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Got into a car accident October 2012. It was a 4 car accident

Got into a car accident...
Got into a car accident October 2012. It was a 4 car accident to which I was not at fault. My car was totaled while I was on the clock at work. I have since then been to the chiropractor 27xs. My initial visit to the chiropractor (for a pinched nerve in my back) happened 2 hours before the accident occurred.

The insurance company who did claim fault, paid for the damage to my totaled car. Now with processing the payments of my chiropractic visits and payments from the insurance company at fault, I feel I am getting completely minimized in my settlement. The total bill for my chiropractic visits was $4590. My work comp people paid my chiropractor, $2,374.15 thus far. The Insurance company at fault is offering me a settlement of $4500 of which $2,734.15 is going to go to the chiropractor and $2,125.85 would be coming to me.

What I don't understand is, why isn't the chiropractor getting the full amount he is billing for? and why is my settlement from the insurance company less than the actual medical bill? None of this seems right to me. Shouldn't their settlement be based somewhat off the $4590? So both the chiropractor gets paid in full and I get a fair settlement?

Because work comp was involved in this case, I didn't want to seek out legal advice...but since receiving this offer today from the insurance company...I may have to change my plan. This isn't a greed driven motive, it just seems that my medical service provider is getting the short end of the stick as well. And I'm not legally versed enough to know what the next step should involve.

So for all the lawyers looking at this case, what is your advice on this...and is this all just standard procedure for my particular case and I'm complaining for no reason. Or are we getting short ended?

Please advise.
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Answered in 2 minutes by:
4/17/2013
Ely
Ely, Counselor at Law
Category: Legal
Satisfied Customers: 102,923
Experience: Private practice with focus on family, criminal, PI, consumer protection, and business consultation.
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Hello, my name is Ely. Welcome to JustAnswer. Please note: (1) this is general information only, not legal advice; and (2) my function is to give you honest information and not necessarily to tell you what you wish to hear. Note: there may be a slight delay between your follow ups and my replies.

I am sorry for your situation. To clarify, can you please tell me:

1) Is the insure company you are dealing with the company of the insured driver who was at fault, or, your own/your company's (and you had comprehensible coverage)?

2) Did the police come out and if so, who did they ticket, if anyone?

This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. Thank you in advance.
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Customer reply replied 4 years ago

1) Yes, the insurance company (Federated) of the driver at fault is the one I'm dealing with as far as the settlement and lien payment to my work comp. Also my work comp company (Traveller's) is involved...just for clarity.


 


2) They ticketed the person who caused the accident to happen, which is in turn the company who is dealing with me. (Federated)

Thank you for your clarification. Please understand how this works. Once someone hits you and they have insurance, the insurance is liable for the judgment that you'd get against the driver if you sue them (in limited amount, but usually pretty high). Ergo, to avoid paying out huge sums from a judgment where their driver is likely responsible, the insurance company likes to settle the claim to avoid litigation. Once an agreement is reached, you sign a release and waive your rights to sue in exchange for the payout.

But, how does one reach that settlement? The insurance adjuster. The adjuster's job is to make you miserable. They may ignore you, confuse you, and ask for redundant and seemingly needless paperwork in an effort to talk you into a small settlement or have you give up all-together. And their offer will be little. Finally remember, statute of limitations usually only gives you a limited time to file suit, which is TWO years per ARS 12-542.. They know this; they hope you do not. If you miss the two year mark, you can no longer file against their driver, which means they do not even have to work with you.

What they are offering should at least cover:
1) all medical bills;
2) all bills for vehicle repair;
3) missed work; and
4) pain and suffering.

Not that they have to, but because they know that you'll at least get that in Court. The last one (pain and suffering) is the wild card, and there is where they will try to avoid paying much.

The chiropractor is receiving their full payment because this is what they have charged to the insurance company. The insurance company is attempting to pay as little as possible, and is skimping off the top of their little offer to you to pay the chiropractor even more so. In other words, they are trying to take advantage of you. Once you accept that payment, the matter would be deemed finalized and you can no longer bring suit.

An attorney usually cuts through this malarkey since the adjuster knows counsel does not put up with this and WILL file suit if needed unless a decent settlement is offered (whereas here, they do not see you as much of a threat without an attorney since you filing or winning a suit without counsel is unlikely). Then a settlement is usually reached. The attorney should take this on a contingency basis, meaning they do not get paid unless you do. Usual set up is their take is 33% settlement, 40% win at trial, 45% at appeal; plus some office costs. Everything is negotiable.

May I recommend the AZ Bar referral programs - here. The attorneys are vetted and qualified. You should be able to find an attorney you are confident with and whom you can trust, and who is available ASAP.

In the end, even with the attorney taking their percentage, one is still more likely to get MORE from the insurance company than one would if the matter is settled one's self without counsel.

I hope this helps and clarifies. Good luck.

IMPORTANT: Please use REPLY button to keep chatting, or RATE my answer when we are finished. Kindly rate my answer as one of the top three faces before submitting the rating, because this is how I get credit for my time with you. Rating my answer the bottom two faces does not give me credit and reflects negatively on me as an expert, even if my answer is correct. I work very hard to formulate an informative and honest answer for you; please reciprocate my good faith. Do not worry, you may always ask follow ups for free after rating. My ultimate goal is your complete satisfaction.
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Customer reply replied 4 years ago

1 more thing to add about what I should ballpark as a "fair" settlement:


 


My total bill for Medical: $4590


My Total car loss and compensation was: $6,918.77



Only missed 1 day of work.


Pain and suffering over 30 days (if that means anything)

Thank you for your follow up.

