Question about bodily injury settlements: “I was injured in an auto accident five months ago. I was not at fault and the person that caused the accident has no car insurance. At this point my chiropractor just released me after treating neck and back soft tissue injuries. The chiropractor’s notes say I reached maximum improvement, that it is doubtful I will ever get back to pre-accident condition and that I am still in pain. I have to claim through my own uninsured policy. Should I get the maximum bodily injury settlement? I want to do this myself because attorneys want to take 35%. The chiropractic bills and my lost income add up to around $4,500. Should I get the total policy limit?”
Your question raises several issues and I’m happy to answer.
What is my case worth?
People injured in car accidents or other mishaps ask this question more often than any other. Some of the TV lawyers bang their fists on the table promising to “get you what you deserve” or that they’re “not like other lawyers.” In reality insurance companies evaluate all bodily injury claims by computer. For the longest time they denied it. But it’s still true.
Insurance companies and their software look for a number of top indicators in your records. Did you receive medical treatment right away after the accident? If not how long was the delay? Not what excuse did you have for not treating right away, but how soon after the accident was the first treatment and what was the nature of the treatment.
Are medical diagnoses and treatments properly coded? As of the time of this writing some 600 injury codes exist and approximately 12 thousand CPT codes represent various treatments. Another factor, like it or not, rates objective clinical observations more highly than subjective ones.
Case value rises if there are verifiable lost wages backed up by employer documentation and a physician’s statement of disability.
Is injured person represented by an attorney? One study found that represented claimants injured in motor vehicle accidents recovered 90% more than those who did not have attorneys. One insurance industry insider with perspective found that represented people with injury claims recovered “two to five times” as much as those without a lawyer. All of these factors and more go into bodily injury settlements.
Bodily Injury Settlements and Insurance Policy Limits
You should definitely go for the policy limits if the supporting documents and facts support it. What are the limits? Some states have minimum mandatory insurance provision limits. Massachusetts is $20,000. Insurance is not even mandatory in in New Hampshire. But the minimum underinsurance requirement in New Hampshire is $25,000.
Getting back to your question, the underlying facts documented in the case drive bodily injury settlement value and not the arbitrary policy limit. As noted above policy limits vary from state to state. They also vary depending on the coverage people select when they buy car insurance.
People have called me after attempting a settlement and getting bashed down. They’ve made statements and the insurance company is now throwing it back in their face. Oh, you weren’t seriously injured? You didn’t go to the hospital right away? Oh, you only had chiropractic treatment? You said in your initial statement you were “basically OK” after the accident.
See where I’m going with this?
Maximum Medical Improvement
Abbreviated in the medical notes sometimes as MMI this term means that the medical provider that wrote it down has done everything they can do for you. In other words you may not be ready to run a marathon or bench press 500 pounds. At the same time you could undergo medical treatment forever but it won’t get you any further
Those with serious injuries after a motor vehicle accident have every right to pursue an insurance claim, as long as they were not at fault for the accident. Also, when a claim against an insurance company goes forward, setting an arbitrary number, such as the policy limit, puts the case in the wrong perspective. Pain and suffering is a term of art which some say is hard to pin down precisely. At the same time those with serious injuries or any injuries after a serious car accident know what they’re going through. It takes correct documentation and thoughtful presentation to get your claim where it needs to go.
Source: Attorney representation as a factor increasing claim value documented in Delay, Deny Defend, Jay M. Feinman, 2010. See: p. 88. One study commissioned by the insurance industry indicated that minimum impact soft tissue claims doubled in value where the injured accident claimant was represented by an attorney. An industry consulting company reported that generally those represented by attorneys recovered 2 to 5 times more than unrepresented people in their personal injury claims.
What to do after an auto accident in Massachusetts. Click here.
What to do after an auto accident in New Hampshire. Click here.
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