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It’s
8:00 AM on a Thursday and a clear, dry day. You’re on your way to work in your
motor vehicle proceeding North on Main Street in your home town. You’re 64 years
old and the assistant manager of a local video store.
Fred Fuddle is a chronically
unemployed local with a reputation for being a loud-mouth degenerate who has,
over the past several years, been arrested for drunken, disorderly conduct.
Fuddle is driving
his dilapidated van at a high rate of speed, proceeding East on Elm Street.
As you approach the intersection of Main and Elm you have a green light. You
proceed through, perking along under the posted speed limit. Too late, Fuddle
suddenly realizes he has a red light. He hits his brakes, leaving 70 feet of
skid marks behind him as he flies into the intersection. The front of his van
strikes your left rear with a mighty crash. Your arm hits the steering wheel
and the $300.00 watch your loving spouse gave you for your last birthday, is
destroyed. The Property Damage to your motor vehicle will be determined to be
$1,700.00.
The police investigate
at the scene. Fuddle is charged with dangerous driving which you soon discover
is written into in the Police Report. The ambulance takes you to the Angel Of
Mercy Hospital Emergency Room, where you’re x-rayed and treated. Diagnosis:
A severe strain to the cervical-dorsal area, which is a "Whiplash -Type" of
injury.
You’re eventually
treated by your family physician, Ole’ Doc Comfort. You later ask for and receive
copies of all Medical Reports from the Angel Of Mercy and also a copy of the
"Final Medical Report" from Doc Comfort.
Shortly after
impact you asked your son “Chip” to return to the scene of the accident where
he takes a dozen photos of the skid marks plus the damages to your motor vehicle
and Fuddles van. Chip very wisely visits the police station where he purchases
a copy of the report that the Cruiser Patrolmen wrote at the scene.
PROPERTY
DAMAGES: Cost to repair your motor vehicle is $1,750.00 plus
the replacement of your wrist watch will be $300.00. YOUR TOTAL PROPERTY
DAMAGE LOSS COMES TO: $2,050.00.
THE
BASE FORMULA does not include Property Damages! These will be added
on when you come to the value of your Personal Injury after you settle your
case. Your case is going to yield four initial values:The "Low", "Middle", "Mean"
and "Premium". So now, let's determine what those 4 figures have come to be:
After you've finally recovered
and been released from treatment your provable damages are: Ambulance $311.80,
Emergency Room $387.46, X-Rays $215.00, Dr. Comforts Final Bill $468.30, Prescriptions
For Pain $87.98, Heating Pad $68.56, Plus your "Lost Wages" ($700.00 a 5 day
week or $140.00 a day) for a total of 6 days or $840.00. So, your "Special Damages"
come to a total of $2,379.10.
To discover the 4 values (Low/Core/Mean and Premium) you multiply
that $2,379.10 by 2, then 3, then 3.5 and finally 4. The four BASE FORMULA
values you going to come up with are:
2. X $2,379.10 = $4,758.20 * The "LOW VALUE" is $4,758.20
3 X $2,379.80 = $7,139.40 * The "CORE
VALUE" is $7,139.40
3.5 X $2,379.80 = $8,329.30 * The "MEAN VALUE" is
$8,329.30
4 X $2379.80 = $9,516.40 * The "PREMIUM VALUE" is
$9.516.40
The four values listed above descend from the lowest to
the highest. These four values provides you with a minimum (Low
Value) and a maximum (Premium Value) which places your
Personal Injury claim value into "The Correct Ballpark" of the four BASE
FORMULA VALUE'S, (plus your Property Damages).
No two cases are alike. You should
begin with the CORE VALUE you've arrived at as a "starting point" and
then add or subtract weight to the claim based on the circumstances and variables.Typically
more "Variables" must be added (and/or subtracted) in order to determine what
your "Pain and Suffering" is worth.
"Variables" include things such
as the extent of your personal injury (visible bruises or scars, etc.) as well
as the personal character, profession, age, and driving record of both you and
the other driver involved in the accident. In other words if you're an unemployed
ex-con, you should realistically deduct points and could end up at shooting
for the LOW VALUE. Whereas if you're a 73 year old retired lady school
teacher, who is loved and admired within the community, you should probably
attempt to receive the PREMIUM VALUE.
Your case has a number of positive
factors that fall on your side of the evaluation ledger, such as: Fred Fuddle
is far from being a model citizen. He was driving his vehicle much too fast,
as evidenced by the skid marks Chip captured on film. The police cited Fuddle
for operating his van in a dangerous manner, as proved by the copy of the Police
Report, which you now have in your possession.
Your Ole’ Doc Comforts Medical
Report (which you have a copy of) indicates you sustained a “Whiplash-Type”
injury to the cervical-dorsal area. Following Doc Comforts instructions (as
stated in his report) you purchased a heating pad (a copy of that bill you have
for proof) which you used to help relieve your “Pain and Suffering“. In addition
to the hospital bills, you’ve also kept copies of the pain killer prescription
drugs that Doc Comfort insisted you must take.
