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It’s been well over a over a year now that Fred Fuddle smashed into you
broadside doing several thousand dollars of Property Damage to your motor vehicle
and causing you to suffer a Personal Injury. Fuddle was cited by the police
for running a Stop Sign.
You and Insurance Adjuster
I. M. Smart, who represents Fuddle's carrier, The Rock Solid Insurance Corporation,
have jostled each other around long enough. You’ve now returned to work and
your Ole’ Doc “Comfort” has released you from any further treatment. The time
has come to settle your claim plus be reimbursed for the days, weeks, or months
of “Pain and Suffering” you’ve had to endure.
consider the 7 most important Personal Injury Claim areas you must take into
account - - so you’ll end up with the tallest pile of settlement dollars possible:
let Smart go on and on regarding “Contributory Negligence” Regarding: Who’s
at fault? You tell him you’ve read and learned that in the majority of motor
vehicle accidents statistics prove fault can easily be determined, and all the
2003 records show that in 83 percent of accidents it’s clear who was at fault.
End your response with, “Look, your man was nailed for running a Stop Sign,
so let’s cut out the fault stuff and get down to brass tacks”.
#2. TYPE OF INJURY:
If there are severe injuries (which are the result of only
10 to 15 percent of all motor vehicle accidents last year) you should obtain
the services of an attorney. But, if you’ve had minor to moderate injuries,
as, for example: whiplash, bumps, bruises, sprains and/or strains, you can and
should settle the claim yourself.
THE FOLLOWING ARE FOUR SPECIAL CATEGORIES REFERRED
TO (AND UTILIZED) IN PERSONAL INJURY LITIGATION
(a) TEMPORARY TOTAL DISABILITY:
This is the seriously injured person who was temporarily hospitalized, (or perhaps
even impaired at home for awhile) but expected to eventually regain full function.
(b) TEMPORARY PARTIAL DISABILITY: This comes
to pass when, following the initial period of complete impairment of the seriously
injured party (that period of “Temporary Total Disability”), one must recover
from and is able to resume some (but unfortunately not all) of his or her formal
(c) PERMANENT TOTAL DISABILITY: This describes a
condition (usually in the most severe cases) in which the injury produces a
total impairment to the body as a whole - - again, placing the
emphasis both on the extent of the functional impairment, and its duration
(d) PERMANENT PARTIAL DISABILITY: This is when the injured party
still retains some substantial body function or earning capacity. The emphasis
here is centered on the extent of the functional impairment itself.
“BIGGIE” MANY PEOPLE ARE NOT AWARE OF:
You (and your resident family members) may also be covered as pedestrians
- - regarding the payment of medical bills - - should you or they have been
struck and injured by a motor vehicle.
A WORD HERE ABOUT MEDICAL BILL COVERAGES
Be sure to review your Motor Vehicle Accident Insurance
Policy to discover if you have what is usually identified as “Medical Payments”
coverage. Also check all your non-automobile insurance policies. You may have
some coverages which will pay for your medical bills - - regardless of who was
at fault. If you have a Health Insurance policy and/or Health Plan of some sort,
read the fine print. Your policy many not require you to pay back the medical
payments made to you from them - - even when you later collect from Rock
#3. TYPE OF PERSON YOU ARE:
and be brutally honest. You’re most likely Mr. Average Joe, living a normal
life. However, if you enjoy your shots and beers and that often gets your posterior
in a sling (a fact well known to the local police) you’ll have to take that
into consideration when forming expectations about the amount of dollars Rock
Solid is willing to pony up to settle your claim.
If Smart gets into that, you should respond
with, “Look, what you’re telling me has nothing to do with what we’re talking
about here. Your guy ran a stop sign. This case is never going to court and
you know it. We’re not talking about liability here - - only how much money
you should pay me to settle my claim. So, let’s get on with it. Just do the
right thing. I got creamed and you owe me some big bucks.”
#4. TYPE OF PERSON FRED
better Fred Fuddle looks, or the better the “entity” of the owner of the vehicle
(Fuddle’s business or company, etc.) appears, the better for Rock Solid. But,
if Fuddle is the town drunk and a first rate trouble maker, Rock Solid is up
to their eyeballs with settlement problems. On the other hand, if Fuddle is
a well-loved philanthropist, that can be a plus for Rock Solid. And, if the
“entity” that smashed into you was a van driven by Pastor Fuddle, and the named
insured is The Fuddle Camp For Lost Souls, that can come down on the plus side
of the scale for Adjuster I. M. Smart and the people who pay his salary, The
Rock Solid Insurance Corporation.
if the “entity” that hit you was a dilapidated junk pile on wheels operated
by a stumbling, stammering, whacked-out Fred Fuddle and the named insured is
identified as The Fuddle Slam-Bang Refuse Company, that’s a huge minus
for Rock Solid.
a question of liability (who was at fault) these factors often come into play.
However, in this (above) particular example, Fuddle ran a Stop Sign and was
cited for it. Whatever may be negative, and happens to crash down on your side
of the scale, is meaningless when it comes to placing a value on your ”Pain
are 3 areas here that should be understood and must be addressed. They are:
“Medical Special Damages”, Non-Medical “Special Damages”, and “Property Damages”.
