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Dealing with Insurance Co. - got hit by a car...(11 posts)

Dealing with Insurance Co. - got hit by a car...MPH74
Dec 2, 2002 11:46 PM
hey all, i've read some of the previous discussions on this very subject and found them helpful, but thought i may get some useful feedback by describing the situation i'm in... thanks in advance for your advice.

my accident happend on Nov. 22 in austin, tx. i was traveling on the shoulder and a car coming toward me made a left turn in front of me. tarffic was backed up and two cars (traveling the same direction as me) in the two lanes next to me made a gap for the car that hit me to make that left turn. i never saw it coming since i had no idea there was a gap there. i hit the front quarter panel of the car and my bike and i went flying. the driver was cited by the cops. i was taken to the hospital for a check-up. so far my medical bills are near $2000 and i am going to my regular doc on wednesday for a follow-up. i have no broken bones, but have road rash and plenlty of bruises. i was on cruches for about 5 days. my knee is still sore (and it's making wierd noises - doc may recommend physical therapy...). my bike was trashed. i have gone to two LBS and received replacement cost estimates of approx. $2760 for the bike (2000 model). Including my eye glasses, clothing, helmet, shoes, and a few accesories, the total replacement cost of all my property damage is about $3,619.

i've played phone tag with the adjuster. we haven't spoken yet. i've read everyone's comments pertaining to another case regarding lawyers, small claims court, pain and suffering payment, etc. i'm hoping the insurance company will be reasonable, and we can come to a fair settlement, but i figured i'd see if anyone has any insightful comments based on the facts i've provided... i'd appreciate any comments on how to handle the initial conversation with the adjuster. because of the knee concern i don't think it wise to sign a waiver and settle quickly. i do, however, want to get the property damage taken care of asap cuz assuming my knee heals up, i want to buy a replacement bike to ride asap. will the insurance company be willing to settle the property damage before the medical costs? assuming the insurance co. depreciates my bike i hope that a pain and suffering payment will help me get a new one like the one i had. what is reasonable to expect for pain and suffering? in my case, it's more like a payment for completely screwing up my training schedule!!!! who knows how long my knee will take to heal... i'm not intent on getting more that what is fair, but i appreciate any advice on how to handle the adjuster (or whether i should be seeking a lawyer). thanks a ton!
Glad you are healing.......Len J
Dec 3, 2002 4:41 AM
hope it continues.

My experience so far:

1.) The Ins co has settled the property claim for the replacement value of a 1.5 year old bike. In my case that was $2,750 for a 1.5 year old Trek 5500. They then let me have the bike for $200 from which I've salvaged parts.

2.) In Maryland, there is a program where the Ins co will pay you up to $2,500 (Within the first year) for Medical reimbursment and lost wages. I have filed that claim & received the check for $2,500. All other portions of the claim fall under the Liability portion of the policy.

3.) I have my last MD appt on Monday. After that, I will tally up everything and make a final claim on the INS co. In my case, there are no long term effects that will require additional treatment. The best advice I got (from this board) was to be patient & make sure I was healed before settling. As a condition of most settlements is a waiver of any future claim for this event.

4.) Re: contracting with an attorney: In my case, I went to an attorney & bought a couple of hours of advice. I didn't think I needed to get an attorney to get adequately compensated. An attorney gets anywhere between 30% & 50% of the settlement plus expenses, therefor the settlement has to be significantly larger with an attorney in order for you to put the same amount in your pocket. I figured it out (assuming that an attorney could get the rule of thumb 3 times medical for Pain & suffering) and with $3,000 worth of medical bills, as long as I get a pain & suffering settlement from the Ins co of at least $3,000, I'm even with what an attorney would cost. Anything above that & I'm putting the money in my pocket. The Ins Co knows this & will negotiate an amount that is less for them than if you get an attorney & more for me. Of course the down side of this is that I have to dio all the work.

My case is realativly straightforward though, injuries, while severe, healed predictibly, blame was not contested and losses were simple. If any of these weren't true, I would probably have relied on an attorney.

Good Luck

Largely agree with Len J, but . . .ms
Dec 3, 2002 7:54 AM
I am a lawyer, so there always is a "but" or "on the other hand." First my disclaimers: I do not do personal injury work and I have represented insurance companies in business-related matters (in plain English -- take what I say with a big grain of salt and I also have a potential conflict of interest).

What Len J says makes a lot of sense. It is one of the best guides to claims settlement that I have seen. The real key to any intelligent settlement negotiation is knowing the extent of your loss. The property loss is easy. The personal injury loss often is harder to assess. Until your physician says that your injuries are healed and that he/she does not expect that you will have any future effects from the accident, you are not in a position to settle (at least not without a lawyer's advice). One thing of which you should be aware, each state has a limited period in which you can sue someone -- the statute of limitations. Although the period is two or three years in most states, make sure that you know the applicable period -- you don't want to wait until it is too late.

