Bodily Injury Claim Bicycle/Car Accident. Please Advise

by lovedalways » Thu Jan 28, 2010 08:31 am

My husband was riding his bicycle to work. The driver in a parked vehicle opened his door at the wrong time and my husband struck the door. He suffered a broken shoulder, broken left-hand knuckle (he is right-handed), lacerations above his eye and in his ear, and a concussion. He does not remember the accident at all. He was taken by ambulance to the hospital and was kept overnight for observation. He had a ctscan, xrays, splint for his hand, brace for his shoulder, and stitches on his eye and in his ear. Our state (CA) law says that the driver of the vehicle was at fault, the driver admitted the fault and the insurance company of the driver accepts liability. We are waiting to settle with the insurance company mainly because medical bills are still pending. My husband is still suffering from headaches/dizziness/pain in shoulder and hand. He is 31 years old and was in good health before this accident. We had a meeting with the claims agent and he basically said that the medical costs/lost wages/cost to repair his bicycle will be covered. He also said that they will consider pain when they offer us a settlement. We are supposed to call him when we are ready to settle.

I have been trying to do research on a fair bodily injury settlement. I understand that there are many factors that lead to bodily injury claims.

I have read that one method you take the medical expenses and multiply by 2, 3, or even 4 based on different levels to give you an idea on what you might receive. But, I am confused by these numbers. Currently, there is about $35,000 (10,000 processed 25,000 pending) in medical expenses billed to our health insurance. Our health insurance negotiates this amount with the health care provider, pays a portion, then we pay a portion. Right now the portion we owe on the 10,000 that was processed is about 1,000. So, I am estimating that once the 25,000 is also processed we will owe another 2,500. So that's 3,500 out of pocket.

Do I use the out of pocket 3,500 amount or the billed 35,000 amount as medical expenses? Multiplying those amounts by 2 are such radically different numbers.

Will my health insurance provider want to be reimbursed for the amount they have paid? (I'm assuming yes) So if yes, then is this part of the settlement amount I need to negotiate or is this something that is handled between the two insurance companies?

I am really just looking for an estimated range here. I have never been in an accident so this whole process is new to me. I'd like to have an idea of a settlement amount before starting the settlement process. Is there a better way to estimate this than the multiplying method? We would prefer to deal with this directly than through a lawyer.

Thank you in advance for any advice.

Total Comments: 4

Posted: Thu Jan 28, 2010 11:14 am Post Subject: Bodily injury claim

Determining the settlement amount for bodily injury claim is difficult. As you said, there are several factors that need to be taken account of before the estimation. The methods of calculating a claim differs from company to company. But it is the insurance company who handles the reimbursement and negotiates with the other company. You need not worry about it.

Posted: Fri Jan 29, 2010 06:13 am Post Subject:

What state are you in?

Posted: Fri Jan 29, 2010 09:42 am Post Subject:

Hi lovedalways

The other party's liability is supposed to pay for bills you receive for medical treatment i.e. cost of medicine, service provided by the doctor, medical equipment, employment related losses. It must also compensate for pain and suffering, emotional distress. A factor of 3 is what you must multiply it by to get the proper estimate of damages.

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