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Help with demand letter? (Pennsylvania)

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SnapApples

Junior Member
Hello all, my name is Jackie and I live in Pennsylvania. I was hit by another driver about a year ago and am finally showing some improvement pain wise and I have already tried every treatment I can, so now I am getting ready to send a demand letter to the insurance company. I had a lawyer but he released me because he had too many other bigger accounts. I think because I had limited tort, he didn't feel like my case was worth his time. =( I have spent the last few months searching the internet for help with how to write a demand letter but I still feel inadequate going up against the clever insurance adjusters. I am not one for writing letters so I was hoping I could get some comments on the one I have written? Any suggestions or corrections are whole-heartily wanted. I have withheld any names to protect the privacy of those mentioned.
---------------------------

Jackie (my last name)
(my address)
August 27, 2010


(claims adjuster's name)
Claims Adjuster
(address)
Re: Your Insured, (insured name)
Claim No: XXXXXX
Claimant: Jackie
Date of Loss : XXXXX

Dear Ms. (claims adjuster),
On (date of accident), I was injured in a car accident with your insurer (name of insurer). My husband and I were traveling West on (road name) when your insurer crossed the center of the roadway and slammed into the rear quarter panel of our vehicle. We were wearing our seat belts.

Your insurer is responsible for the accident due to her driving too fast for the road conditions (as shown in the police report) and she crossing over the traffic line and into my lane of traffic. From the pictures of my car damage, you can see the force of the impact with which my vehicle was hit.

As a result of the collision, my vehicle was violently spun around into the opposite direction. This is a clear indicator that your insurer was driving too fast as the impact was enough to spin our vehicle. The force of spin forced my neck and back to snap forward violently and slam me back into my seat as our vehicle stopped facing the wrong direction in the road. Due to the damage to my vehicle, your insurance company had it totaled.

Shortly after the accident, I felt stiffness in my neck and back. As soon as the officer would allow us to leave the accident, I went to the emergency room at Heart of Lancaster. They took a Cat Scan. The doctor diagnosed me with muscle strain and I was given pain relief medication and told to take Tylenol as needed.

I followed up with my family doctor who prescribed me pain medication. After not showing much improvement, my family doctor referred me to physical therapy which I completed for approximately 2 months as recommended by my doctor. I also was treated by a chiropractic doctor. After little to no improvement, I was referred to an Orthopedic doctor by my family doctor. He ordered a blood test and bone scan. I mentioned to him that after two months, the pain pills weren’t as effective as before and he recommended that I stop taking them. The Orthopedic then referred me to a Rheumatologist. Neither doctor was able to offer me any suggestions on what I should do next. Still seeking relief, I tried massage therapy but didn’t see significant improvement so I talked to my chiropractic doctor who referred me to an acupuncturist. This was the most helpful treatment and I continued it for 7 months until I began to see no significant improvement.

Here are the medical expenses for my treatment that are shown on my medical billing records: (see attached payment log and other bills)

Emergency Room $x
Doctor Visits $x
Physical Therapy $x
Prescription Medicine,
Heating Pad, Tylenol $x
Orthopedic $x
Rheumatologist $x
Chiropractic Care $x
Acupuncture $x

Total $5,500.00
I had to miss 39.25 hours (at an hourly rate of $x) of work due to my injuries and doctor's appointments. I have included a letter from my supervisor, (supervisors name), totaling my lost income at $x.

Due to your insurer’s negligence by driving too fast for the road condition (as stated in the police report) and crossing over the road line into my direction of traffic, I have been in pain daily for over a year.

I still have back and neck pain today. There has not been one pain free day since the accident. The injuries have disrupted my lifestyle and have made it painful to do my job due to the long time of required sitting. I have difficulty laying down or standing for long periods. For over a year, I have spent much of my free time going for treatment. Many of the activities I used to enjoy I could not do and now only can do to a certain extent due to the pain they cause and how my body grows tired quickly. This put extra strain on my husband because of the extra work he had to do because I could not. It also caused me great mental anguish at not being able to do the things I love and not knowing if I would ever improve. I am not back to where I was before the accident and still have daily pain.

As a result of these injuries and my continuing pain and suffering, I demand compensation in the amount of $25,000.
I hope to hear from you soon.
Sincerely,
Jackie (my last name)

_______________________

The reason I went with such a high amount was because I was told online that you take your medical expenses x 3 (somewhere between 1-5 times based on severity) and then try to double it so you have some space for counter offers. I also based it on the fact that in Pennsylvania, even with state minimum insurance, you at least have $25,000 as the cap of what can be dispersed.
I am hoping after counter offers for them to agree to $15,000.
I am concerned that I am not ever going to have my life back to what it was before, so I am hoping that I can seek out my own treatments in the future as they become available. I can't know the extent of my injuries and how they will show themselves in the coming years so I want to be able to pay for those things without causing myself a hardship. Plus, I pretty much lost a year of my life. I know money can't replace that, but that's the only thing the insurance company can offer as compensation. I don't want to be unrealistic, but I also don't want to get taken for a ride by the insurance company. =(
 
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ecmst12

Senior Member
You are likely to end up with less then $10k for such minor injuries. You don't have any VISIBLE documentation of injury (nothing showing on any imaging scan), so it's all soft tissue injury which is very subjective and hard to prove. You won't get nothing, but $25k is a laughable amount for the injuries you had. Especially since in PA, your insurance pays the medical bills and you don't need to reimburse them out of your settlement.

Incidentally, you do have the full tort option on your policy correct?
 

SnapApples

Junior Member
I am not expecting them to pay that amount, but if I ask for what I want, they will always offer less so I figured it would be best to ask for a higher amount. Do you have any suggestions for what I should ask for to insure I have enough cushion to counter offer? I do not have full tort, which I believe, is the reason my lawyer decided my case was not worth his time.

EDITED 12:45pm:


I had coverage for $5,000 of medical bills so $500 was out of pocket. (I have a HSA so I need meet a deductible before the insurance company will cover things) But in any case, I was reading online, I can’t find it now, but it said that the insurance adjuster cannot say that they don’t owe you anything more just because your medical bills were paid. There was a special wording they used for why this is not allowed but I can not remember it. Perhaps you can shed some light on this? I understand that not everything online is accurate, so I could be wrong but I would very much like to be well informed on how this is handled by insurance companies.
 
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ecmst12

Senior Member
If you don't have full tort, you can't get a penny over actual costs, so anything more then $500 that they give you is a GIFT.
 

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