Len J's advice about contracting with an attorney is excellent. The hidden price for the mantra of most personal injury lawyers -- you don't pay unless we recover -- is that when the personal injury lawyer recovers, he/she takes a substantial percentage of the recovery. Getting advice from a lawyer at his/her hourly rate and doing the leg work yourself makes a great deal of sense to me in a case where a recovery is certain (i.e., what you pay on an hourly basis is far less that a large percentage of your recovery) and there are not a lot of complicating factors. The one thing that I would add is that if you are going to take this route, you need to assess your skills as a negotiator. If you do not like to negotiate or if negotiation is something with which you have little experience, it may be worth your while to have a lawyer do it for you.

Fianlly, I would like to add something that I have wanted to say when I have seen other posts about accidents. I would strongly suggest that anyone who posts on this board should not disclose his/her strategy, settlement point or anything else that he/she would not like to disclose to the insurance company or the other side in litigation. In civil litigation, there is a process known as discovery. In discovery, an opponent can ask you written questions (interrogatories), request that you produce documents and ask you oral questions under oath (deposition). Although your communications with your attorney cannot be discovered, your communications with others can be discovered. A common question that one asks in a case to a party is: "With whom have you discussed the facts of the case." For anyone who posts anything about an accident on this board, the answer would include RBR. The follow up questions would then be for your opponent to find out how to get here and then he/she will read your posts.
whenever there is that much injury involvedColnagoFE
Dec 3, 2002 6:59 AM
i'd probably get a lawyer. it will save you hassles. the insurance company is out to pay as little as possible. they are rarely "reasonable".
I'd get a lawyer if I were youpmf1
Dec 3, 2002 7:57 AM
Sounds like a fairly serious accident that could have long term impacts (and costs). Settling now, before you know what those costs are is dangerous. What if you need a year of physical therapy, or possibly an operation? I can understand that you're hot to get a new bike and start riding it, but this is not something to take lightly.

The insurance company will want to settle asap. They have people working for them who specialize in limiting awards. A colleague (not really a friend) of mine has a wife who used to do this for State Farm. She was kind of a jerk and took pleasure out of pressuring people to accept low-ball award offers. She was good at this and made a lot of money doing it. They have pros so maybe you should get one too.

If they dangle $4000, or $5000 in cash in front of your face, have some control and tell them you need to get some more medical advice. Or better yet, to talk to your attorney. You should be made whole again. That includes a new bike (not a used replacement), all medical costs (present and future) paid and an award for pain and suffering (it has a cost). Don't monkey with trying to get some of the money now. If you really need a new bike, put it on a credit card and wait for the entire award.

Hope everything goes well.
I'd get a lawyer if I were youSteve_0
Dec 3, 2002 9:58 AM
Firstly, I (personally) disagree with jumping right into litigation...not judging others but its not my cupotea;

having said that,,,,if you do pursue litigation, I agree with waiting on collecting money for the bike. Its gonna be hard to convince a jury of this terrible pain and suffering you endured, after requesting immediate replacement of your bicycle so you dont lose saddle time.
in some states property and injury are separate (nm)ColnagoFE
Dec 3, 2002 10:52 AM
I didn't say litigation, did I?pmf1
Dec 4, 2002 8:27 AM
I didn't use the "s" word, did I? Like someone said, a few hours of legal advice may be well worth it. You don't have to sue. I think an insurance company will take you a lot more seriously if you tell them a lawyer advised you to do this and that. It would probably impact the amount of the award.

And yeah, I agree that asking for a new bike pronto and then looking for a big pain and suffering award is kind of hinky.
yes, beware of the insurance company traps and tricksTig
Dec 3, 2002 10:08 AM
We are rookies compared to the insurance adjusters when it comes to playing this "game". MPH74, be very, very cautious when talking with the insurance company. Each statement you make must be deliberate and thought through. Take your time while composing an answer. They are a clever enemy that must be dealt with carefully. They might try to convince you that by turning down their current offer, you won't get a second chance for a claim later (happens only of you accept an offer and sign away your rights to future claims or settlements). They can and may try to limit their payout by getting you do say something that weakens your case. Remember, the driver was cited, so that helps as well. There should have been an accident report written and filed as well.

If things look bad, get a lawyer, but first, don't sabotage your potential case by saying something wrong to the insurance company or accepting a premature offer. If you accept something based on your current losses and injuries, what happens if/when you need knee surgery in 6 weeks or beyond? What happens if PT doesn't help with the knee? Some injuries won't show up right away.

Good luck. I hope you heal up quickly. All of this will be over soon enough.
re: Dealing with Insurance Co. - got hit by a car...MPH74
Dec 3, 2002 7:20 PM
Thanks to all for your input! I'll post the outcome so as to help ya'll out if you ever get stuck in such messes...
re: Dealing with Insurance Co. - got hit by a car...biganddumb
Dec 4, 2002 9:47 AM
I got hit in the exact same scenario (except I got broadsided...ouch) and had similar injuries. I've decided to handle the case myself as well.

A couple of things... If you haven't discovered it already, get a copy of Nolo Press's How to Win Your Personal Injury Claim from the libraty. It has a section on bicycle accidents that I found invaluable. Secondly, my advice would be to keep verbal communication with the adjuster to a minimum. Communicate with them through writing and be very direct. I've only contacted the adjuster once since the accident, and am waiting until all my bills (including the bicycle) come in to make any sort of settlement.

Thanks for the post! And let me know how this turned out.