THERE ARE FIVE IMPORTANT ELEMENTS
WHICH YOU MUST IMPLEMENT INTO YOUR "EVALUATION" AND HOW THEY WILL IMPACT UPON
THE BASE FORMULA FIGURES YOU'VE COME UP WITH. They are as follows:
(1) THE FACTS: The gathering
of the provable factual information is crucial. If you try to evaluate your
claim without as complete a file of facts as possible it's like going hunting
for a lion with a slingshot!
(2) THE EVIDENCE: You must weigh all factual
evidence known to you plus the actual evidence you can produce to substantiate
it. No matter what information you believe you're aware of you must have the
evidence to back you up. For example, you can talk until the cows come home
about the unsightly black-and-blue marks you had on your arms, ribs and/or hip,
the slash on your forehead, or the 70 feet of skid marks Fuddles vehicle left
on the highway, before he smashed into you, but Adjuster Smart may never adequately
comprehend this unless you provide him with photographs. Providing Smart with
proof-positive photographs will cause his Supervisor's eyes to bulge as he inhales
a deep breath of resignation and declare, "Hey, this one's gonna cost us".
QUESTION: "How can Dan be so sure about that"?
ANSWER: "Because before Dan retired (after spending over 30 years on
that firing line) he was an Insurance Adjuster, Supervisor, Manager and Trial
Assistant. He's been there, saw, plus heard (and felt)
that thousands of times!"
(3) THE LAW:
As proved in over 83% of the motor vehicle accidents in the United
States in 2002 the impact that you were subjected to is clearly the fault of
"Fumbling" Fred Fuddle. And that being so, in the vast majority of motor vehicle
accidents, the law is on your side.
(4)
INJURY TO YOU: The seriousness of your injury has to be considered. (Ole'
Doc Comfort, your attending physician's Medical Report, must go
into detail about that). Your age will have an affect on the time it takes you
to recover and the time you lost from work has a direct bearing on the length
of your recovery.
(5)
INTANGIBLE ELEMENTS: These include your reasonableness, your economic status,
your standing in the community, the obvious sentiment conjured up when one considers
the degree of the seriousness of your injury, how long it took you to recover,
plus the attitude of Fred Fuddle regarding your case. Sympathy will come into
play if you're a widow or a highly respected Little League Coach, in contrast
to your being identified as a raucous bum with a history of getting into scrapes
with the law. Emotional factors have considerable weight in the evaluation of
a claim. Whatever the intangible elements may be, you must force yourself to
investigate and then evaluate them (as objectively as possible) so, if what
your telling Adjuster Smart is being identified as "Incorrect" by Smart or his
Supervisor you can prove their conclusions not to be true - -
when and if it becomes appropriate you must do so.
SEVEN
QUESTIONS & ANSWERS WHICH SHOULD ASSIST YOU IN MAKING THE PROPER DECISION OF
WHICH OF THE FOUR "BASE" VALUES TO SETTLE YOUR CLAIM AT:
QUESTION
#1: What do claims adjusters attempt to determine when examining a Property
Damage Repair Invoice?
ANSWER:
Typically they look for (A) Replacement parts that were not damaged by the accident.
(B) Replacement of parts that were not damaged at impact. (C) Charges made for
new parts, although used parts were actually installed. (D) Overcharge of parts.
(E) Duplication of parts and labor items. (F) Inclusion of previous damage written
into the new damage estimate. (G)
Plus: Believe it or not - - Incorrect addition!
QUESTION
#2: Must I accept the claims adjuster settlement value for what he has determined
to be a "Total Loss" of my motor vehicle?
ANSWER: The answer to that one is "ABSOLUTELY NOT"!
The figures in Guide Books, such as THE KELLY BLUE BOOK, are not written in
stone.There's no law that requires an individual to accept the Property Damage
figures the adjuster came up with. If the price that's stated seems too low,
you may refuse it. It's written into all proper Property Damage Agreement's
that depreciated values are reached by using common sense, negotiation and mutual
agreement. Because of this you must never be hesitant to bargain, dicker
or even argue with the adjuster.
QUESTION #3: How do I make sure I've obtained all the proper information
regarding the Property Damage estimate of my motor vehicle?
ANSWER:
In the vast majority of motor vehicle accidents there is an "Agreed Cost To
Repair" which has been arrived at between the body shop and the adjuster. That
should be more than sufficient and acceptable!
QUESTION
#4: I have "Medical Payments" coverage on my Auto Insurance Policy. How
does that work?
ANSWER:
This type of coverage will pay you, up to the stated limits, for all the Medical
Bills arising from your accident - - regardless who is at fault!
(You should read this coverage carefully because so many people are covered
in so many different ways).
A
WORD HERE ABOUT HEALTH INSURANCE PLANS: In certain instances it may be possible
to have your medical bills paid (and yet avoid any repayment)
by using your non-automobile Health Insurance Policy and/or some other Insurance
Plan you may have. (Yes, that often means you may be able collect
twice for the same medical bills)!
QUESTION
#5: How do my medical bills impact the value of my personal injury claim?
