How to deal with at-fault party's insurance for medical/property negotiations? (car insurance, red light)

[Amaiziegrace]

My 70-year old mother was in a car accident this weekend, and I’d dearly appreciate some advice. As she was going through an intersection with a green light, a girl distracted on her cell phone blew through the red light in her direction. My mom couldn’t stop in time, and t-boned the back of the girl’s SUV. The girl was charged with the accident, and there were 3 eyewitnesses who remained at the scene the entire time to verify that my mom wasn’t at fault.

My mom didn’t have obvious injuries at the scene, but her back has been killing her since, a repair from rotator cuff surgery several years back is really bothering her, and half of a rear tooth broke/filling came out – we’re guessing at impact.

Today, she heard from the other party’s insurance company – they have totaled her car, and they are offering her about $3K less than she could buy a comparable car for (same model/year/mileage). My mom is so worried about the car part, but I am more worried about the medical part – namely, will she have to have surgery for her shoulder in the future, dental costs, etc. I am sending her to the ER to be checked out tomorrow morning (should have done this to begin with, but she was so resistant to go), and am taking over dealing with the girl’s insurance company myself since my mom doesn’t do well with those sort of things. I’m kind of lost as to what to demand/go to from here. I know there are a million attorney’s we could hire, but don’t want her to lose much of what she might get to an attorney rather than making sure she’s made as whole as possible from an unfortunate event she bore absolutely no responsibility in (I realize I might be wrong to think this – just have no experience here).

If anyone’s been in this kind of situation or has any ideas, would love to hear about it!

[CSD610]

Hire an attorney and let them sort it out.

[markg91359]

Originally Posted by Amaiziegrace

My 70-year old mother was in a car accident this weekend, and I’d dearly appreciate some advice. As she was going through an intersection with a green light, a girl distracted on her cell phone blew through the red light in her direction. My mom couldn’t stop in time, and t-boned the back of the girl’s SUV. The girl was charged with the accident, and there were 3 eyewitnesses who remained at the scene the entire time to verify that my mom wasn’t at fault.

My mom didn’t have obvious injuries at the scene, but her back has been killing her since, a repair from rotator cuff surgery several years back is really bothering her, and half of a rear tooth broke/filling came out – we’re guessing at impact.

Today, she heard from the other party’s insurance company – they have totaled her car, and they are offering her about $3K less than she could buy a comparable car for (same model/year/mileage). My mom is so worried about the car part, but I am more worried about the medical part – namely, will she have to have surgery for her shoulder in the future, dental costs, etc. I am sending her to the ER to be checked out tomorrow morning (should have done this to begin with, but she was so resistant to go), and am taking over dealing with the girl’s insurance company myself since my mom doesn’t do well with those sort of things. I’m kind of lost as to what to demand/go to from here. I know there are a million attorney’s we could hire, but don’t want her to lose much of what she might get to an attorney rather than making sure she’s made as whole as possible from an unfortunate event she bore absolutely no responsibility in (I realize I might be wrong to think this – just have no experience here).

If anyone’s been in this kind of situation or has any ideas, would love to hear about it!

If you needed a brain operation would you operate on yourself? Basically, you are suggesting doing something similar by representing your mother in an injury accident claim when you have never done this before.

I am an accident attorney. I will share this with you: Fees will be about a third of what is recovered, but the part you are leaving out is that the total settlement will be much higher because an attorney is involved. There are statistics from insurance companies that say that cases with attorneys get over 85% of all the money paid in settlements.


http://www.insurance-research.org/re...nsurance-costs

If you insist on doing this yourself ask yourself these questions:

1. If I get a settlement offer will I feel good about it?
2. How many mistakes will I make before I get to the end?
3. Is it fair to possibly cost my mother money by insisting on doing this myself?
4. Do I doubt that someone who knew what they were doing could get a significantly better result?
5. What can I do if the insurance company refuses to be fair in its negotiations? (without an attorney, you lack the power to do things like file suit or pursue an arbitration process)

Do what you will, but think carefully about it.

[Rabrrita]

Originally Posted by Amaiziegrace

I’m kind of lost as to what to demand/go to from here.

