Expert: Jane Pytel - 2/9/2012

Question
Hi, thanks for volunteering. I'm writing for my friend Hattie who was just in a car accident with her 12 year old daughter in the car. In Jacksonville, FL. They were hurt and the officer said it was their fault (not even a little possible). The question is about her daughter Amari and what she should accept on Amari's behalf. Amari just had a soar shoulder that the Dr. said was just strained after he took x-rays.

The other car's insurance says they will pay 80% of Amari's bill. And then they extimated it to be $1800 plus the ambulance so they want Hattie to take $2000. Us girls say it doesn't matter what they say, its going to be way too low and that Hattie needs to ask for more incase the bill is higher....and likely it will be since they are the ones estimating it!

What do you think? How does she figure out what to take from the other insurance company for Amari's injury? She tried calling a lawyer but they won't help since she is at fault. What we need is an insurance adjuster's opinion- how does she know what to agree to- is there some formula you use?

Thanks again,
Lisa

Answer
 Hello Lisa,

Let's look at this logically.  First, you state that your friend is at fault.  Why?  Because the police officer said so?  Was he a witness?

The point is, adjusters are bound to conduct their own investigations and they simply cannot take the officer's conclusions as fact.  They need to look at vehicle damages, take witness statements, and come to a conclusion separate from the police report. Yes, they can use the report as a reference, but the fact is the officer is no more a witness to the incident than is the adjuster. And, I highly doubt the officer is an accident reconstructionist.

So how does all of this relate?  Because if the other carrier truly believed she was at fault, they wouldn't offer her a dime!  Why would they?  Sounds like they see liability on their driver and they are simply offering a "cash out" to make your friend go away. Yes, go away.  When she accepts the money, she will be required to sign a release as payment in full for her daughter's injuries.

If the child is not permanently injured, 80% from a company that is supposedly not responsible is fine... especially since she also has PIP benefits.  But what if she has more significant injuries? And what if your friend really wasn't at fault?  If she was not responsible, and if she or her daughter are seriously injured then one or both would be entitled to a fair liability settlement.

You only ask for more if you are actually entitled to it.  

And remember, in Florida we have Florida No Fault (PIP) which pays for the first $10,000 of medical benefits regardless of fault.  If your friend is concerned only about medical bills, PIP will take care of that - or at least a portion of it. If she is concerned about permanent injuries, then liability needs to be argued way beyond what the police officer said!

If there are extensive and permanent injuries, she needs a personal injury attorney.

Hope this helps, Lisa.

Jane Pytel

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