Insurance Representative doesn't have authority to release full amount.

[JamesMR1967]

Here's an update on my situation.
I went and spoke with my lawyers yesterday, I didn't really get the results I wanted, then again I was very nervous and didn't want to come off rude. So my lawyer basically says that the lawyer speaking with the adjuster wrote up a post-mediation report so the "higher" up person who needs to approve releasing a higher amount of money already knows about the request for approval, and he's "looking it over". Not really sure what that means. He then says he's going to get a deposition from my surgeon and try to get a picture of the x-ray of my leg fracture. I was surprised because I thought he already had this. I mentioned sending a demand letter for a set amount as a last resort, but he seemed to really be pushing getting this deposition and I didn't want to upset them. He told me the lawyer working with the adjuster is a good friend and he has faith the insurance company will take his advice.

These lawyers are very nice people and I don't want to come off as rude, but they aren't very good at communicating. The 1st woman who handled my case said it could take up to 6 months, she also took pictures of my injuries. After my deposition my attorney was asking if I had any pictures of my injuries, so I guess they must of lost them during the switch over. My lawyers seemed surprised and almost baffled by the low offers the other side was making, do they really not know about "adjuster limits" by now. Surely this can't be the 1st time they have run into this problem. If they were going to request the limits they should of made sure we were actually talking to someone who had the authority to approve that. Mediation was a waste of time and money that comes out of my settlement.

Furthermore, I don't see why they didn't get the deposition of the surgeon by now. It seems like my lawyer is taking it as a last minute negotiating tactic to pressure the other side into talking about a settlement. This should of been done before mediation, my lawyers walked into the mediation like cowboys, after an hour of not getting anywhere, they were ready to leave. The mediator had to calm them down, they didn't even talk to me about anything.

Mediation is required before trail in this state, I think. So I initially thought that my mediation was on pause, then shortly after they would get in touch with this "higher up" person. I'm confused now as if this counted as an unsuccessful mediation, meaning that the insurance company doesn't have to continue negotiating. If that's the case, send them a demand letter for an amount I won't go lower than (I don't need the limits, but they didn't even discuss this with me), make it clear we won't settle for any lower, and schedule a trail date. Bottom line is they will either eventually pay that amount or they won't. If they are going to draw this out anyways, might as well schedule a trail date. What's bad is I've thought this over, 325k is not that far from 250k, it leaves the insurance company with some money. My lawyers want to take them for everything because their client lied about the accident, but the insurance company has the money, I just don't think that attitude is going to get us anywhere in terms of negotiating and apparently they can't even back it up. I feel like I have no say in this case at all.

 

[PayrollHRGuy]

Who is wanting the depo from your Dr. Your lawyers or the insurance companies? That is not clear in your post.

Sending a demand letter in the middle of negotiations is not a good idea at all.

$325K is exactly $75K away from $250K.

 

[JamesMR1967]

Who is wanting the depo from your Dr. Your lawyers or the insurance companies? That is not clear in your post.

Sending a demand letter in the middle of negotiations is not a good idea at all.

$325K is exactly $75K away from $250K.

My lawyer wants it. He says that after he gets it the other side will be more likely to talk about a settlement. The thing is who knows if this doctor still lives here or is even willing to be a part of this at all. What's the worse that can happen by sending a demand letter? Either they agree to settle for that amount or not. In my opinion if they are not willing to pay that and they are willing to go to trial at this point, if that's their attitude there is not much we can do to change their minds.

 

[PayrollHRGuy]

My lawyer wants it. He says that after he gets it the other side will be more likely to talk about a settlement. The thing is who knows if this doctor still lives here or is even willing to be a part of this at all. What's the worse that can happen by sending a demand letter? Either they agree to settle for that amount or not. In my opinion if they are not willing to pay that and they are willing to go to trial at this point, if that's their attitude there is not much we can do to change their minds.

Surgeons don't just move and if you have no reason think he did that shouldn't be a concern. It also shouldn't be a concern that he doesn't want to be involved. My bet this isn't his first rodeo.

Sending a demand letter now could derail negotiations and cause delays that keep you in court for years.

Let your lawyer do his job.

 

[ALawyer]

Just a couple of thoughts. As you incurred medical bills, you should make darn sure as to whether or not your auto or health insurance company may have the right to any part of the recovery you collect. Very often an insurance company or government agency that paid for your medical and related care has a lien -- the right to a portion of the recovery to reimburse it for the medical expenses it paid out for your benefit. Resolving those liens can be complicated -- and expensive. You really should have that thought through.

As another poster has advised you, adjusters for insurance companies often have fixed limits that restrict their ability to approve or agree to a settlement. If the amount is beyond the adjuster's authority he or she must get approval from an adjuster with higher limits. In nearly all cases an insurer has restricted the authority of its adjusters to go beyond a set dollar amount when settling claims, and to go beyond that dollar limit requires approval of a junior officer (who has his or her own limits). Even junior officers have their authority limits, and they may require an okay from a more senior officer -- sometimes even the Executive Vice President for claims -- to sign off on a large dollar amount to settle a case.

And yes, there is a bit of strategy involved. You and your lawyer likely want to settle sooner rather than later, and by sending an adjuster or junior officer with limited authority to the mediation who honestly shares his or her limited authority often will encourage some claimants to say "I'll take the lower amount" so they can get paid quickly rather than incur further delay and incur risk the more senior executive says "no" which thus forces the matter to go to trial, with its inherent delay and risks.... Any halfway experienced accident lawyer should know that.