MEDICAL “SPECIAL DAMAGES”: These include the cost of Ambulance, Emergency
Room Care, Hospital or Clinic charges, Doctor, Chiropractor, Specialist and/or
Dentist, Over-the-Counter Drugs, and/or prescription Medications, Laboratory
Fees and Services, Diagnostic Tests (X-Rays and CT Scan), Prosthetic Appliances
or Surgical Apparatus (Canes & Crutches), Physical Therapy and/or Practical
Nurse Fees, Ace Bandages, Gauze and Tape, Heating Pads, Creams, Lotions, Ointments,
Balms and Salves.
it comes to listing your Medical Special Damage “expenses”, don’t overlook one
single dollar because, when it comes time to settle your claim, that single
dollar will increase the value of the payment made for your “Pain and
Suffering” by three to five dollars!
What exactly does that mean? ANSWER: It means that a $10.00 “Special
Damage” bill is worth $30.00 to $50.00 more, in your pocket, from Rock Solid
at settlement time. That’s a fact of life in the business of insurance claims.
Take it from Dan who battled his way through and within America’s insurance
claim program/system for over three decades. Believe me when I say, “You can
take these facts to the bank”!
NON-MEDICAL “SPECIAL DAMAGES”: These typically include Lost Wages and Earnings,
Lost Vacation Time and Sick Leave, Travel Expenses (car rentals, public transportation
- - also any expenses incurred getting to and from the doctor and/or hospital)
plus Household Help during disability and even Child Care.
WAGES AND EARNINGS: This is an area where adjusters often take terrible
advantage of people because most know so little about it. Although Smart will
never tell you, Commissions and/or Overtime can be of great advantage to you.
Don’t let him heap a snow job on you about this particular situation. Obtain
a documented letter of proof from your employer (which must include all “other”
payments that would have been made to you, for any other income lost, during
that same period). This can make a huge difference in the value
of your claim. Don’t let Smart twist the facts regarding this additional lost
income. The time you lost from work (including all the extra dollars
you may have also lost) is calculated and this element constitutes what is know
as “Lost Wages”, or “Lost Wage Verification”. (Smart may attempt to go to battle
with you over this but you must stick to your guns. He’s only trying to manipulate
you with one of his typical, and usually most successful, “Con-Jobs“).
Did the injury necessitate a change of job or employment at a lesser rate? Or,
did the injury allow you to return to work but only on a part-time basis? If
the answer to either one of those question’s is “Yes”, ask your employer to
document these facts on his letterhead. If you’re salaried you should obtain
a statement of lost earnings (or “Time Lost Verification”) on your employer’s
letterhead. (This is absolutely “Legit“. Don’t let Smart tell you it’s not)!
CLOSELY TO THIS ONE: In some states you’re still entitled to compensation
for time and earnings, even if you have no actual loss of money! Such
as, for example, when your salary is paid for by your own insurance or by taking
sick leave, or some similar arrangement. If Smart gives you an argument on this
(and he usually will) you tell him you’ve read up on it and he’s dead wrong!
YOU’RE SELF-EMPLOYED: To prove your lost income you’ll probably have to
assemble your routine bookkeeping for Smart to review. If you balk at the idea
of submitting personal documents to him (in the privacy of your home or office)
your only alternative will be to produce them in front of a judge and/or jury
in the wide-open environment of a courtroom. Under normal circumstances, if
you want to prove your damages and collect the compensation that’s due you,
this is your only alternative.
ABSOLUTELY CRUCIAL FOR YOU TO KNOW THE FOLLOWING
if you’ve been paid while out of work, you can still compute your lost time
from work as “Lost Wages” to discover what your “Pain and Suffering” is worth.
This can be achieved by executing (The Baldyga Auto Accident Settlement Evaluation
Formula) THE BASE FORMULA which is explained in my third "How To" Insurance
Claim book AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM (How To Evaluate
And Settle Your Loss) found on the internet at http://www.autoaccidentclaims.com.
PROPERTY DAMAGE EXPENSES:
include auto repair, damaged clothing, broken glasses, cost of substitute car
rentals, plus towing, etc. Keep the originals of all bills. Be sure to have
all documents in your possession when you and Smart hunker down to ”Talk Turkey”.
Photocopies are absolutely sufficient to give him.
vehicle accident victims between the ages of 3 or 5 and into their pre-teens,
generally have outstanding settlement results. Those between the ages of 20
and 55 have a fair case because they’re generally considered to be at the height
of their physical stamina. Those in their late 60’s (and over) often fare extremely
well! This is due to the sympathy they often invoke from a judge and/or jury
when it comes to generalized attitudes regarding frail and the elderly.
SHOULD NEVER FORGET
like I. M. Smart play a crucial role when it comes to the evaluation of your
case. So it's wise to: “Be nice”!
underestimate the importance of Smart's impressions and conclusions! What he
feels and reports about you, his insured Fred Fuddle, and/or possible witnesses
(in addition to the evidence you’ve documented for him) has a heavy influence
on his superiors - - those individuals back in the Claims Department at The
Rock Solid Insurance Corporation Home Office who are reading Smart's memos,
as they come flowing in over the long months of his negotiation talks with you
- - and then finally, when it comes to placing a value on your claim.
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" books on this subject matter. Dan's latest book AUTO ACCIDENT PERSONAL INJURY
INSURANCE CLAIM (How To Evaluate And Settle Your Loss) can be found on the internet
This article, YOUR MOTOR VEHICLE ACCIDENT CLAIM ~ ITS
TIME TO SETTLE - - ARE YOU READY? is intended for background information.
Its purpose is to help people understand the motor vehicle accident claim process.
Neither Dan Baldyga, EXPERTPAGES.COM nor FREEADVICE.COM make any
guarantee of any kind whatsoever; NOR purport to engage in rendering
any professional legal service, substitute for a lawyer, an insurance adjuster
or claims consultant, or the like. Whenever such professional help is desired,
it is THE INDIVIDUAL'S RESPONSIBILITY to obtain it.