Ready to settle auto accident case
 

As many may remember, my '88 Carrera was rear ended while my wife was driving alone. I fixed the car, lost interest and sold it. She suffered a back injury. After a visit to an emergency clinic, went to her doc. He told her she needed an orthopedic.

Well, it turned out that no decent orthopods will take an accident case unless you give them YOUR insurance info. Sure enough, the office cleared with our health ins co and treatment began early in 2010. So, we are out of pocket quite a bit for the various deductibles for PT and office visits. And the injury lingers as they all do although she is getting by OK.

We have a family attorney who has monitored the situation. I talked to him today. He tells me that soft tissue injuries are a tough case to pursue. I believe that. So the plan as of today is to negotiate directly with the at fault's company. They paid for the physical damage and I have not relinquished my right to a claim for value depreciation, but I know that's a long shot. I might bring it up once just for the factor.

We need a settlement to cover out-of-pocket. The attorney says to let the ins cos fight it out amongst themselves for the money paid to medical claims. I'm fine with that. We need a settlement for time and travel to PT which we will document along with the deductibles paid. And I think my wife deserves some compensation for the ensuing problems over the last year, the ones that are hard to prove. I know about it, of course.

So here's the question to the legal eagles that can't dispense legal advice and those of you that may have been in a like situation. As I said, I can go back to the attorney anytime, but he is giving me the go ahead for now. Do I get to "represent" my wife?

What tactic? Attorney says "presentation, presentation." He gives me a chance of getting xK as a "make it go away" fee. I always figured more, but I've never been injured, so what do I know? He says they will come at me with xxxx right off. (I hope he meant over and beyond actual out-of-pocket.)

Oh, and for you guys that say why pursue a settlement? Things like a new orthopedic bed have been indirect but yet direct? expenses. No prescription for that, but it had to be done. We won't make any profit here.

I think you should go talk to an attorney that specializes in automobile tort claims. Usually, there is no charge to talk to them; ask if unsure.

I'd find the biggest best one - a place that does a lot of these types of cases.

Why? There can be only so much money and they need a large part to stay in business. My guy is suggesting I can net more.

But, that wasn't the question, was it?

1. they are lots better at it than a general lawyer

2. when the ins. co. sees their letter it will have a very different reaction than when they see your letter (ins. co. knows they might have to pay lots of fees to them & none to you)

the real question is whether your return is more than 1.4 * what they get (they usually take 30% as fees)

Point taken. I can't talk strategy here because they might read. But, rest assured the attorney is not far away. He has handled 2 worker comp cases for us, he's in the car.

The unfortunate reality is that some judges look at someone representing themselves and laugh.
They don't care about the law.
The only care about who is saying the vague, generalized statements which they'll rule on....

Wait, John, trial is not in the plan at this point. I asked if I can negotiate with the ins co in my wife's behalf. That's what my attorney implied. I guess the real question boils down to whose signature goes on the letters if I'm behind the deal making.

If the ins co wants to throw this to trial, I will make sure to spend plenty of their money. We can't lose. We are owed money. That's plain and simple. A stack of paid medical bills attests to that fact.

Yes you can negotiate on her behalf. Your signature goes on the letter.

Milt, the answer to your question is yes, you can negotiate on behalf of your wife. It's not unusual and the adjuster should be used to it. Just have your wife talk to the guy when you're on the line and have her confirm you can talk for her. She has to sign all the documents when you settle, so it doesn't matter too much to the adjuster who he talks too. She has to give final approval.

In all fairness, a decent personal injury specialist will charge you between 20% and 1/3 of the recovery but he will increase the settlement by more than the amount he charges plus he takes all the hasle out of the paperwork. A below average non-personal injury lawyer won't do much better than you can do on your own. There is a range of fair settlements for a given injury and aliability scenario. The question is what is it in your area, will you know it when you hear it, and is the adjuster willing to offer it to you without being represented. And is there additional information that only a lawyer would recognize as being important that could be submitted to change the adjuster's evaluation.

Some companies and adjusters will quite honestly evaluate the claim independent of who represents you and offer the same whether you have a crackshot lawyer or are pro se. Some play games with anyone who crosses their path. It's hard to know what you're dealing with and how to evaluate the offer if you're not a pro.

If you feel comfortable doing it, and you have a number in mind, and you've got someone in the wings to guide you, there's no harm in taking a swing at it yourself. I would be happy to talk to you and give you a ballpark evaluation and some suggestions for how to approach the adjuster to bolster your claim and make the best settlement possible. In the end, if you get the result you were looking for and you're able to put the incident behind you without more trouble and hassle, then you got a good settlement. If you got ten times that amount but came away bitter and dissatisfied, then it was a bad settlement. The settlement that makes you happy is the only good settlement there is.

I had a similar situation about 15 years ago. I still have pain. I took a tiny settlement because the claims adjuster told me I had to close the claim. I just wanted medical attention for the injury I had, nothing more.

I would sit down and determine what you need. Is it on-going care? Or is it recouping out of pocket? Or other?

When you see what you need you can determine your strategy. I work in insurance and claims people are driven to minimize claims. No news there. If you have a modest and reasonable request, it may be paid out no problem. If the claims person disagrees with your request, you can escalate up the ladder. I would be straight forward and no nonsense in your approach and communicate that this is what you are going to do. Tell them that if you have to hire an attorney, it will come out of their pocket.