Remember too that the insurance company has a huge amount of information as to what other similar cases settled for and/or recovered in court judgments. Further, the insurer also has a fairly accurate profile of your lawyer. It can fairly accurately determine if your lawyer is someone who relies on a large volume of low value cases and tends to quickly settle the cases, or if he or she is a serious lawyer who is y willing to hold out for a higher settlement amount (where justified) and if not is truly capable and willing to take cases to trial. Some lawyers are unwilling (and incapable) of going to trial and are all bluff -- which the insurers are aware of.

 

[JamesMR1967]

Surgeons don't just move and if you have no reason think he did that shouldn't be a concern. It also shouldn't be a concern that he doesn't want to be involved. My bet this isn't his first rodeo.

Sending a demand letter now could derail negotiations and cause delays that keep you in court for years.

Let your lawyer do his job.

Great, so it looks like i'm just at the mercy of this insurance company. I wouldn't wish any of this on my worst enemy.

 

[justalayman]

Great, so it looks like i'm just at the mercy of this insurance company. I wouldn't wish any of this on my worst enemy.

No, you’re not. If the delay appears excessive or intentional, your lawyer can intitiate contact or suggest the case be pushed and head to court. Your attorney surely can push the issue by seeking to depose the doctor.

But the best advice is to listen to the advice of your attorney.

 

[JamesMR1967]

Update:
About a week ago I get a call from my lawyer's assistant. She tells me a trail date will be set sometime the following week and my lawyer would like to meet with me a day before to discuss things. It was good to hear this case would finally be resolved because I've stressed night and day about it and to be honest I'm sick to death of dealing with it and my attorneys. I did some research and I read that only 5% of personal injury cases go to trail and those that do, the plaintiff has only won 50% of the time. I also read that personal injury cases usually only go to trial when one side is being unreasonable. My attorney told me that he was sure that the insurance company would settle because he is good friends with their attorney, it looks like he was wrong.

Anyways I was suppose to meet with my lawyer in 2 days from now but I still didn't get a scheduled time. I had my fingers crossed this whole week that the insurance company and my attorney would reach a settlement before the trail date. Lo and behold I get a call, it's the lawyer's assistant. She tells me my case will not be going to trail this week. I was excited hearing this at 1st because I thought she was going to tell me a settlement has been offered or reached. Then she tells me the defense has discovered something that will be very beneficial to my case and is going to ask the judge to push the trial date back further.

At this point after everything that has happened, I was so upset I don't think there was even an emotion to match it, I honestly didn't feel anything. I did schedule an appointment to meet with my attorney so I can get a better understanding of what's going, because I'm clueless. I don't understand what more there is to discover, this entire thing has been some hellish nightmare, some strange type of mental torture with money being held over my head. At this point I honestly just want to say to hell with the whole thing.

 

[adjusterjack]

the defense has discovered something that will be very beneficial to my case

Defense? That doesn't make any sense. Why would the defense care about what's beneficial to your case?

At this point after everything that has happened, I was so upset I don't think there was even an emotion to match it, I honestly didn't feel anything. I did schedule an appointment to meet with my attorney so I can get a better understanding of what's going, because I'm clueless. I don't understand what more there is to discover, this entire thing has been some hellish nightmare, some strange type of mental torture with money being held over my head.

That's exactly what it is. Find something else to focus your attention and try to ignore what's going on with the lawsuit. It'll play out when it plays out. Understand that settlements can occur at any time up to the minute the jury comes back into the room with that piece of paper. You need to figure out a way to chill out or you play right into the enemies hands.

At this point I honestly just want to say to hell with the whole thing.

Then they win and you regret it for the rest of your life.

 

[Taxing Matters]

Defense? That doesn't make any sense. Why would the defense care about what's beneficial to your case?

The defense of course cares about that. Any good lawyer will want to know everything that impacts the case. The lawyer does not want to be blindsided at trial with information he or she did not have and thus did not prepare for. If the defense just found out something new, whether helpful to its case or the plaintiff's, it would want time to figure out how to deal with that at the trial, and seeking a continuance would make sense. This assumes that something truly new was found and isn't just an excuse to further delay the trial and the eventual pay out for the insurance company.

 

[Zigner]

Defense? That doesn't make any sense. Why would the defense care about what's beneficial to your case?

I think that maybe the defense discovered something that is beneficial to the defense in his case

 

[JamesMR1967]

I just met with my lawyers, they asked me to come in, which I thought was strange at 1st, and I have great news. I guess an audio recording of the conversation between the police and the defendant was found somehow and it has the defendant lying on it, and the officers describing how the accident happened. This is why my lawyers decided not to go to trail, they played the recording for the insurance company's attorney and they increased their last offer up significantly because the attorney said it would basically destroy their case if they went to trial. My lawyers asked me to come in to see if I would accept this offer and I did. So now they are going to tell the insurance company and I will have to sign a release form.

I am beyond happy, I guess someone out there decided I suffered enough, I can't believe this day has come.

 

[adjusterjack]

I am beyond happy, I guess someone out there decided I suffered enough, I can't believe this day has come.

Good. What's the new number? This inquiring mind wants to know.

 

[JamesMR1967]

Good. What's the new number? This inquiring mind wants to know.

Since I haven't signed anything yet i'll make a post on here after I do, just to be safe. All I can is my lawyers were able to negotiate with some of my medical bills which was a huge help.

 

[Zigner]

I suspect that the settlement may include a non-disclosure. You should be careful about giving out information related to the settlement.