Cyberarted: Mar 7, 2008

Friday, March 07, 2008

Auto Accident Insurance Ode

AUTO ACCIDENT INSURANCE CAIM Getting Reimbursed For Your "Pain and Suffering"

You’ve had a motor vehicle accident some time ago when a local character by the name of Fred Fuddle smashed into your rear end but now you're in the home stretch with his Adjuster, I. M. Strong, and you’re going to be paid for your loss by Strong’s employer, Rock Solid Insurance. A good portion of it will be for your "Pain and Suffering". That is, in the lingo of insurance claim settlements, your "Compensatory Damages". Let's talk about that:

BODILY INJURY PAIN: How much pain can an individual stand? The answer to that is: Reaction to pain not only differs with each of us, but often within each of us. While pain can usually be scientifically measured, the limits of human endurance cannot. We all have a different "Pain Threshold" - - that is, the point at which we begin to feel physical distress as we enter into, and then deal with, a period of suffering.

A lot depends on what's going on in your life and how you experience it. Temperament and psychological factors are involved. Like, for example, your personal life is in a shambles (for any number of reasons) and that has hindered your ability to recover. Or, perhaps the company you work for is on the brink of bankruptcy!

The mechanism through which you feel an injury is so complicated that there are times when the same pain appears to be more (or less) than that of previous days. For example: one day you have a problem that causes you to complain endlessly. This makes you impossible to live with and your pain seems to be much stronger. Yet, a similar situation on a much better day, doesn’t upset you so profoundly and the pain is not nearly as bad.

YOUR "PAIN AND SUFFERING" (Your “Compensatory Damages“): The type of injury you suffered, as a result of Fred Fuddle crashing into you (plus the nature and length of your treatment) are two of the best indicators for both the adjuster and Rock Solid Insurance to consider regarding the "Pain and Suffering" you experienced. However, there are several other areas you should call to the attention of Adjuster Strong so as to make him aware of what you've been dealing with.

MEDICATION: The fact that you were prescribed either over-the-counter or prescription medication by Ole’ “Doc” Comfort, your family physician, to relieve pain, inflammation (and/or any other injury symptoms), will help to convince I. M. Strong that your injuries were serious and caused you to endure a great deal of "Pain and Suffering". No matter which way you slice that cake, the more powerful the medication, and the longer it’s prescribed for, the greater the value your claim will be. That's a fact of life in the business of insurance claims.

LENGTH OF RECOVERY: The longer your recovery period, the greater your "Pain and Suffering"- - therefore the higher the settlement value of your bodily injury. Make sure “Doc” Comfort clearly indicates this in his Final Medical Report. Tell him he must state in writing (via the weeks and months) how long it will be, before you were able to engage in your routine activities. Make sure he doesn't send that report directly to Adjuster Strong. You get it first and then later on you’ll send it along to Strong. But, before you do, read it. If good Ole’ “Doc” Comfort hasn't clearly stated this, hand it back to him and tell him he must. You have every right to insist that he does. You're paying his bills, it's your report, your insurance claim, and your big bucks he's not being serious about!

As long as you continue to have physical problems you should keep going back to see your doctor, again and again, and again ! Other than the obvious "Pain and Suffering" it will help to convince Rock Solid Insurance you’ve endured, there are two other very good reasons for doing this. They are as follows:

(1) The fact that your records show visit’s to your doctor, four, six, eight (or even more) weeks after the accident, will convince Adjuster Strong and Rock Solid that your injury took a long time to deal and required continual attention. (Plus it clearly indicates each and every day you were unable to work and therefore it proves, beyond the shadow of any doubt, the income you lost). Never forget: Your attending physician’s Medical Report is the only way you can prove you were unable to work and in any court of law that will justify your claim for lost wages.

(2) When you visit “Doc” Comfort be sure to tell him there's been little (if any!) decrease of your pain, discomfort, stiffness or immobility. Make sure, when he does execute that Final Medical Report, this is clearly stated in his written remarks. If it isn't you have every right to go back, hand it to him and insist that it is.

SCARS: In many instances large and obvious scaring increase's the value of your claim (big time!) - - especially if the scarred portion of your body is visible. If you've been sitting at a desk for 25 years, your chin is double, your hair is gone, and you own a bulging stomach, and that’s where the scar is, it’s not going to be worth much. But, if you're a tall, dark and handsome, twenty year old and the scar is on your face, than it's worth a ton. Take colored photographs of every scar and every scrape that causes swelling and/or discoloration to your skin plus every mark on your body! After you’ve handed a copy of those photographs to Adjuster I M. Strong he’ll be sending them to his boss in the Home Office. I’ve been in that seat so I can flat out guarantee you his immediate superior in the home office will stare at those photo’s and gulp. He’ll blanch, take a deep breath and send Strong a one liner that reads something like: “Do whatever it takes to get rid of this one. Se! ttle it and let‘s move on.”

