if it's a minimum policy.

Injury claim

Hi. Your claim is worth more than the $13k you have been offered. You have continuing neck pain and are still undergoing treatment. In order to fairly compensate you, the insurer will need to offer a larger amount for pain and suffering, as well as payment for future medical expenses, which could be on-going for some time. Furthermore, the fact that some of your injuries are likely to be somewhat long term increases the value of your claim. These issues have to be properly presented and argued to the adjuster, otherwise, they most likely will not budge, and, if they do, they may offer you only another $1000-$2000 at this point. You should be entitled to reimbursement for the cost of hiring a home health care aide to assist your husband as well, because but-for the accident, this would not have been necessary.
Finally, although the policy limit is $25k, it is often possible to receive more than this by combining policies. The language of your own policy and the policy of the negligent driver would have to be glanced at to determine if this is a possibility.
I am a Missouri injury attorney. I hope this helps at least some. Thanks.

NOTE: This answer is for educational purposes and does not constitute legal advice. The use of this site does not create an attorney-client relationship or privilege between the user and the attorney responding.

LOL @ ^

I am a defense attorney, and I don't even pay $25k for some broken bones. Neck pain is not going to automatically give rise to a claim for the full policy. Keep fighting the adjuster yourself and if you don't like where the negotiations are heading, only then should you consider giving 1/3 of your money to the local plaintiff's bar.

Good luck.