Expert: Claims Guy - 2/14/2009

Question
Hello,

I did not have to have surgery because I responded well to orthopedic surgeon changes in physical therapy.  I was seen in occupational medicine because I was hit by car during lunch.  Most on my expenses were covered under worker's comp.  My adjuster sent the totals to me.  I will recover 100% however will take about 3-6 months more.  I will need more psychotherapy and will continue medications for at least 6 more months.  I have been discharged by my doctor however was told to return if any problems.  I have returned to work without any restrictions. I will continue pyschotherapy and medications for depression and anxiety.

I will have to begin my probation at work all over again because I was only on job 6 weeks prior to my accident.  I also had to cancel a vacation and put my wedding plans on hold due to my injury.  I had to stop bowling and gained 15 pounds due to my injury.

My medical bills are as follow:

$2,400 for MRI and X-rays.
$2,000 for physical therapy.
$6,000 for doctor and orthopedic surgeon appointments.
$2,000 for phsyciatrist and psychotherapy visits.
$800 for medications.

$22,500 in lost wages.

Thanks

Answer
My opinion is that your claim value falls in a range between $35,000 and $50,000.  Anything in that range could be considered fair.

Claim valuation is a very subjective business.  You are trying to estimate what a judge or jury would award you.  

You have a lot of expenses and lost wages.  But the primary injury was not that serious compared to others.  Many people would have had the same primary injury (knee trauma/strain) and not had as many problems or expenses as you did. They must consider all your expenses/problems but they also can consider what would have happened to most people in the same scenario.

When you start negotiating, make a list of all the negative things that have happened since the accident.  Keep the list brief and in bullet format.  Whenever the adjuster starts to tell you why the claim is worth less, give him one or two reasons from your list why the claim is worth more.  You make an offer, then he/she makes an offer, and go back and forth several times.  Do not be in a rush to settle.  He will want to close your claim soon.  Make him wait a little, and he'll likely offer more to close the claim.  You can probably get his best offer on the 2nd or 3rd conversation.  Probably his 3rd or 4th offer.

Hiring an attorney is always an option, but the attorney will take 33% to negotiate a settlement, 40% to file suit and settle, or up to 50% to go to trial.  This can be a lot of money and you'll probably get more on your own.

Keep in mind I am not an attorney and this is my opinion, and not legal advice.