by eeyore241976 » Wed Jul 08, 2009 06:47 pm
Just a little bit of the story. My husband was in a accident. The person was sited for failure to yield to oncoming traffic. My husband was the passenger in the truck that was hit. The driver (my brother-in-law) obtained a lawyer to handle the issue (he has heard nothing from the insurance company or the lawyer).
My husband said he just wanted his medical bills covered, loss of wages and a little kick back for the pain and suffering. He contacted the insurance company himself. They called him up today with a offer for $6k and stated they would pay all his medical bills, he said "so you are going to pay the medical bills and I get $6,000 dollars, the guy said yes" and faxed it over to be signed and a check cut by the end of the week.
My question is, on the Agreement and Release document, there is a paragrah that says: I further agree that said consideration of payment include any medical payments benefits afforded by the Insurance Company by accepting this agreement.
To me it sounds like the medical bills will be deducted out of the $6,000 they are going to give him. On the letter he faxed it states, sign and fax back, once approved I will send you a check and issue the checks to your medical providers. What do you think? Sounds fishy to me but can't be certain. My husband is what you call a redneck and not real smart on the wording of things. HELP!!!!
My husband said he just wanted his medical bills covered, loss of wages and a little kick back for the pain and suffering. He contacted the insurance company himself. They called him up today with a offer for $6k and stated they would pay all his medical bills, he said "so you are going to pay the medical bills and I get $6,000 dollars, the guy said yes" and faxed it over to be signed and a check cut by the end of the week.
My question is, on the Agreement and Release document, there is a paragrah that says: I further agree that said consideration of payment include any medical payments benefits afforded by the Insurance Company by accepting this agreement.
To me it sounds like the medical bills will be deducted out of the $6,000 they are going to give him. On the letter he faxed it states, sign and fax back, once approved I will send you a check and issue the checks to your medical providers. What do you think? Sounds fishy to me but can't be certain. My husband is what you call a redneck and not real smart on the wording of things. HELP!!!!
Posted: Wed Jul 08, 2009 10:38 pm Post Subject:
The release should be for the full amount of the payment, not just the $6000. That is, it should be for $6000 plus the medical bills that are going to be paid. So if the medical bills are $6000, the release should be for $10,000.
Now, I'm betting that the adjuster just made a mistake as those releases can be very difficult to use correctly. There is no much "legalize" in them that adjuster don't know what they say 1/2 the time.
Someone needs to call the adjuster and point out that the release is not correct and needs to include the amount of the medical bills as well. If this amount is not known by the adjuster, then the adjuster should not be sending out the release (as it's not correct anyway).
The release does not change who is paid and how much, it simply settles the injury claim for that amount of money. If needed the adjuster would pay a portion to the medical providers (if given a lien) or your husband and your husband would settle the medical bills. A decent adjuster would get this correct.
My recommendation is to make sure you know the amount of all the medical bills and then have the adjuster pay you directly (for the meds plus the $6000). You can then call the providers, let them know that you've settled the claim and are interested in paying the bill but your settlement was not very much (whatever you want to say) and ask them if they can lower the bill in return for you paying that amount right then and there. In some/many cases the medical providers will take 20%-50% off the bill knowing that it will be paid right away. It can't hurt to ask and it means more money in your pocket.
Posted: Thu Jul 09, 2009 05:03 am Post Subject:
Hello Eeyore241976,
There isn't much for me to add after what Tcope has said :D. Contact the adjuster and let him know about the issue.
If I have got you correctly, you want to receive $6k above the medical expenses, right? How much is the medical cost? Have you made this point clear to the adjuster when you spoke or there were some ambiguity?
What has happened with the lawyer? Have you not contacted your brother-in-law afterward to know about the progress of the claim?
Posted: Thu Jul 09, 2009 07:36 pm Post Subject: I think my husband is being taken advantage of by a insuranc
I asked if the $6k was for the medical bills and compensation and he stated the the medical bills were being paid seperate which total $13K, pending the bill from emergency room physicia this amount orginally said $12,000 and it is listed on a different section of the release. My brother in law called his lawyer to see what was up and the lawyer has not yet returned his calls. Seems to be a ongoing issue witht his guy per my brother in law. My husband didn't want to get a lawyer even though everyone said he could get more. He said a little kick back for the pain he suffered and the bills paid for and he would fine. He feels $6k is more then enough. I have the pdf he emailed me if you would like to see it so it makes more since.
Posted: Thu Jul 09, 2009 08:15 pm Post Subject:
So the release has another section where the specific amounts of the medical bills to be paid are listed? Anything is possible but to me this does not make sense. If it's listed, why list it in a different area? Payment is payment, a settlement amount is a settlement amount. I see no reason to list amounts in two different sections. Unless one is an opened ended amount. Sometimes releases will mentioned something like, "... and up to $15,000 in related medical expenses:.
Posted: Thu Jul 09, 2009 09:15 pm Post Subject:
The first section of the Agreement and Release says For and in consideration of the payment to or for me/us of the sum of six thousand ($6,000) this date and the promise of payment to or for me by the insurance company accepting this agreement of benefits in accordance with the schedule of benefits set forth below.
Then below that paragraph it says BENEFITS SCHEDULE
All reasonable expenses for medical, dental or surgrical treatment, ambulance, hospital, professional nuring and prosethic device incurred within 90 days following the accident and caused by it not to exceed in total for any one person $13,000.
$N/A for each day within n/a days after the accident, continuously and necessarily confined indoors due to injury, under the care of a licensed physician other than himself-payable monthly
Posted: Fri Jul 10, 2009 06:23 am Post Subject:
Okay Stepha, then the insurance company has paid for the medical bills separately. I had the impression from your first post that the release of $6k was all inclusive.
However, it seems that at the most they would release $13k towards the medical expenses. How much you guys have incurred towards the medical bills?
Also, are they going to pay you directly or would direct the check for medical expenses to the health insurance provider? Except this I can't see any other reason for mentioning the settlement amounts separately.
Posted: Fri Jul 10, 2009 12:08 pm Post Subject:
It looks like an open ended release with meds incurred up to 13k for 90 days...Call the adjuster and make sure that is the plan. Also as T mentioned, you need to KNOW how much these medical bills are.
Could be that the adjuster has received a lein from the medical providers and he/she has to pay them directly for the med bills.
Just call and verify that the adjuster has all the bills, that no more are 'out there' and that the 13k will cover those bills.
Posted: Fri Jul 10, 2009 07:02 pm Post Subject:
They plan on cutting checks to pay the medical expense, according to the release they want signed. I just want to make sure that the 6k they are offering is stictly for pain and suffering. From what everyone has said here it sounds like this may be the case. I have asked the adjuster about the cost exceeding 13k, what will happen. He appears to be waiting on 1 more bill.
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