by camper650 » Fri May 08, 2009 12:59 am
I was involved in an auto accident (hit head on) in early January, the other person was at fault. The properity damage (vehicle totaled, clothing, etc.) was settled in a somewhat timely manner.
Since then, I have had very little contact with the adjuster (Nationwide Commercial). He was complaining of not being able to get copies of my medical records in March, so I got copies of all the medical billing and lost wage info and faxed to him, but he said that wasn't good enough, he needed the "originals" directly from the medical providers. Since then, I have not heard from him.
Is this a normal timeframe? Is this some sort of tactic to "minimize" the claim? Should I follow up with the state insurance commisioner? His supervisor?
Medical treatment was completed by the end of February, so I would think 60 days would have been plenty to gather info and make an offer on a bodily injury claim.
What do you think??
Since then, I have had very little contact with the adjuster (Nationwide Commercial). He was complaining of not being able to get copies of my medical records in March, so I got copies of all the medical billing and lost wage info and faxed to him, but he said that wasn't good enough, he needed the "originals" directly from the medical providers. Since then, I have not heard from him.
Is this a normal timeframe? Is this some sort of tactic to "minimize" the claim? Should I follow up with the state insurance commisioner? His supervisor?
Medical treatment was completed by the end of February, so I would think 60 days would have been plenty to gather info and make an offer on a bodily injury claim.
What do you think??
Posted: Fri May 08, 2009 07:26 am Post Subject:
Medical treatment was completed by the end of February, so I would think 60 days would have been plenty to gather info and make an offer on a bodily injury claim.
Apparently its sufficient, infact the adjuster should have contacted you within thirty days. But at times it may take little longer because of their work pressure. We hardly can imagine the work pressure under which the adjusters have to perform. I'd suggest you to follow-up with the adjuster again.
Is this a normal timeframe? Is this some sort of tactic to "minimize" the claim?
If you have filed within the statute of limitation the insurance company would address the claim anyway. They might negotiate on certain bill amount but the time taken by the adjuster has nothing to do with lowering the claim value.
Posted: Fri May 08, 2009 08:48 am Post Subject:
Well, in a way it can be a way to make you impatient so you jump at their first offer. You'd try to get the matters settle at the earliest. It's make the settlement easy.
Get in touch with the adjuster without losing more time. And, do keep us updated as well.
Posted: Fri May 08, 2009 08:49 am Post Subject:
Hi Camper650,
Is this a normal timeframe? Is this some sort of tactic to "minimize" the claim? Should I follow up with the state insurance commisioner? His supervisor?
Since your medical treatment had ended in February and that he was complaining in March, it clearly suggests that he has contacted you within 30 days. Now, even though it falls under their responsibility to make things easier for you, you can't really rest until you have your claim settled.
Checking with the state DOI would come at a later stage if you're finally not satisfied with his settlement offers. Now, your primary responsibility is to call him up and know whats going on at his end. If it's his 'work pressure', I'd term it as a sheer unprofessional behavior on his part. On the other hand, you may start analyzing the pros and cons of providing him with the real documents. Go through your policy papers and don't wait for him to call you up. Also, keep us updated of what follows next!
Steven
Posted: Fri May 08, 2009 11:32 am Post Subject:
he said that wasn't good enough, he needed the "originals" directly from the medical providers. Since then, I have not heard from him.
He's right, that's why you had to sign a med auth, he sends that to your docs with a request for whatever he needs...
Is this a normal timeframe? Is this some sort of tactic to "minimize" the claim? Should I follow up with the state insurance commisioner? His supervisor?
I'd just call him and see where he is on this BI claim? See what he needs to be ready to make you an offer of settlement.Medical treatment was completed by the end of February, so I would think 60 days would have been plenty to gather info and make an offer on a bodily injury claim.
I think your adjuster is probably lazy...or may not even work there anymore and you got lost in the suffle, no excuse..he should've called you with an update...What do you think??
I'd advise calling him...if you get his voice mail zero out and ask to talk with his supervisor, tell them you haven't heard anything in 'x' amount of time, and want to know what's going on with your claim...that should get it moving..
Well, in a way it can be a way to make you impatient so you jump at their first offer. You'd try to get the matters settle at the earliest. It's make the settlement easy.
I don't buy that one in fact it would tick off the claimant, making settlement more difficult...there's no underlining reason here (IMO) other than a lazy adjuster.. :roll:I'd term it as a sheer unprofessional behavior on his part.
I agree with this steven, but not with this...if you're finally not satisfied with his settlement offers
The DOI will not have anything to do with the amount of offer or if it's the correct amount or not (on BI"s) there job is to make sure the carrier is adhering to the fair claims practice laws...NOT ever the amount of the BI offer of settlement.Call him now!!! let us know what you find out and we'll help all we can.
Posted: Sat May 09, 2009 10:55 pm Post Subject: Thanks to all...
Thanks to all for the informative responses. I guess what I was refering to as "minimizing" the claim was the fact that "time heals all". I'm not so sure that if I was an adjuster, I wouldn't want to settle while the "pain" was still so fresh in a claimants mind. What was so painful and inconvient today will just be "remember that accident you were in..." a year later.
