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Auto Insurance Claims/Auto Injury Accident Settlement for Pain & Suffering


I was in an auto accident on Jan 30, 2013.  I was not the responsible party.  My car was totaled and I have settled on that portion of the claim.  I was taken to a local hospital via ambulance, had a CT scan for precautionary measures and xrays of my rt foot where the pain was the worst, along with an xray of my left shin where it had hit the underneath side of the dash.  I was released later that day with nothing more than an RX for the pain.  I was off work for 2 days and returned to work with my employer understanding that I would work as much as I could of my 8-hr days.  My left shin was black and blue and swelled up about the size of a softball and my rt ankle and foot were swollen and black and blue.  I could barely walk because each leg was injured.  On day 6 I contacted my primary care physician and they would not see me because of the 3rd party billing so I went to an urgent care.  They did another set of xrays to check for fractures--no fractures, but could tell I had deep tissue bruising.  They provided me with crutches and a boot and could not believe the original hospital sent me home without a boot for my foot or a set of crutches.  For the foot injury they provided me with a name of a podiatrist to contact if the pain didn't ease in a few days.  I was patient and hopeful that the pain would subside.  On March 4th I contacted my primary care physician for a referral to a podiatrist, who I was able to see on Mar 21st.  After seeing the podiatrist I found out I had a dislocated tarsometatarsal, which was treated with a formed insert during multiple visits over a 6 wk +/- period of time.  The inserts are still worn daily.  I have been recommended to return annually as needed for a new shoe insert fitting.  I still have numbness/tingling in my left shin, along with a bruise that seems to be permanent.  My rt foot still hurts, pops and aches.  

On Oct 31st I was FINALLY offered a "one-time pain and suffering offer" of $4,000.  There are two liens against the insurance company from providers, so the insurance company will pay those 2 bills directly.  I will be responsible to pay the rest of the providers directly totaling $8000 +/-.  I will be reimbursed the amount of lost wages I claimed.  So in total, the offer including medical expense reimbursement is $12000 +/-.

Of course, from the time of the accident the adjustor was kind to check in with me to see how I was doing--until all of my medical records and employment records were reviewed.  On the day of the offer she called me during my business hours and asked if we could discuss their P&S offer.  When I asked her to email me detailed information about the offer because I was at work she shut me down, stating she'd rather just do it quickly over the phone.  I told her to give me the numbers, and she rattled them off quicker than I could take notes.  After she was done I asked her to follow our conversation up with an email.  She agreed.  Her email was a simple one-sentence paragraph, no more detailed than our phone conversation.  I responded to her asking her to provide me with a summary of the medical bills along with any other reimbursements (lost wages, etc).  Again, she responded with the minimum information.  

My question I able to counteroffer their "one-time" offer?  I'm not looking to get rich, but I feel that the one-time offer should be MORE than the total medical expenses incurred, not 1/3 of the costs.

Thank you for your time.

 Hello DeeDee,

I am missing one vital element - the liability coverage limits for the at fault driver.  The $8000 is also a serious concern. How has the liability carried justified that?  Do you have PIP?  Will this be covered by your health insurance?

However, based on the information you have provided, I can sum this up for you in one sentence.

You're being ripped off.

You have a permanent injury that could go on for years.  You could continue to miss work.  Your pain and suffering could go on forever.  And, the adjuster wants to settle this with one sentence!

Like most people, you want to settle this fairly.  Unfortunately, insurance companies won't generally pay to be "fair". The problem is compounded because most people only consider economic damages which generally include, but aren't limited to, lost wages  medical bills, and other direct costs.  

What most people do not understand is that they are also entitled to general or non-economic damages which include pain and suffering and distress. General damages are much more complex to calculate.  In general they depend on the extent of injuries and the impact of the injuries on  lifestyle.

I will recommend what I always recommend in these types of questions.  You need to consult with a competent personal injury attorney. Usually, a consultation is free.  Many people resist this because they do not want to split the proceeds (usually 30%).  But a skilled attorney is trained to compute losses based on many factors some of which include future medical bills, your age, your dependents, any permanent limitations as a result of your injuries, impact on your future earning capacity, activities you no longer enjoy, or your long term prognosis.

I strongly suggest that you must not try to do this alone.  All of the tell-tale signs support that. And remember, once you settle your bodily injury claim, you will forever lose any right to additional recovery. Not to mention, if you have UM coverage which might apply, you will need an attorney to assist you with that as well.

Keep one important rule in mind. Almost always insurance companies pay equitably only when they have no other alternative. Generally that occurs only for claimants who are attorney represented.  The only exception would be a payment of full policy limits.  Rest assured, that rarely occurs.  Unless the limits are extremely low and the carrier accepts that the loss reaches the level of those benefits.  That's a tall order!

Speak to an attorney.



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Jane Pytel


I can answer questions related to auto accidents, auto damage, auto theft claims, or personal injury claims. I am specifically suited to answer questions concerning insurance investigations and the effects of those investigations such as claim delays, claim denials, examinations under oath, or the special investigations unit. I can answer most any question that relates to proper claims investigations, or claims handling procedures and processes. I have authored several ebooks which provide claim guidance for consumers. Those books are available on Amazon Kindle: Power To Profit - will provide you with the knowledge you need to overcome the patterned obstacles that insurance companies will use to delay, devalue, or deny your valid insurance claim. The No Nonsense Guide to Accident Settlement - Teaches you how to manage your claim, how to identify the precise tactics likely to be used against you, and how you must respond.


12 years of experience with 3 major insurance companies. I hold an all lines adjusters license in Florida. I am well versed in claims handling, claims investigations, and industry standards related to both. The bulk of my experience stems from my 10 years as a police officer / detective. Building on that investigative experience, I became an SIU (Special Investigations Unit) Investigator. Accordingly, my unique expertise lies in the investigation of claims. What is necessary and related, what is not necessary and related? What constitutes a fair claims investigation? What recourse is available for consumers who suspect they are experiencing unfair claims delays? During the course of my experience, I became a certified trainer, instructing adjusters and investigators proper techniques for claims investigation and claims handling.

B.A., Communications, University of Miami 350 credit hours of intense investigative training, Miami Dade Police 80 hours of investigative training, various Federal Agencies, Miami, Fl Intensive Accident Reconstruction and Pedestrian Injury Analysis, NHTSA, National Highway Traffic Safety Agency, Oklahoma City, OK 2 weeks Auto Damage Appraisal, Winston Salem, NC Legal Principles Claim Specialist, AEI

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