Expert: Bennie719 - 2/6/2008

Question
Bennie,
I am not sure how much you deal with personal injury claims, but I hope you can help.  I was rear ended in August of last year while stopped.  The at fault party's insurer has accepted liability, but is offering only to pay $500 over my medical bills of $1,525.37.  Directly after the accident, I saw a doctor and a started a chiropractic care treatment plan.  The chiropractor's report indicates that "the paravertebral supporting structures were stretched beyond their para-physiological range of motion, resulting in tearing of the tissues due to sprain and strain".  I still experiece pain at times after I have exerted myself physically.  I have written demand letters, and the claims adjuster just responds with their same offer each time.  What can I do?

Answer
Hi Craig,
You should really be able to settle a 'soft tissue' injury directly with the adverse insurance company without having such a major problem.
You mention that you have been sending demand letters to the adjuster, but do not not mention the amount that you are demanding.  This could be the big hang-up in your situation.
You should be made aware that the entire insurance industry, Auto,
Health and MediCare are very anti Chiropractor.  MediCare has a $1,500 maximum annual limit to chiropractors as do a large number of health insurance policies.
An auto insurance company will place a value on a personal injury claim where all treatment was performed by a chiropractor, that is less than 50% of the value they would place if all treatment was provided by a Medical Doctor and prescribed Physical Therapy.
Based on my past experiences, I have found that insurance companies usually offer and settle Chiropractor treated claims for an amount that is usually between 1.2 and 1.5 times your medical bills.
I have found this to hold true (based on questions and answers from people like you) that this amount applies whether you are self represented or have an attorney.
I have received many questions from people who had to reimburse their health insurance company for medical bills when recovery was made from a 3rd party, complaining that their attorney settled their Chiropractor treated cases for amounts that didn't leave them enough to reimburse their health insurance after the attorney deducted his 1/3 fee.
Your settlement offer is about mid-way between 1.2 and 1.5 times your medical bills.  A new demand letter for an amount between $2,275 and $2,300 would probably lead to a settlement of your claim.
I hope this information has been of help.
Your feedback by rating my answer will be appreciated.
Sincerely,
Bennie
San Francisco Bay Area