If the scar is bad enough insist that Dr. Comfort refer you to a Plastic Surgeon for an opinion as to whether your scar can be repaired and/or removed. Once you've been examined ask that Specialist to detail in writing (and insist that he send his report to you) how much it will cost to make it look right again. You may never get it repaired, and/or removed, but include that Plastic Surgeon's report, plus copies of the bills you’ve accumulated because of your visits to him, and hand them to Adjuster Strong. This will absolutely, positively give your claim more value !

QUESTIONS & ANSWERS REGARDING OBTAINING THE SERVICES OF A LAWYER:

QUESTION: “Is it necessary to obtain the services of an attorney who will take a cut of 33 1/3% of the settlement (in some states up to 50%) he recovers from the insurance company of the individual who struck you“? ANSWER: “Yes, there are some situations where it makes sense to do so“. HOWEVER: Especially in a case where the impact is absolutely not your fault in any way, shape, manor or form - - you should be clear with the lawyer you choose that those out-of-pocket expenses you would have been paid (weather they represented you or not) should not be part of his settlement!

Let’s say, for example: You were at a dead stop while waiting for a light to change from red to green, when struck a tremendous blow in the rear by a distracted driver. It’s 100% clear to all concerned that the damages you received will be paid by the insurance company of the individual that struck you.

The property damage to your motor vehicle is $2,800, your lost wages are $450, your final Doctor’s bill (plus all your other Out-Of-Pocket “Medical Expenses”) comes to $750 for a total (Property Damages/Lost Wages/Medical Bills) of $4,000. you live in an area where the lawyers typical “Contingency Fee” is 33 1/3%. QUESTION: “Should that lawyer take 33/13% ($1,333.33) of that $4,000“? ANSWER: “No“! QUESTION: “Why not“? ANSWER: “Because you were going to get that $4,000 weather there was an attorney representing you or not“! In a situation where the liability is clear the attorney should take, as his fee, 33 1/3% of everything he gets above and beyond , that $4,000!

So, let’s say the attorney obtained a settlement of $4,800 for your “Pain and Suffering”. When that figure is added to the $4,000 of Out-Of-Pocket Expenses (as detailed above) the total would come to $8,800. To be fair he should not take 1/3 of $8,800 ($2,933.33 - - thus leaving you with $5,866.66) but 1/3 of the $4,800 ($1,600 - - thus leaving you with $7,200). QUESTION: “What has he done to earn that additional $1,333.34“? ANSWER: “Absolutely nothing”!

DISCLAIMER: The only purpose of this article ~ AUTO ACCIDENT INSURANCE CLAIM ~ Getting Reimbursed For Your “Pain And Suffering” is to help people understand the motor vehicle insurance claim process. Neither Dan Baldyga nor ARTICLE CITY make any kind of guarantee whatsoever; NOR do they purport to engage in rendering any professional or legal service; NOR to substitute for a lawyer, an insurance adjuster, or claims consultant, or the like. Where such professional help is desired IT IS THE INDIVIDUALS RESPONSIBILITY to obtain such services.

Copyright (c) by Daniel G. Baldyga. All Rights Reserved. Dan Badyga’s latest book Auto Accident Personal Injury Insurance Claim (How To Evaluate And Settle Your Loss) can be found on the internet at http://www.autoaccidentclaims.com or visit your favorite bookstore. For 30 years Dan Baldyga was a claims adjuster, supervisor, manager and also a trial assistant. He is now retired and spends his time attempting to assist those involved in motor vehicle accident claims so they will not be taken advantage of.

Labels: _notyet_cyberarted, Auto+Accident+Insurance, Cars, Health, Insurance

Medical Personal Injury Insurance Serenade

Medical Bills - Evaluating Your Personal Injury Insurance Claim

The value of a personal injury claim has a direct relationship to the amount of your medical bills. Why? Because a claim with medical bills of $500.00 is worth three to five times more than a claim with $100.00, or less. And that’s a fact of life in the world of insurance claims.

The adjuster will reason if you were hurt badly enough to run up $500.00 in medical expenses than it’s correct to assume that your injuries must be substantial. But, if you see your chiropractor or physician only once or twice, and your final bills are in the vicinity of $100.00, that adjuster will assume you weren’t hurt too seriously.