I expect that you have a 25% chance of successfully negotiating this yourself, but it is worth it.

Best of luck. This sucks.
Larry

MRM and Larry's advice is right on. Unless I missed something, doesn't seem like there's a downside to trying to negotiate yourself. Have a number in mind and have a rational explaination for everything that goes into that figure. Go in with the attitude that you're going to try to work things out in good faith and if it doesn't go well, then let them know you'll bring in your lawyer.

In my jurisdiction the SETTLEMENT value of damages for "specials" (i.e., past/future lost wages, pain/suffering, hedonic damages, future med expense, your loss of consortium, etc) is about 3-10 times the amount of actual damages (property and medical paid). Many factors go into play as to whethether its 3 or 10X's.

May be a moot point depending on limits of other guy's insurance coverage....at which time the ins co could pay policy limits and say good luck on collecting excess. At that point you may have to look to going after your own insurance company for uninsured motorist/under-insured motoristPlus there are unique laws that vary from state to state as far as indemnification, subrogation, compromising medical liens, etc. And you have to consider the impact a settlement has on your wife's health ins coverage for future med coverage...especiaally if she has Medicare.

It ain't rocket surgery but its a bit more complex than you think if its likely your wife will have future medical issues post settlemnt. If she is ecxcpected to recover completely its slightly less of a problem.

Good luck.

One thing to consider is that the lawyers and insurance consider the "meds" at face value. Meaning that they add up all the Medical Bills at full face value and are not concerned about the insurance discounts, deductibles and Copays. This greatly inflates the medical liability claim over actual out of pocket losses - but this is how it it done. I was surprised and asked our attorney for careful reiteration.

I have wondered how much effect this has on the inflated bills from ER's, hospitals and physicians over what is actually allowed by most insurances. Perhaps tort lawyers are partially responsible for the high cost of medical care.....? The auto accident victim is likely to get $30K in hospital care before surgery in tests, CT scans and facility fees. Insurance pays 1/4 - 1/2 this amount but the $30K is what is used for negotiations.

If this is the case for you then you would want to have all the initial bills totaled rather than the out of pocket actual costs.

Thanks notmytarga. I don't think that's a well known fact.

We're not robbers. I don't believe in tort law all that much. We all know the price this country has paid. I did end up without a 911 because this just proves you don't commute in your hobby car. All messed up, I fixed it and dumped it. It went to Europe and got fully certified.

Wife is not as easy to fix and won't be getting dumped.

Your direct negotiation needs to include a term of offer so that if you name a number (as in all negotiations, first one to name a number loses) and then later bring in an attorney, they cannot revert to your proffered number.

Contrary to masses of expensive and effective insurance company propaganda, rarely does an injured party get "made whole" by the time the process is done. That is, unless the whole shebang is under $10-15K, in which case, overcompensation is typical.

I guess you meant "terms of offer" in that they pay this now or fight it out with the lawyer.

I have been having a PM conversation with an attorney indicating that in most cases an ins co would be better off settling directly vs. paying the 30% premium that goes to the attorney. That is predicated on the idea that the claimant and the ins co understand the amount of damages w/o having a attorney building the amount.

I'm sure I'm weak in that dept.

Since this involves 2 women drivers, maybe I'll say I'm gonna call Gloria Allred. I might get double as a "go away" payment.

While you can't predict the outcome (whether an atty would get you 30%+ more), I disagree with the above.

I agree with the theory of it. That it is better for both you and the insurance company to settle directly, thus cutting out the lawyer's 30%. That makes perfect sense, in theory.

Unfortunately, that's not the way insurance companies operate.

You are a good guy, and a reasonable guy. The insurance company is therefore going to eat your lunch.

If I were you, I'd take the opposite approach. I would have the atty send a letter, with an aggressive demand (high $$), and enclosed with that letter would be a draft complaint against the insured for an even more aggressive demand (really high $$$), and descriptions of the actual medical procedures, the injuries, and the *continuing* injuries that may continue forever. And for recovery of atty fees, if there is a basis.

The letter would invite a settlement dialog, and state that unless the matter is resolved, the complaint will be filed.

That is what insurance companies understand and respond favorably to. Letters from husbands, not so much.

Unfortunately, I think McLovin nailed it.

Larry

"Letters from husbands, not so much." That has to be the where things get changed if I were to pursue this with an "offer of term/time" and have my attorney looking over my shoulder at any given point. It's game on or game avoided. I'm sure game on is 99% of their business.

Someone there has a job of strictly limiting liability whether it is to transfer quilt or simply negotiating the lowest possible overall outlay to settle a case. Frankly, I don't think current day ins cos have enough staff to effect that. They may have developed other means of expediting the case thinking they are saving money. I need to know all of this.

It's true, everyone who knows me said I should have been a cop or a lawyer. I end up being a contractor that is on the consumer's side and saving everyone money. I guess I would have been good at the adjusting biz. I champion the consumer.

Call me little David Horowitz if you will. ;)

OK, guys, take that tack. What would Horowitz do?

This could be an interesting case. I've got a dozen qualified l****y's behind me and I push deep into this. Every day, every move comes back to a set of PM's so the defendants can't see. The result helps all understand how the process works and when and why to hire an attorney when the whole process is put forth on line.

Folks, I was surprised at the numbers suggested to me by PM. You might have noticed I entered a value of $**** initially. Well add an asterisk folks according to those in the know.