partiallypeeved
Junior Member
What is the name of your state (only U.S. law)? WI
Hi, my wife was injured in a car accident earlier this year. With it already established that the accident was 100% the fault of the other party, we decided to hold off on hiring an attorney - figuring we would go that route only if the settlement offer was insufficient.
That said, in order to arrive at what is "sufficient", I consulted mighty Google and found two approaches at calculating a "reasonable" settlement amount that includes an allowance for pain and suffering: the Per Diem approach and the Multiple of Specials approach.
The Per Diem approach is straight-forward enough. But when I am compiling medical costs for the Multiple of Specials approach, what figure is appropriate to use? For instance, if:
* the health care provider bills $250 to my medical insurance company, and
* the "approved" amount works out to $150 after the discount for being an in-network provider, and
* my co-pay is $15?
On the one hand, using $250 makes sense because the other party's car insurance company would be benefiting from the fact that I have personal medical insurance. On the other hand, $150 makes sense because that was the actual cost that was incurred. Of course, using $15 wouldn't make sense because my personal medical insurance company would need to be reimbursed for any money that it paid out to the health care providers.
Again, I am only doing this calculation exercise to try to gauge reasonableness of the settlement offer. If push comes to shove, we will involve an attorney. Your input is greatly appreciated. Thanks.
Hi, my wife was injured in a car accident earlier this year. With it already established that the accident was 100% the fault of the other party, we decided to hold off on hiring an attorney - figuring we would go that route only if the settlement offer was insufficient.
That said, in order to arrive at what is "sufficient", I consulted mighty Google and found two approaches at calculating a "reasonable" settlement amount that includes an allowance for pain and suffering: the Per Diem approach and the Multiple of Specials approach.
The Per Diem approach is straight-forward enough. But when I am compiling medical costs for the Multiple of Specials approach, what figure is appropriate to use? For instance, if:
* the health care provider bills $250 to my medical insurance company, and
* the "approved" amount works out to $150 after the discount for being an in-network provider, and
* my co-pay is $15?
On the one hand, using $250 makes sense because the other party's car insurance company would be benefiting from the fact that I have personal medical insurance. On the other hand, $150 makes sense because that was the actual cost that was incurred. Of course, using $15 wouldn't make sense because my personal medical insurance company would need to be reimbursed for any money that it paid out to the health care providers.
Again, I am only doing this calculation exercise to try to gauge reasonableness of the settlement offer. If push comes to shove, we will involve an attorney. Your input is greatly appreciated. Thanks.