by Guest » Wed Sep 21, 2011 09:44 am
Hi,
I messed up the dates in my record and realized I only have two weeks to file a claim for the following:
- Was on bicycle in official bike lane. Driver of vehicle swerved into bike lane to park without seeing me, I hit car and fell.
- I did not get ambulance (should have) despite pain in chest, went to primary care the next day.
- Driver was on way to a probation meeting, admitted fault.
- I was diagnosed with a couple of fractured ribs by physician, though no X-ray was taken. I specifically raised this with him, and his response was that treatment did not change because there is no change in treatment for this. There was more minor soft-tissue damage.
- One follow up visit after a month to record continuing symptoms (pain with deep breaths, trouble sleeping - these symptoms persisted for a couple of months)
- Still have a strange sensation in rib when I work out, but have not gone back for treatment, hence "gaps" in coverage were I to raise the issue. I would still prefer to put off settling until I have figured this issue out, but its too late for that.
- Total medicals are low in this case: around $600 in doctors visits and medication, largely because there is nothing to do for the injury except let it heal. Property damage of $500 to bicycle.
- Insurance company accepted fault, harassed me aggressively to settle early, but I wanted to wait until recovered, and stopped returning their calls.
Now it is VERY LATE (I know, I'm stupid for letting it go). Any suggestions for:
1) the best way to handle this expeditiously? I am thinking I should prepare for filing a suit (possibly a max small claims) and talk to adjuster in parallel. Not sure if I have time to wait on a response to a demand letter, etc. Is this something I can expect to work out quickly via fax/phone with the adjuster?
2) A reasonable value for Pain and Suffering here? I would have paid $15K to avoid having my ribs broken, and if someone wanted to break my ribs, the price would be > $25K given the suffering I experienced. To me that says the truth is somewhere in the middle, but I know this is probably too high by industry standards given specials.
Thanks for any advice.
I messed up the dates in my record and realized I only have two weeks to file a claim for the following:
- Was on bicycle in official bike lane. Driver of vehicle swerved into bike lane to park without seeing me, I hit car and fell.
- I did not get ambulance (should have) despite pain in chest, went to primary care the next day.
- Driver was on way to a probation meeting, admitted fault.
- I was diagnosed with a couple of fractured ribs by physician, though no X-ray was taken. I specifically raised this with him, and his response was that treatment did not change because there is no change in treatment for this. There was more minor soft-tissue damage.
- One follow up visit after a month to record continuing symptoms (pain with deep breaths, trouble sleeping - these symptoms persisted for a couple of months)
- Still have a strange sensation in rib when I work out, but have not gone back for treatment, hence "gaps" in coverage were I to raise the issue. I would still prefer to put off settling until I have figured this issue out, but its too late for that.
- Total medicals are low in this case: around $600 in doctors visits and medication, largely because there is nothing to do for the injury except let it heal. Property damage of $500 to bicycle.
- Insurance company accepted fault, harassed me aggressively to settle early, but I wanted to wait until recovered, and stopped returning their calls.
Now it is VERY LATE (I know, I'm stupid for letting it go). Any suggestions for:
1) the best way to handle this expeditiously? I am thinking I should prepare for filing a suit (possibly a max small claims) and talk to adjuster in parallel. Not sure if I have time to wait on a response to a demand letter, etc. Is this something I can expect to work out quickly via fax/phone with the adjuster?
2) A reasonable value for Pain and Suffering here? I would have paid $15K to avoid having my ribs broken, and if someone wanted to break my ribs, the price would be > $25K given the suffering I experienced. To me that says the truth is somewhere in the middle, but I know this is probably too high by industry standards given specials.
Thanks for any advice.
Posted: Wed Sep 21, 2011 12:17 pm Post Subject:
I think it’s ok to wait until you recover or get better before settling a claim.
However I don’t know why no x-rays were done and how much will you get for pain and suffering because you don’t have documents for it. Insurance companies can really drill you and will invariably pay you the least since you are already confused and repented for being late.