Originally Posted by Amaiziegrace

I’m kind of lost as to what to demand/go to from here.

Originally Posted by Amaiziegrace

I’m kind of lost as to what to demand/go to from here.

Originally Posted by Amaiziegrace

I’m kind of lost as to what to demand/go to from here.

Originally Posted by Amaiziegrace

I know there are a million attorney’s we could hire, but don’t want her to lose much of what she might get to an attorney rather than making sure she’s made as whole as possible from an unfortunate event

Originally Posted by Amaiziegrace

I’m kind of lost as to what to demand/go to from here.

Originally Posted by Amaiziegrace

I’m kind of lost as to what to demand/go to from here.

Originally Posted by Amaiziegrace

I’m kind of lost as to what to demand/go to from here.

Originally Posted by Amaiziegrace

I’m kind of lost as to what to demand/go to from here.

How much are you willing to lose for her?

An experienced qualified Attorney will probably get her more after their cut versus what you can get playing Perry Mason.

[howard555]

Originally Posted by markg91359

There are statistics from insurance companies that say that cases with attorneys get over 85% of all the money paid in settlements.

Can you give an example of how it could be as high as 85% or are the statistics by insurance companies far from reality?

The Op's question brought up the various parts of a settlement.

Someone said part of a settlement can include mileage to and from doctor appointments and the IRS allows 55 cents a mile. We saw an IRS site that implied it is closer to 29 cents a mile.

Are multipliers more commonly used or Colossus or other program where the insurance company enters data and they may very well enter the low end of the ranges on each data point?

Thanks.

[markg91359]

Originally Posted by howard555

Can you give an example of how it could be as high as 85% or are the statistics by insurance companies far from reality?

The Op's question brought up the various parts of a settlement.

Someone said part of a settlement can include mileage to and from doctor appointments and the IRS allows 55 cents a mile. We saw an IRS site that implied it is closer to 29 cents a mile.

Are multipliers more commonly used or Colossus or other program where the insurance company enters data and they may very well enter the low end of the ranges on each data point?

Thanks.

This post is over three months old, but I will address your questions:

1. "Can you give an example of how it could be as high as 85% or are the statistics by insurance companies far from reality?"

The statistics are real and may even understate the total bodily injury claims money paid to attorneys.

The first thing you must understand is that an attorney has options that an unrepresented claimant does not. If I am unhappy with a settlement offer by an insurance company I can initiate a lawsuit or, in my state, demand arbitration as a matter of right. Both of these actions cause the insurance company to incur significant expenditures. They must begin to evaluate the claim in terms of not only what they think an injury is worth, but in terms of what the case is going to cost them if they refuse to come up with a mutually agreeable settlement. This is how insurance companies operate. Its a business model where the whole question is to determine what course of action saves them the most money.

I meet people all the time who just can't imagine not taking the highest offer the insurance company will make. I find those offers very low in many cases and insist on resolution primarily through arbitration. In arbitration, a neutral third party gets to decide how much the insurance company has to pay on the claim. The decision is totally removed from the cheapskates that run many insurance companies.

2. Mileage? I don't even claim that as an item of damages. If I did it would add up to pennies in most cases. What I do focus on is a claim for general damages, or pain and suffering. The important thing here is documentation. What do your medical records say? Do you have credible friends and family who can testify that during phases of your recovery from an injury you could not do specific activities? Did you miss any work? Was the reason you missed it for doctor's appointments, hospitalization, or a legitimate medical reason?

3. "Are multipliers used or Colossus or other program where insurance company enters data and they may very well enter the low end of the ranges on each data point?"

I'm not sure what you are asking here. Some insurance companies like Allstate use computer models like Colossus to determine how much they want to offer to settle a case for. I find Colossus to be a total joke. I have stopped even trying to settle cases with Allstate. If I have a client in an accident and Allstate is the responsible insurance company, I file suit almost immediately. I want the case to be resolved by a neutral third party through an arbitration process and I am not interested really in knowing what Allstate thinks the case is worth. I know from past experience that Colossus will come up with some ridiculous number that is totally inadequate.

The arbitration awards I receive are far in excess of settlement offers made to claimants who try to pursue these cases without an attorney. They are in excess of settlement offers received by attorneys who choose to negotiate with Allstate instead of pursuing arbitration.

