by Guest » Thu Oct 09, 2008 12:35 pm
Hello! Back in December 2006 I was a passenger of a car that was in an accident. My husband was going about 45 mph when this 17 year old pulled out to make aleft turn, hitting us on the front passenger side. There were no immediate injuries. The car had about $2500 in damages. About 3 weeks later I started getting a terrible migraine and neck pain that was constant.
I don't want to get into allthe specifics because I'd be writing all day, but I have been on countless medications, have had many procedures done, and multiple diagnosis. Whiplash, Degeneration, tiny bone spur, Cervial Spondylosis, and the latest Firbomyalgia. At this point, I don't really care what it is called. I am still in pain. It is a little better than before, and not constant. I am averaging 2-3 days of neck, shoulder, and head pain.
My medical bills are around $30,000 and time missed from work is about $2,000. Since the statute of limitations is coming up, I have to begin the settlement process. The insurance company offered me $30,000, which doesn't cover all my expenses, nor future medical since I am still undergoing treatment. I have decided to get a lawyer to handle this.
My question is this: There is a lein on my medical insurance of $20,000. Meaning they are entitled to this amount as a result of the accident. Since I got a lawyer she is going to take her part. My question is what happens if we settle for a low amount and there isn't enough to pay the insurance lein, will I be responsible for paying that? Or what if there is enough, but not enough to pay me for my out of pocket expenses and pain and suffering, does the insurance company get their cut no matter what?
I don't want to get into allthe specifics because I'd be writing all day, but I have been on countless medications, have had many procedures done, and multiple diagnosis. Whiplash, Degeneration, tiny bone spur, Cervial Spondylosis, and the latest Firbomyalgia. At this point, I don't really care what it is called. I am still in pain. It is a little better than before, and not constant. I am averaging 2-3 days of neck, shoulder, and head pain.
My medical bills are around $30,000 and time missed from work is about $2,000. Since the statute of limitations is coming up, I have to begin the settlement process. The insurance company offered me $30,000, which doesn't cover all my expenses, nor future medical since I am still undergoing treatment. I have decided to get a lawyer to handle this.
My question is this: There is a lein on my medical insurance of $20,000. Meaning they are entitled to this amount as a result of the accident. Since I got a lawyer she is going to take her part. My question is what happens if we settle for a low amount and there isn't enough to pay the insurance lein, will I be responsible for paying that? Or what if there is enough, but not enough to pay me for my out of pocket expenses and pain and suffering, does the insurance company get their cut no matter what?
Posted: Thu Oct 09, 2008 01:22 pm Post Subject:
If the other person's auto carrier has been sent a lien, they are responsible for paying that full amount. If they are arguing partial negligence against your husband (I doubt they are) then they would only owe a percentage of the lien. You would not be responsible to pay any remaining amount to your health carrier.
It sounds to me like the other auto carrier is arguing that some of your condition was pre-existing. As such (and/or, if so) your health carrier should not be attempting to recover 100% of your medical treatment. So you can always make a deal with your health carrier to accept a much lower amount.
What you really need to do is speak to your attorney about this... as you are paying this person a lot of money to answer your questions.
Posted: Thu Oct 09, 2008 03:01 pm Post Subject:
Tscope is really very correct here. I had soo many questions after my accident and came here for help. One of the other members suggested I make the atty take time to talk to me and help me understand it all. After all this is what we are paying them for
Mine is not settled but I know they put a lein against it (my health ins.) You have no choice but to pay them back first. My only problem is my atty keeps requesting from bcbs to show their right to recover the money..They either say they are going to get the document out or don't respond to phone calls. I am just hoping if it settles and they haven't proven their right to recover that they can not come back against me later for repayment. I will let the atty take care of that.
Posted: Fri Oct 10, 2008 09:41 am Post Subject:
At this point, I don't really care what it is called
You may not care, but the at fault carrier does care, as an example,Degeneration, tiny bone spur, and the latest Firbomyalgiafibromy
are NOT caused by an accident..(I'm not sure about Cervial Spondylosis,but i dont' think it is either)...so these things and treatments would not be or should not be subrogated or a lein against your settlement nor should they be considered in your pain and suffering settlement.Posted: Fri Oct 10, 2008 12:50 pm Post Subject: RE: Insurance Settlemet Question
Its not that they are arguing a preexisting condition, they just feel that for what has been found that it does not justify the treatments I have had. But the bottom line is that I was diagnosed with whiplash and the treatments I had were exactly the way whiplash is treated.
As for the dx, honestly I hear something different from each doctor. I really think they don't know what is wrong. The fibro came out of no where really, as I was not tested. But I researched it and infact I read (I believe on the Mayo clinic's site) that it can be caused by trauma to the neck area.
I can tell you that my pain is from the accident. I had no migraines, muscle spasms, or neck pain before the accident.
One thing my atty said is that the kid's insurance company wouldn't be offering me that amount of money if they didn't think that I had a a true injury from the accident.
I have an appointment with the atty on Monday to talk about the case and how we will move forward with the settlement.
Thanks!
Posted: Fri Oct 10, 2008 06:20 pm Post Subject:
Stop back and let us know how your appointment went. Sometimes it is hard to diagnose an injury. I feel that if you stick to one doctor,preferably your family doctor, they will help you figure out the whole mess. I was injured recently and sometimes got disgusted when they couldn't figure out what was wrong but I hung in their and worked with my doctor and finally got on the path I needed to be.
Posted: Sat Oct 11, 2008 01:53 am Post Subject:
OP, I in no way intended for you to get the impression that I don't think your pain is from the accident, I'm quite sure it is...just the multiple diagnosis' will be a mess for the carriers involved to sort out....
Be sure and talk with your attorney about the possiblity for some of these treatments being 'not' accident related (maybe) thus not subject to subrogation from your settlement...Also don't forget to discuss with your attorney (re: tcope's advise) about negotiating the bills and/or subro amount.
Please do let us know what your attorney has to say and if there is anything else we can offer assistance with please don't hesitate to ask...
(p.s. I (unfortunately) know ALL too well about degenerative disc disease, bone spurs, fibromyalgia, cervical spond., multiple herniated discs and multiple vert. fractures...although no claim....I have all the empathy in the world for you, God bless)...
Posted: Sat Oct 11, 2008 01:56 am Post Subject:
with this kind of case, you really need some professional help like from your attorney. its the best thing that you need to do. its hard to do things that you aren't sure of...
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