Am I Being Offered A Fair Settlement?
One question many personal injury victims have after an automobile accident is the fairness of a settlement offer initially made by the insurance company. It is important for personal injury victims to understand that the insurance carrier will try to pay as little as they possibly can on any claim.
If an insurance adjuster can get away with paying 10 or $.20 on the dollar the adjuster will probably get a raise or a bonus but certainly a pat on the back for settling the case cheap.
It is extremely difficult for individuals who do not deal in personal injury on a daily basis to determine what is a reasonable and fair settlement offer by an insurance company. There is a reason why insurance companies may indicate early on, that “they accept responsibility”, and that is to prevent you from believing you need legal help.
Here are some guidelines for analyzing the fairness of a settlement offer!
You were not at fault but the insurance company seeks to sign new partial responsibility for the crash
One tactic that many insurance companies use is to attempt to shift responsibility from their insured to you or another person as a method of reducing what they are offering you.
While the police report in its entirety may or may not come into evidence in a personal injury trial, portions of the actual report should come into evidence. While the determination by the officer at the scene is not binding on the judge or jury and gives you an idea of whom an impartial third-party thought was at fault for the crash.
The offer of settlement has excluded some of your medical expenses that were actually paid!
Texas has had pretty radical tort reform, which adversely impacted every personal injury claim-taking place in the state of Texas. One of the provisions of the tort reform was to limit the amount available for recovery for medical expenses to the amount that was “paid or incurred”, which means the out-of-pocket payments by you and your health insurance company and not the gross amount billed by the healthcare provider. However, if you are on the hook as owing a balance after payments by your health insurance company that should be included in your medical total.
One tactic that many insurance companies use to try to reduce what they pay out for a car accident is to “disallow” some medical expenses under justifications that include:
- The service was not necessary
- The service was overpriced
- The medical expenses unrelated to the accident
- The procedure or test was done too early or too late
- Various other excuses
While this tactic is common, it is not that effective when a case is taken to trial as the insurance carrier will need to obtain some testimony to support their position regarding the disallowing of a medical expense – in most instances.
The Offer Does Not Include Fair Lost Wages
Many adjusters will attempt to disallow lost wages simply by indicating that the medical records do not indicate the necessity for missing work. In other words, they want a written statement from the doctor. While it may seem funny to some, we have seen this tactic used for people who were so badly injured that they couldn’t even get out of bed.
The Insurance Adjuster Discourages You From Hiring An Attorney
If the insurance adjuster you are dealing with discourages you from speaking with an attorney that is probably your first clue that you probably need legal representation. It is only after the initial offers made by the insurance company that personal injury victims understand that they really need an attorney to help them. Unfortunately, by then many times damage has been done to the claim.
Future Medical Needs
If you have future medical needs that are real and concrete and explained to you by your medical providers, that should be a part of you’re discussions regarding a reasonable settlement amount? If a physician testifies in a personal injury trial that the victim needs ongoing medical treatment and the reasonableness and necessity of the cost of it that should be appropriate for consideration by the judge or jury.
If you have future medical needs that are clearly identified in the medical records, and the adjuster is not including that in your settlement offer- it may not be fair.
Very Serious Injury
The general rule of thumb is if your injury is very serious you probably need an attorney. If your injury is minor and her medical expenses small, you may or may not require the services of an attorney to help you through the process.
Limited Insurance Coverage
Every personal injury claim is unique and must stand on its own merits. Nevertheless, attorneys who handle personal injury claims learn through experience the value of an individual claim. The value can only be determined after a thorough review of the facts of the accident and studying the medical records with a fine toothcomb. Additionally, the amount of insurance available to cover the crash can play a part in many valuations particularly when the insurance coverage is limited.
Many people sustain very bad injuries but the insurance coverage is inadequate and unless your defendant turns out to be independently wealthy, the amount of insurance coverage is a big factor.
Houston Auto Accident Injury Attorneys
Hiring an experienced and reputable car accident attorney is often the best step for handling a claim with the insurance company. The ability to file a lawsuit and march toward a jury trial serves as leverage forcing a reasonable evaluation of a damage claim when liability is relatively clear.
To get help on a car accident case in Houston call the Baumgartner Law Firm at 281-587-1111.