My process takes time, but it is not outrageously long. I can generally get a result within nine to twelve months of signing up the client.

I have made most of my living over the last thirty years pursuing such claims with car insurance companies. I wouldn't be in business at this point if I had not been successful in doing so. The community I live in is not that large. Word would get around if I could not consistently deliver for injured clients.

[howard555]

Originally Posted by markg91359

The arbitration awards I receive are far in excess of settlement offers made to claimants who try to pursue these cases without an attorney. They are in excess of settlement offers received by attorneys who choose to negotiate with Allstate instead of pursuing arbitration.

My process takes time, but it is not outrageously long. I can generally get a result within nine to twelve months of signing up the client.

I have made most of my living over the last thirty years pursuing such claims with car insurance companies. I wouldn't be in business at this point if I had not been successful in doing so. The community I live in is not that large. Word would get around if I could not consistently deliver for injured clients.

Thank you for the reply and I'm sure it can be of value to others.
We have a close friend involved in an accident and trying to weakly predict the outcome since they have an attorney.

[maggiekate]

Do you have an attorney let them do the fight not you or your Mom. Most lawyers only want big also if your Mom had prior issues it may be hard to prove. Question is it worth stress and court with an attorney who may not wish to take the case. Also if medicare pays they will want money back.

[cheesenugget]

Originally Posted by maggiekate

Do you have an attorney let them do the fight not you or your Mom. Most lawyers only want big also if your Mom had prior issues it may be hard to prove. Question is it worth stress and court with an attorney who may not wish to take the case. Also if medicare pays they will want money back.

All if not most personal injury attorneys will take the case as long as the at fault party have insurance. The firm I used to work at have cases where 70% of them are small 10/20 bi policies. Not only that, if the client's medical bills and anticipated future treatments extends beyond the policy limits, and she have uninsured motorists coverage, the attorney can seek that amount as well. As previously mentioned by a post written by an attorney, they get paid by the %, usually at 33 1/3%.

I'm a paralegal and speaking from experience, it is worth hiring an attorney if you are hurt and needs treatment. There are so many times where we have people calling asking for an attorney AFTER they accepted settlement from the insurance company. They realize how much they got screwed over. We couldn't help them because they already signed a release form.

When an attorney steps in, the opposing side knows better. They are faster to respond to the phone calls, negotiations, and pretty much want to avoid having to go to litigation to defend the case which can take years and costing thousands of dollars in fees and costs. Not only that, your attorney is responsible for making sure you come out with as much money as possible by reducing the costs of your medical bills. Do you know how much time it takes to collect, negotiate and convince medical providers to waive their balances for you? These providers do it because they build a relationship with your attorney and trust him/her. You could not do that by yourself.

People don't understand how much work, stress, and time it takes to build a case. Some attorneys are nice enough to waive administrative costs in hundreds of dollars so you could have more money in your pocket. All your attorney asks for is your patience and cooperation.

Just a quick note about the priors... it doesn't mean you will not collect any money at all. The burden is on the insurance company to find those priors and proof the injuries were related so you would collect less. Your attorney is trained to know how to read the records, mri reports and speak to experts.

And Medicare do not seek reimbursement from you. They create a lien and they would seek reimbursement from your car insurance or the at fault party.

[howard555]

Originally Posted by cheesenugget

Not only that, your attorney is responsible for making sure you come out with as much money as possible by reducing the costs of your medical bills.

We were told that across the board the lawyer gets 33% the entire settlement which includes all medical bills. As a hypothetical example only, if the medical is $3000 then they have to get at least $1500 in pain and suffering because the lawyer gets 1/3 of that as well. $3000 + $1500 = $4500 and lawyer receives $1500 leaving the injured $3000 to pay the medical bills. Also, the legal fee comes out of the gross or original medical bill for doctor #1 even if the patient got a 40% reduction by merely asking. The lawyer sees all three figures and base their fee on the medical bill before any reduction. So if doctor #1 charged $450 but gave the patient 20% off or $90 the lawyer bases their 1/3 fee on the $450 not the $360. This per 4 different local attorneys. Can they all be wrong?