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Tim co

@comcast.net

Claim update questions

So i go in tomorrow for my mri on my hip. My doctor says hes 90% sure i need surgery.
The last time i talked to my adjuster i told her this and told her id get in touch after my mri.
Well today i tried to fac her the lien from my health insurance cause they wont settle till the pay my health insurance. My fax said jt did not get an answer so i called her to get her fax number. The first person i talked to said my claim was now being handled by a different adjuster.

My first question is why would they have changes adjusters. They changed it already back in auguest to someone in their upper level adjuster deptment i think is how they worded it. I dont understand why they would give it to another adjuster again

Second. How is a surgery going to effect my settlement. Ik its going to make it take longer. But im guessing with surgery i will get a larger settlement. Im thought is if i get surgery its time to get a lawyer for sure. Would u agree

billydunwood

join:2008-04-23
united state
kudos:2
said by Tim co :

So i go in tomorrow for my mri on my hip. My doctor says hes 90% sure i need surgery.
The last time i talked to my adjuster i told her this and told her id get in touch after my mri.
Well today i tried to fac her the lien from my health insurance cause they wont settle till the pay my health insurance. My fax said jt did not get an answer so i called her to get her fax number. The first person i talked to said my claim was now being handled by a different adjuster.

My first question is why would they have changes adjusters. They changed it already back in auguest to someone in their upper level adjuster deptment i think is how they worded it. I dont understand why they would give it to another adjuster again

Second. How is a surgery going to effect my settlement. Ik its going to make it take longer. But im guessing with surgery i will get a larger settlement. Im thought is if i get surgery its time to get a lawyer for sure. Would u agree

They could have changed adjusters for many reason: She quit, got fired, moved departments, promoted, demoted, etc. Second, a surgery will probably up your settlement, not only due to the cost of surgery, but usually because pain and suffering during and after surgey and missed work because of it. I wont and can't give a specific number, but hopefully everything works out in your favor.
Just as a side note, my friend got t boned. He had to miss 5 days of work, could not exercise for 3 weeks and was in minor to moderate pain for the 3 weeks. Went to the ER, 2 different doctors and a chiropractor. They gave him 8k(after he paid the 2k in medical). However, it take them almost 1 year to get the settlement.
--
No Victim=No Crime


Tim co

@comcast.net
Thats what i figured. I had been asked about coverage limits in a past post i got those today
Bodily injury is 25000 per person 50000 per occurrence
Property damage 20000
The uninsured is 25000/50000
underinsured bodily in is 50000/50000

Is im alittle confused on the max i can get. Since the policey is in my moms name and the driver is a friend of mine. Can i collect under the bodily injury and underinsured coverages. Also does the bi coverage include medical bills. Im concerened cause if i can get only the bodily injury coverage (25000) and it includes my med bill. If i have hip surgery the surgery is likely to wipe out the bodily injury coverage. My knee surgery was 18000 dollars


craig70130
Premium
join:2004-04-27
New Orleans, LA
reply to Tim co
You need to get an attorney involved in my opinion. The insurance people will -not- look out for you.

billydunwood

join:2008-04-23
united state
kudos:2
said by craig70130:

You need to get an attorney involved in my opinion. The insurance people will -not- look out for you.

Depends. Most personal injury/accident attorneys will charge between 30%-40% and sometimes higher depending on the case. If it is a case worth a lot of money and the insurance company isn't offering much, sure. But, if he gets a solid offer he should take it(of course negotiate and NEVER take the first offer). Also, getting an attorney usually means you have to wait longer than if you just straight settled with insurance.
--
No Victim=No Crime

tcope
Premium
join:2003-05-07
Sandy, UT
kudos:2
reply to Tim co
said by Tim co :

Is im alittle confused on the max i can get. Since the policey is in my moms name and the driver is a friend of mine. Can i collect under the bodily injury and underinsured coverages.

I've always been confused as to why/what they are paying as well. I went back and looked at your other post (it's not helping that you keep creating new posts). As far I can tell, a friend was driving your rental car and hit a truck coming over a hill. Your friend appears to be at fault. You state it's your mothers carrier that is going to make an offer to you. I can see where your friend, the driver may not have auto insurance. What I don't understand is why the rental company is not extending some form of injury coverage. Perhaps they are denying the claim as the driver was not listed. You never mention a denial from them. Also, I don't know that they could deny bodily injury coverage.

If you are getting coverage from your mothers policy then I'd only guess it's uninsured motorist bodily injury coverage (as the driver should have had bodily injury coverage but does not). You _really_ need to ask what coverage your mothers carrier is providing and why. I'd do this first.

You can't collect BI from your mothers policy as you are an insured. If you get UMBI then the max you can collect is $25,000. If this is correct then it's a no brainer... your mothers carrier offers you $25,000 and it's a done deal. But if this is the case I don't know why they have not already made this no brainer offer. It should have been obvious to them for awhile now that their limits are not enough to address your claim. So I think perhaps there is something else involved.