I'll be giving them a call on Monday and will let you know what I find out,
Thanks Again
Posted: Mon May 11, 2009 09:42 pm Post Subject: New news...
Called the adjuster today. He said he was still waiting on some med. bills, but had enough info to go ahead and make a settlement offer.
This is something that I've not heard before, although I had $5000 in med bills, only $1500 were "value added", the rest were diagnostic, and therefore add no value to my claim. I can understand what he's saying, just not sure I agree.
Here's what he offered $5000 for med. bills, $5800 for lost wages and $3200 for pain and suffering. I was off work for 3 weeks, under Drs. care for 6 weeks. So, what do you think? Not sure he put a lot of work into this offer, he sounded like he was figuring out as we spoke on the phone, so I'm sure he's got some room to work.
Opinions and advise appreciated!!
The Camper
Posted: Tue May 12, 2009 03:26 am Post Subject:
The DOI will not have anything to do with the amount of offer or if it's the correct amount or not (on BI"s) there job is to make sure the carrier is adhering to the fair claims practice laws...NOT ever the amount of the BI offer of settlement.
Amen Lori. Thank you for clarifying what the DOI does. Regulators, not adjusters. No judicial authority, cannot determine liability or award damages. Regulates insurance companies licensed to do business within the state.
Daystar
Posted: Tue May 12, 2009 04:50 am Post Subject:
They are going to look at diagnostic bills differently then treatment bills. All companies do it. There are some injured parties that go the hospital/doctor after an accident and get every MRI and scan possible which inflates the amount of the medicals when you are talking $500.00 to $2,000.00 per scan. I’ve had some that went through all the scans and nothing was found wrong. They would then go to a couple weeks of chiropractic visits and turn in 7K in bills with 6K of them being a bunch of tests.
As for your settlement, you have to figure out first…. Are they covering your medical bills? Second….are they covering your lost wages? These are the two easy parts. If they aren’t covering everything then you should ask them to cover it.
Pain and suffering? That’s the difficult part of every settlement, and as it has been posted time and again it really is up to you what is fair. Nobody here can tell you what is fair as everyone reacts to pain differently and every accident is different and everyone thinks they are owed differently. Some people think that they are owed the world since they were “wronged”, some are happy with less. It really just depends.
If this was their first offer, it should not be their highest. You may be able to squeeze a little more out of them, but I wouldn’t assume much more. To be honest, it seems like they are not blinking at paying your lost wages which is usually a big sticking point with a lot of carriers. You must have documented it well.
As to putting a lot of effort into your settlement, it really isn’t that difficult for a claim with 5K in medicals. Believe me the adjuster already knows his high end of settlement and didn’t offer you basically 14K off the cuff. Why it most likely sounded like he was making it up is because he does not have a large amount of room to move and wanted to offer something that you might accept (and wouldn’t offend you) but also leave himself some room to move up if necessary.
You could always make a counter offer…say the 5K in meds, 5,800 in wages and $x.xxK for pain and suffering and see what they come back with. What you have to be is reasonable, but not short change yourself. (I understand that is the catch but if you are happy with the settlement that is all that really matters.) If you go back with a counter that is unreasonable you may get the adjuster on the offensive and negotiations will break down. You need to figure what you want to walk away with past your meds and wages. It also helps if you can give him a reason why you think you are owned more, and no you are not owed more just cause you had the accident. Give him tangible reasons that he can not argue with. I always liked when people gave me real reasons that they thought they were owed more. It allowed me to go back to my boss if I did not have that much authority with something more then “X” wants more money.
Posted: Tue May 12, 2009 10:59 am Post Subject:
GREAT post Dasfuk.. :)
Camper, since he doesn't have all your med bills MAKE SURE he has all the correct amounts...once you're paid you're done, (unless an open ended med release is signed, and 'we' really would prefer not to :wink: -keeps the claim open longer :wink: ) just make sure that 5000 is the total of all your medical bills..
Don't think you posted exactly what your injury was...if this is a soft tissue, chiro and/or PT injury and you're feeling ok now, I think the adjuster is being more than fair...what is/was your diganosis?
As Das said, he will NEVER offer the top of his range first...so since he's offered 14k, I'd say that his range is likely 13-16k ish, maybe little less or little more...once you ascertain that the med bills and your loss of wage (is he paying you gross or net in the 5k figure?), then you'll have to decide how much more you think you're due for the suffering of it...let us know your injury, and we might have a better idea where the adjuster is coming from...
Posted: Tue May 12, 2009 09:04 pm Post Subject:
Thanks for the replys Lori and Das,
Don't think you posted exactly what your injury was...
Yes, soft tissue, scrapes and burns from the airbag, and just generally "beat up". Head on collision at 45 mph. Treatment was rest and PT. Fully recovered, now.
(is he paying you gross or net in the 5k figure?),
That would be gross, plus overtime, and yes, I documented lost overtime with 3 weeks of paystubs and a letter from my employer.
I will be crunching the numbers, going over the med. bills and hopefully going back to him with a counter offer next week.
I'll let you know how it goes.
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