My total bill for Medical: $4590
My Total car loss and compensation was: $6,918.77
Only missed 1 day of work.
Pain and suffering over 30 days (if that means anything)


Then, the settlement should at the very least absolve you of any unpaid medical bills out of pocket, reimburse your day of work, and pain and suffering (the variable).

Ergo:

(medical) 4590 + (loss) 6,918 + (employment for one day) ? + (pain and suffering - likely a few thousand at least).

So say $15,000 or thereabouts at least would be fair... Allow your attorney to help you negotiate - the insurance adjusters are notoriously tricky and deviant. They do not have your best interest in mind, but that of the insurance company, i.e. pay as least as possible.

IMPORTANT: Please use REPLY button to keep chatting, or RATE my answer when we are finished. Kindly rate my answer as one of the top three faces before submitting the rating, because this is how I get credit for my time with you. Rating my answer the bottom two faces does not give me credit and reflects negatively on me as an expert, even if my answer is correct. I work very hard to formulate an informative and honest answer for you; please reciprocate my good faith. Do not worry, you may always ask follow ups for free after rating. My ultimate goal is your complete satisfaction.
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Customer reply replied 4 years ago

Ok I guess that other question did not make it into the queue. I will make it brief as possible.


 


I am most likely, going to seek legal counsel in this.


 


Right now, should I even deal with the insurance adjuster directly and respond to her saying that I am not ok with this settlement..and leave it at that? How would you advise going about that, what should I say and sound professional?


 


In my previous response, I was stating that the insurance adjuster thus far was very fair in what they gave me for the total loss of my car and was actually really nice to me and handled all things promptly and professionally (I was actually very surprised at how well she treated me) We happened to find a common ground in that we grew up in the same hometown, and had a couple semi personal conversations. I hope that doesn't bite me in the ass at some point. Maybe this was just tactics on her end so I wouldn't get a lawyer. I didn't exactly get fooled...but I'm a sucker for nice people.


 


Regardless of that, should I have any worries about a lawyer going after my work comp people as well? This is the main reason why I didn't want to seek legal counsel to begin with. Of course that concerns me.


 


This should be the last of my questions...you have been a great help thus far.

Friend,

I am most likely, going to seek legal counsel in this.

Good idea, sir, yes.

Right now, should I even deal with the insurance adjuster directly and respond to her saying that I am not ok with this settlement..and leave it at that? How would you advise going about that, what should I say and sound professional?

One may wish to state something along the lines of, "At this time, the offer is not enough for me, and I am going to explore other options. You will her from me or my attorney soon."

In my previous response, I was stating that the insurance adjuster thus far was very fair in what they gave me for the total loss of my car and was actually really nice to me and handled all things promptly and professionally (I was actually very surprised at how well she treated me) We happened to find a common ground in that we grew up in the same hometown, and had a couple semi personal conversations. I hope that doesn't bite me in the ass at some point. Maybe this was just tactics on her end so I wouldn't get a lawyer. I didn't exactly get fooled...but I'm a sucker for nice people.

It is a tactic. "Is this a bad offer? Nah... the adjuster is U>so nice, it could not be!" Do not feel bad, literally hundreds if not thousands of people settle for less every year just due to these tricks.

Regardless of that, should I have any worries about a lawyer going after my work comp people as well? This is the main reason why I didn't want to seek legal counsel to begin with. Of course that concerns me.

They will not do anything unless you tell them. Do not worry. It is not a "shark unleashed," so to speak. Your attorney should be able to tell you where you can get more, and, get more for you. It is their job.

This should be the last of my questions...you have been a great help thus far.

Thank you for your kind words. Ask as much as you need to - this is why I am here.

IMPORTANT: Please use REPLY button to keep chatting, or RATE my answer when we are finished. Kindly rate my answer as one of the top three faces before submitting the rating, because this is how I get credit for my time with you. Rating my answer the bottom two faces does not give me credit and reflects negatively on me as an expert, even if my answer is correct. I work very hard to formulate an informative and honest answer for you; please reciprocate my good faith. Do not worry, you may always ask follow ups for free after rating. My ultimate goal is your complete satisfaction.
Ely
Ely, Counselor at Law
Category: Legal
Satisfied Customers: 102,923
Experience: Private practice with focus on family, criminal, PI, consumer protection, and business consultation.
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Customer reply replied 4 years ago

Couldn't find a way to say thank you...besides giving you an excellent service Rating.


 


So I just want to formally thank you. Your advice has really made my decision clear on what direction to take next.


 


If I were to think of another question regarding this case, how would I ask you that...and how long do I have to do so?


 


Thank you again Ely,


 


Mike.

Again, my pleasure. You can always come back to this thread anytime - no end date.

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Customer reply replied 4 years ago

I truly appreciate your knowledge and advice.

 

Keep up the great work. I will let you know what comes about in the end of this...or if I reach a snag, I'll reach out to you again.

 

Enjoy the rest of the day or early evening if you are on the east side of the country.

 

I guess the last question I'd like to ask is:

 

Because I went in for 1 treatment almost immediately prior to my accident...should that have any negative impacts on my case? The accident definitely could have made my pinched nerve worse, thus my need for extra medical attention. Could this be the insurance company's reasoning for such a low settlement or should it even matter?

 

 

This will be the last question for the evening sir! I believe I am all clear thus far.

(ignore - edit)

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Because I went in for 1 treatment almost immediately prior to my accident...should that have any negative impacts on my case? The accident definitely could have made my pinched nerve worse, thus my need for extra medical attention. Could this be the insurance company's reasoning for such a low settlement or should it even matter?

Hmm... the insurance can try to claim that this was a preexisting condition, so not caused by the driver. However, the attorney will press them, stating "care to have the jury make that decision?" So likely, this will still end in a settlement. But it may be the basis for their original low-ball offer, yes.
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