I'd recommend you speak to the adjuster at your mothers carrier and ask what coverage they are paying under and why. Find out why the rental companies coverage is not addressing this loss (even though they rented out the car, it's registered to them so they are required to have at least minimum state limits).

If you only have $25,000 available then you should not get an attorney. Your attorney would then take $8250 right off the time and leave you with $16,750. Far less then you simply accepting the $25,000. However... you may want to find out the information above and then speak to an attorney. Ask them to explain what is going on and _if_ there is anyone else you can collect from or are you going to be limited to the $25,000. If it's only $25,000... then collect it yourself. If it's more then $25,000 then they can either explain why and/or you can use that attorney to collect more and charge you 33% of your settlement.

At the end of the day, negotiate down any unpaid medical expenses before paying them.


Timcolardo

@comcast.net
reply to billydunwood
Thats always been my experience. Iv had a few major accidents. When i was 18 a unisured driver hit my sisters car i was a passanger. Back shoulder issues i got referred to a back surgeon who said i needed surgery looking at an xray two doctors said was fine. I took his recommendation to my sisters insurance got 15k 8 months after the wreck. Few years ago. 9k because knee surgery i would got triple but i had some issues arise needed a quick settement. I figure they have everything they need to make an inital offer as of today. Once i get that low ball offer ill throw the mri And doctor recommendation of surgery at them if they dont be realistic get a lawyer

harald

join:2010-10-22
Columbus, OH
kudos:2
reply to Tim co
You may not need an attorney to pursue a settlement, but you may wish to consult with one on an hourly basis to understand what your rights are, and where the settlement money goes.

It first goes to whoever is paying your medical bills, and you get what is left.

Your insurance agent may also be able to help you.


Timcolorado

@myvzw.com
I talked with my adjuster today oddly as i pulled in for my mri. When she looked thrue my file she got happy seeing what she thought was last treatment in sept. When i said no iv changed doctors and am pulling in for a mri to see what surgery i need. Her tone changed also when i said i felt like i needed to consult an attorney. She said as soon as i completed my mri and got a report to connect her and let her know my doctors
recommendation.
Unlike the old adjuster she did seem concerned with my health and doing the right thing. But im sorry i dont trust car salesman lawyers or insurance adjusters

On a side note the mri place said they could not due it cause my size. Though idk why ya imma big guy but same weight n size of my last open mri on my knee. What options do they have if they cant do an mri

billydunwood

join:2008-04-23
united state
kudos:2
said by Timcolorado :

I talked with my adjuster today oddly as i pulled in for my mri. When she looked thrue my file she got happy seeing what she thought was last treatment in sept. When i said no iv changed doctors and am pulling in for a mri to see what surgery i need. Her tone changed also when i said i felt like i needed to consult an attorney. She said as soon as i completed my mri and got a report to connect her and let her know my doctors
recommendation.
Unlike the old adjuster she did seem concerned with my health and doing the right thing. But im sorry i dont trust car salesman lawyers or insurance adjusters

On a side note the mri place said they could not due it cause my size. Though idk why ya imma big guy but same weight n size of my last open mri on my knee. What options do they have if they cant do an mri

In terms of the MRI, you, your doctor or your insurance might need to find what they call as an "open MRI". The size limitations are much better than in a closed MRI
--
No Victim=No Crime

pensioner
Premium
join:2005-02-20
Clarksville, TN
reply to Tim co
I've got to go along with TCOPE on this one - where did mom's policy come into play? Your prior posts talked about you wrecking a car, getting a rental, friend driving and having another accident with you getting hurt - and several of us asked if the 'friend' was listed as an authorized driver on the rental; and now we're talking mom's policy. Are you making this stuff up by the minute just as a form of mental masturbation?


Timcolorado

@myvzw.com
Ill try and explain this as clearly as i can and hopefully shortly

I wrecked a car my parents was letting me use. The policy was in my moms name with me as a driver. Geico paid for the rental car for that accident. Will the insured vehicle was being repair. My friend was driving the rental car cause my blood sugar was extremely high. While crossing a highway at a two way stop we were required to stop. While in the middle of the intersection a truck struck the passenger side of the rental car. I had told the car dealer who was fixing our car and who the rental was through he may drive it if the need arose. My copy of the rental agreement was in the rental when it was wrecked

Geico got the rental agreement from the dealer police reports and our statements. Said it was covered under the policy in my moms name(policy for our vehicle that was wreck for which we had the rental) with my friend as the driver. On all paper work iv got from geico it has my friend listed as the driver and my mom was the policy holder. When they got the policy they were told any license driver not related to them or living with them was covered. Plus the truck that hit us was un insured. But my friend was cited for failure to yield and was deemed at fault by geico thus my moms policy covering it. Ik its complicated it took almost a month before they said it was covered under my moms policy

tcope
Premium
join:2003-05-07
Sandy, UT
kudos:2
reply to Tim co
I still see several issues with this...