ANSWER:
The higher the medical bills the greater value of your claim. Be sure to obtain
all bills for medical services rendered PLUS the "Final Reports"
regarding your physical condition. Make sure these reports include the length
of time of your "Total Disability" and/or your "Partial Disability". "Why?"
Because that will go a long way in justifying both the "Pain and Suffering"
you've had to endure and your Lost Wages. These reports should be in your possession
and not sent directly to the insurance company.(You should keep the originals
and hand, or send, only copies to the adjuster).
QUESTION
#6: What about my "Lost Time From Work?"
ANSWER:
Your entitled to be paid for every single dollar you lost - - even if
you've been reimbursed by some other insurance coverage you may have!
You're entitled to compensation for your "Lost Time and Earnings" Even
if you have no loss of money such as, for example, when your salary
is paid for by some other personal insurance you may have or by taking "Sick
Leave" from work or some other similar arrangement.
QUESTION
#7: Once I know which of the four BASE values I should be shooting
for how do I negotiate a fair settlement for myself?
ANSWER:
Always show the adjuster that you're willing to negotiate in "Good Faith". The
first rule of bargaining is to never lower your demand until the adjuster makes
a counter-offer. You're the "Seller" and the adjuster is the "Buyer". Most of
the time an adjuster's counter-offer, especially his first one, is negotianable.
Your response should be,"Is that your maximum authority?" Now you're asking
him to bid against himself and you've not committed yourself to a lower figure
than your initial demand. Adjusters are all assigned a heavy work load of new
claims each month. Because of this they are continually working to close as
many files as possible, just to stay even! They're under heavy pressure to settle
your claim - - to get rid of it and move on. Most people aren't aware of the
advantage this holds for them.
Alright
now, enough time has passed for you to sit down with Insurance Adjuster I. M.
Smart of GRANITE MOUNTAIN INSURANCE CORPORATION. Smart knows the potential
of your developing more physical problems (which can always be tied into the
accident) is much greater especially because of your age. No matter
which way Smart would like to slice your cake he’s aware that you went through
a ton of inconvenience plus a solid period of “Pain and Suffering”
which has been clearly sustained within the confines of Doc Comfort’s written
report.
PROCEEDING FORWARD WITH THE BASE FORMULA: You have photographs of the
injuries you sustained plus of the skid marks left by Fumblin' Fred Fuddles
van and there's no question that Fuddle is 100% responsible for the accident!
Those 3 facts alone place your claim slightly above the area of the "CORE
VALUE" of $7,137.39. The fact that the accident caused you to lose 6 days
from work, the fact that Fuddle was cited for "Dangerous Driving" (plus Doc
Comforts Medical Report clearly states you sustained a "Whiplash Injury") raises
you even further up into the area of the "MEAN
VALUE" of $8,329.30. Your settlement demand should always be a little over
twice that figure or (in this particular
situation - - as detailed above) $17,000.00 (plus your Property Damage of $2,050.00).
Adjuster
Smart will hem, haw and splutter but you should stick to your guns. As described
above the personal injury portion of your claim is worth a minimum
of $8,329.30. Don't let him con you into anything less than that.
And, if you're willing to fight him right to the last shot (with the positive
variables working for you - - as detailed above) you should be able to settle
your loss for close to ten thousand dollars - - plus your Motor Vehicle
and wrist watch Property Damage's.
During
the difficult days (or months) of dealing with Adjuster I. M. Smart never allow
the thought's of a trial come foolishly stumbling into the gray matter between
your ears, to trip you up. Cases are decided on the evidence. When reviewing
cases before them judges never use the phrase, "The truth of the matter is".
But rather they say, "The evidence shows". You've got the evidence and both
Smart, and his supervisors at Granite Mountain Insurance Corporation, know that
to be true. Hang in there and don't give up because THE BASE FORMULA
has provided you with what you need to get the amount of settlement dollars
you deserve.
By: Dan
Baldyga Email: dbpaw@comcast.net.
Copyright (c) 2004 By Daniel G. Baldyga. All Rights Reserved. Reprinted with
permission. Dan Baldyga has a lifetime of experience in motor vehicle accidents,
personal injury and compensation. Over the years Dan has written several "How
To" book's on this subject matter. Dans latest book AUTO ACCIDENT PERSONAL INJURY
INSURANCE CLAIM (How To Evaluate And Settle Your Loss) can be found on the internet
at http://www.caraccidentclaims.com
OR http://www.autoaccidentcaims.com
DISCLAIMER:
The only purpose of this article ~ BASE ~ THE BALDYGA AUTO ACCIDENT SETTLEMENT
EVALUATION FORMULA is to help readers understand the motor vehicle accident
claim process. Neither Dan Baldyga, EXPERTPAGES.COM nor FREEADVICE.COM make
any guarantee of any kind whatsoever; NOR do they purport to engage in rendering
any professional or legal service; NOR to substitute for a lawyer, an insurance
adjuster, claims adjuster, or the like. Wherever such help is desired it is
THE INDIVIDUAL'S RESPONSIBILITY to obtain such services.
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