What Are Our Choices

[darocket]

I went and revewed my documents online and could not find anything that even mentions P & S. Maybe we're just out of luck on this one. For medical, I have Tricare Prime for retirees. We continue to pay our co-pay but not sure how they're going to handle this situation. As far as the adjuster goes, I realize he has other clients and that it might take awhile to get back with me but what constitutes a reasonable amount of time? First and last spoke with him on Monday.

 

[moburkes]

I'm not sure what is reasonable, but you could nicely ask him when he does call back.

Remember, that your health insurance will want to be reimbursed for all the money they spent on the auto accident.

 

[darocket]

I was planning on it if he ever returns my call or emails.

 

[ecmst12]

Remember that you are at MUCH less of a disadvantage when dealing with your own insurance company for claims, simply because you are their customer and they have an interest in keeping you happy. And you should be having your wife's doctors send all her accident-related bills directly to your insurance company, not to the health insurance company. If it turns out the other driver was insured, then they can seek reimbursement from the other insurance company, but your health insurance DEFINITELY is not responsible until all your auto coverage is used up. She won't have to pay any copays, either, which will make things easier. But you shouldn't need a lawyer to get medical bills paid by your own insurance company. If the other driver was uninsured, just tell the lawyer that you won't need his services. And don't sign anything until you know for sure!

 

[alnorth]

You dont sue insurance companies or retain a lawyer to speak to your insurance company unless they make an offer that you feel is grossly unfair. If you have an obvious valid medical claim, the insurance company is likely going to pay you off, because if they dont they could be hit with some serious punitive damages in a bad faith lawsuit.

Hiring a lawyer who wants 1/3 of the money that the insurance company will pay, before you even hear from the insurance company how much they are willing to pay is foolish.

 

[stephenk]

First, pain and suffering is recoverable in an uninsured/underinsured motorist claim.

If the other party has no insurance you notify your carrier that you are making an uninsured motorist claim. You would handle the claim as if you were making it against the other party's insurance carrier.

If the other party is insured, but their policy limit is less than the full value of your wife's claim and less than your own policy limits, you would need to settle for the other carrier's policy limits and then you can make an underinsured motorist claim for the balance available on your own policy.

If your wife has an injury that you believe is worth more than $100k I strongly suggest you consult with an attorney.

 

[stephenk]

You shouldn't be speaking to your agent about an insurance claim. You should be speaking to the adjuster. Oh, you will need to read your policy to see if it covers pain and suffering. Most UM coverages do not, since, as was stated earlier, their client (you and your wife) did not cause the P&S.

What are you talking about? UM coverage is to replace the coverage an at fault driver would have if they were insured. That recovery most definitely includes general damages (pain and suffering).