Talk to the adjuster at the earliest and don’t let yourself get further confused by him/her.
Try and get enough documents from your doc to prove your pain and suffering. Produce them as needed and get a proper settlement.
Posted: Wed Sep 21, 2011 12:41 pm Post Subject:
I was diagnosed with a couple of fractured ribs by physician, though no X-ray was taken.
Now I'm no doctor but I also fail to see why x-rays were not taken. Did this doctor have a big S on his chest and wear a lot of red a blue? Perhaps a cape? While I don't know for sure, I don't think a doctor can really know its just fractured ribs without an x-ray and I fail to see why this doctor would not have at least ordered 1-2 x-rays to cover his/her butt in that diagnosis. I wonder what the medical notes state.
I can tell you with only $600 in medical bills and not enough time for the adjuster to see any actual bills or medical notes, your offer will probably be around $1000, perhaps $1500.
I'd say your best bet at this point would be to have an attorney file suit to protect the statute. Of course you then will need to pay an attorney 40% of your settlement.
Posted: Wed Sep 21, 2011 02:18 pm Post Subject:
I'd say your best bet at this point would be to have an attorney file suit to protect the statute. Of course you then will need to pay an attorney 40% of your settlement.
This is not going to attract the attention of any attorney. They aren't going to sign on to represent someone for $200-$500.
This is a small claims matter, if you want to pursue more than what the insurance company has offered. (Have you even talked to them about a settlement at this point? If not, you should.) If you want to sue in small claims court, then you file against the DRIVER, not his insurance company, and you would file for whatever the maximum small claims limit is -- but expect not to get more than what you can prove (your medical bills, lost wages, repair/ replacement of the bike, anything else with an actual $$ value attached). You might get lucky and be allowed a small amount of "general damages" for "pain & suffering", but don't count on it.
If you go the way of small claims court, you will need receipts or other documentation to prove your loss. Without that, you are toast, because the court cannot just take your word for the amount of damages.
Negotiating a settlement with the insurance company in the next week will be easier and less time-consuming.
Posted: Wed Sep 21, 2011 02:55 pm Post Subject:
Its a $1000 claim to you and I. Its a $50,000 claim to an injury attorney. The OP could spit and hit 10 injury attorneys that would take any case that walked in the door. Spend a couple of hours on a $10,0000 or spend 20 mins on a $1000 claim. Filing suit yields 40% plus expenses and the attorney will just file the complaint to protect the statute... nothing else. He/she can than do what normally would have been done if suit was not filed.
Again, the attorney will make a case for fractured ribs, that the OP went through months of pain and that the claim is worth $40,000. With suit filed its no longer an issue of what the claim is worth, rather how much defense costs are. I see that every day. Do I want to spend $5000 defending a $1000 claim or just pay $3000. Its $6000 vs $3000. Sometimes you do need to spend the $6000 but its still twice as much.
Posted: Wed Sep 21, 2011 04:44 pm Post Subject:
Thank you all very much for knowledgable replies.
- Re the XRays: I specifically asked my MD for them. You are correct he can't know for sure, but that was his diagnosis. He did not suspect a punctured lung, hence no NEED for XRays because the treatment does change for fractured ribs (just time to rest and heal). His argument was that, from a treatment perspective, he'd rather spare me the radiation, and he was not going to xray me for insurance purposes (it would have been easier if he did). I have notes of all of this and he is willing to talk to the insurance company if they desire. Does that help?
- I agree that there is not really enough time for the adjuster to go through the medical records, talk to the doctor, etc. Perhaps I should file a small claims suit against the driver, get a court date, but keep negotiating with the adjuster in hopes of resolving it once he has a chance to review everything? Or will the act of filing a claim turn things more adversarial?
Thanks again.
Posted: Thu Sep 22, 2011 05:50 am Post Subject:
If you file a small claims action, that will not necessarily stop the adjuster from working up a settlement. You can agree to drop your suit if you settle with the at fault party or their insurance company. It should not make the situation adversarial.
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