Expert: Claims Guy - 1/31/2010

Question
QUESTION: Hi,i was involved in an accident it was the other parties fualt.i was passenger bumped knee rash on forehead from airbag did not seek med. att.usaa already sent me a chk.The driver had neck back and numbing in her arm,totaled her car missed worked for a week and ahalf.Stayed in hospital for 2 days running test.Is there any set formula for what she might recieve for all her losses in cluding pain and suffering.

ANSWER: There is no set formula.  Many years ago, some people used a rough forumula of 3 times medical bills related to treatment (like physical therapy or surgery) and one times diagnostic bills (like xrays) and lost wages.  But nowadays, insurers try hard to stay away from formulas.  They will pay for the related bills and lost wages, then add an amount for pain/suffering/inconvenience/etc.  

I would need specifics of all the medical bills, injuries, treatment, diagnosis, prognosis, dates, $ amount of lost wages, etc in order to provide an evaluation of the claim.  This is not an easy or objective process.  It is very subjective.  You should try to estimate what a jury would award your friend if the case went to trial.  That is what the insurer will do.  if you provide the specifics, I can give you my opinion.

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QUESTION: recieved rental car two days without vehichle at all.when in at 10 am x-rays,mri,cat scan was done all proved neg. other than inflamation and being sore,released the following day at 4 pm.was told to do follow up week later then released back to work.three prescriptions,300 dollars in lost wages.10,000+ in med bills.If not for me being in town it would have been a real nightmare.No way to pick up son from school, get around,single mom no med ins.thankfully it eas not any worse than it was.Thinking about att. but not sure?Ins. co. is coopearating so far.

Answer
This appears to be an unusual claim in that the injuries were very minor but the medical bills were very high.  If her injuries were just soreness and inflamation, these medical bills are outrageous.  The hospital bill should have been about $500 and it looks like they way over-treated her.

Assuming she healed after one week, I would estimate the value of her claim at about $12,000-$13,000.  She is not responsible for the over-charges by the hospital but it does not make this a high value claim either.

If there is more to the story than my answer might change.

If you hire an attorney, he/she will charge about 33% of the settlement.  If the case goes to trial, the fee increases to 40-50% depending on the attorney.  In many cases, you end up with more money handling it yourself.  You need to consider whether or not you think you can do that effectively.