by adydebra » Wed Jan 26, 2011 03:11 am
My wife and I both suffered neck and back injuries after being rearended at a stop light. The driver that hit us admitted fault and after over twelve thousand in medical bills the offered settlement was offered at seven thousand dollars to us. Does this sound normal and fair as we have never been in this situation before? Any info would be helpful. Thanks Sean
Posted: Wed Jan 26, 2011 03:52 am Post Subject:
There is no real good way to know as "back injury" could mean anything from a sore back to being paralyzed. Your location, age, missed work, treatment, etc. also all come into play. I will say that it sounds "reasonable" if it's just a soft tissue injury.
Posted: Sat Jan 29, 2011 07:04 pm Post Subject:
insurance companies will pay reasonable and necessary charges plus an amount for your general damages (pain and suffering) bodily injury adjusters are trained in researching the medical records. they cross reference ICD-9 and CPT codes vs the notes and prognosis reports from the Dr. to try to determine reasonable and necessary care. Information is collected and compared to other similar cases that have settled and a range value is established to work towards settling.
Excessive treatment by the claimant or Doctor is not owed. Typical soft tissue injury usually doesn't take but a few weeks, maybe a couple months of treatment. A lot depends on the age, condition, and severity of the accident. But unless something was broken or permanently injured or a residual injury (disability), although very painful soreness and limited movement is expected in the early stage of treatment, soft tissue is something that usually will heal over time.
Adjuster also need to know if there are pre-exisiting conditions that could have been aggravated and /or other circumstances that should be taken in consideration, but documentation must exist for the adjuster to be able work with you regarding additional money. I would suggest talking with the adjuster and see how exactly he came to your settlement value. does the adjuster have ALL the information to determine your case? did the the treating doctor overcharge, if so why and how do they know it was not necessary? were there excessive treatments, why was it considered unnecessary? although the settlement is negotiable, it's all about documentation. Your adjuster should be willing and able to discuss all information in detail on how exactly the arrived at the the value of your settlement.
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