DEMAND THAT ALL YOUR MEDICAL BILLS BE PAID: The adjuster may try to disallow a substantial part of your total medical expenses which he contends doesn’t qualify as “medical” in character. He’ll often attempt to divide your medical costs into two arbitrary parts - - “Diagnostic” and “Treatment”. In the “Diagnostic” category he’ll include items such as ambulance and emergency room costs, costs of X-rays, and other diagnostic procedures, plus visits to specialists. And the rest (principally costs of the hospital and regular office visits to doctors, physical therapy and medication) will be termed "Treatment”. The items that are categorized as “Diagnostic” expenses are the bills the adjuster would like to disallow as not being “Medical” types of activities.

He may try to do this because with a differentiation (between what is “Diagnostic” and what is supposedly true medical “Treatment”) the basic worth of your claim will have been drastically reduced, as the amount of your “Special Damages” and thus drastically reduce the true value of your claim. At that point the adjuster will argue that the “Treatment” portion of your medical bills that’s “directly related” to the severity of your injury, therefore it’s what truly reflects (and measures) your “Pain and Suffering”.

Don’t let him get away with that! If he should attempt to pull this on you tell him, “It’s absurd and illogical to separate medical expenses into two arbitrary categories and designate one as “Diagnostic” and the other as “Treatment”. Each area works hand-in-hand with the other in medical practice. I can’t get properly treated without being diagnosed!

He’ll gulp, because he knows what you say is true and that will usually be the end of such nonsense on his part.

“PERMANENT” AND/OR “TEMPORARY” DISABILITY: In discussing “Disability”. it’s important to develop a working knowledge of these two legitimate concepts. Commonly, personal injuries are classified as either “Permanent” or “Temporary”. These two terms are used basically to describe the anticipated duration of an injury, and not its degree of severity! Thus, if an injury is conceived as one which would continue throughout the remainder of an individuals lifetime, it’s said to be “Permanent” in nature. Conversely, if it’s a reasonable probably that the claimant will attain a full or complete recovery (within some future period) the injury is classified as “Temporary" - - regardless of how severe or extensive the injury might otherwise appear.

TOTAL AND/OR PARTIAL DISABILITY: Another common classification of “Disabilities” will relate to whether they are considered to be “Total” or “Partial”. These terms refer to the actual extent of the claimant’s injuries, regardless of whether they’re permanent or temporary in duration.

THE FOLLOWING FOUR SPECIAL CATEGORIES

ARE REFERRED TO AND UTILIZED IN PERSONAL INJURY LITIGATION

TEMPORARY TOTAL DISABILITY: This is symbolized by a seriously injured person who is temporarily hospitalized or otherwise completely impaired, although expected to eventually regain full function.

TEMPORARY PARTIAL DISABILITY: This is that period when, following the initial period of complete impairment of the seriously injured party (that period of “Temporary Total Disability”), the party recovers and is able to resume some (but not all) formal activities.

PERMANENT TOTAL DISABILITY: This describes a condition (usually applicable in the most sever cases, in which the injury produces a nearly total impairment to the body as a whole) - - again placing the emphasis both on the extent of the functional impairment and its duration.

PERMANENT PARTIAL DISABILITY: This describes a condition where the injured party, (even after sustaining a permanent injury) still retains some substantial body function or earning capacity, with the emphasis centered on the extent of the functional impairment itself.

MEDICAL BILL COVERAGE’S: Read your Motor Vehicle Policy to discover if you have “Medical Payments Coverage”. Also check all your non-automobile insurance policies. You may have coverage(s) to pay 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 may not require you to pay back the medical bill payments made in your behalf - - even if you collect from the person who struck you!

DISCLAIMER: This article ~Medical Bills ~ Evaluating Your Insurance Claim, is intended for background information. Its only purpose is to help people understand the motor vehicle accident claim process. Neither Dan Baldyga, Peter Go nor ARTICLE CITY make no 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, or claims consultant, or the like. Where such professional help is desired IT IS THE INDIVIDUALS RESPONSIBILITY to obtain it!

For more “How To” insurance claim insights read Dan Baldygas latest book AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM (How To Evaluate And Settle Your Loss). This book can be found on the internet at http://www.autoaccidentclaims.com. This book reveals “How To” successfully handle your motor vehicle accident claim, so you won’t be taken advantage of. It also goes into detail regarding the revolutionary BASE(The Baldyga Auto Accident Settlement Evaluation Formula). BASE explains how to determine the value of the “Pain and Suffering” you endured - - because of your personal injury.

Labels: _notyet_cyberarted, Auto+Accident+Insurance, Cars, Health, Insurance