Your friend was driving, was at fault and GEICO is extending liability coverage to him under your mothers policy. If this is the case, it's a Bodily Injury claim to GEICO (you _need_ to confirm this). If this is the case then the maximum GEICO will pay to you is the $25,000 BI limit (again, you _NEED_ to confirm with GEICO that this is the policy limit that applies... that the max they can pay you is $25,000). If that is all correct then if fail to see why they are not just offering you the $25,000 policy limit. If I recall correctly this either does not even address your medical expenses or might be just a little bit above them. In other words, it's a no brainer already that the policy limits are owed. So I fail to see why GEICO would not already have offered this.

*** Correction: I think GEICO might be looking at a BI claim from you for the $25,000 BI max and then also a UIMBI (under insured motorist bodily injury coverage) claim as well. I think you typed the limit wrong and that UIMBI has a $25,000 per person limit, not $50,0000 (25/50, not 50/50). So GEICO might be considering a max payment of $50,000, not $25,000. However, if this is the case, they should still be offering the $25,000 BI max a this time as these are _two separate claims_.

But then there are other issues. As I understand it the driver of the rental as listed as a driver under the rental policy. If that is the case then GEICO might need to be offering UIMBI (under insured motorist bodily injury coverage) if they have it (as the GEICO policy is not enough to address your injury). If the driver of the rental might be an insured under his own policy or someone else's policy (other then GEICO's) then that policy may need to offer BI coverage to him (and pay you as well).

I'd recommend that you call the GEICO adjuster and ask what coverage they are extending to you. Are they offering BI? If that might be a maximum policy payment would they then offer UIMBI? What are those limits, each? When they were looking into coverage, why did GEICO not offer BI or UIMBI? Do they know if GEICO has UIMBI? Do they know if the driver has any other coverage?

You need to find out and _write that information down_!

You easily have a $50,000 claim... the $25,000 BI and $25,000 UIMBI. You need to know if there are any other policies out there to address your loss as it _appears_ your claim is worth far more then GEICO can pay (again... if the info above is correct).

Feel free to post the answers to the questions above but you may want to go ahead and call an attorney and discuss this. My recommendation is that you _not_ agree to pay an attorney 33% of any policy limit offer from GEICO under BI or UIMBI. I say this as I think you might find that they are just going to offer some policy maximums anyway. If they are going to do that anyway, then why pay an attorney 33% just to accept the check. The attorney would be used to find out if any other carriers (such as the rental carrier) needs to be considering payment as well.


Timcolorado

@myvzw.com
Tcope. Thankyou for your help

The paper work for the policy coverage they sent me says underinsured coverage is 50/50.
I think you correct my friend has no coverage at all. From what iv read i think ur right. 25k for the bi coverage 25k for the uimc

I am going to call them right now. I will let you know how that goes

billydunwood

join:2008-04-23
united state
kudos:2
said by Timcolorado :

Tcope. Thankyou for your help

The paper work for the policy coverage they sent me says underinsured coverage is 50/50.
I think you correct my friend has no coverage at all. From what iv read i think ur right. 25k for the bi coverage 25k for the uimc

I am going to call them right now. I will let you know how that goes

If anyone is correct, it would be Tcope. More than helpful with insurance especially on claims
--
No Victim=No Crime

Bigmanco

join:2014-01-16
Granby, CO
I agree he has been a big help. Cant thank him enough. I didnt get a call back from my adjuster today but i will let u all know what she has to say in the morning. Iv registered for the forums so my name will be bigmanco. No more changing names

Bigmanco

join:2014-01-16
Granby, CO
reply to Tim co
I talked to my adjuster. Will i was in the process of asking her bout what coverage it was being paid under. She asked me if i would like her to make me a settlement offer today. I told her she. She said she was going to review everything and speak go her supervisor and call me back

PX Eliezer
Premium
join:2013-03-10
Graustark
kudos:7
Reviews:
·Optimum Voice
·callwithus
·Callcentric
reply to craig70130
said by craig70130:

You need to get an attorney involved in my opinion. The insurance people will -not- look out for you.

Agreed.

This is one case where an accident attorney truly [is] needed.

These people are in way over their heads and are going to be taken advantage of.

The insurance company is probably laughing their heads off.

AsherN
Premium
join:2010-08-23
Thornhill, ON
reply to Timcolorado
said by Timcolorado :

Unlike the old adjuster she did seem concerned with my health and doing the right thing. But im sorry i dont trust car salesman lawyers or insurance adjusters

That is the funniest statement I've read in a long time.


CylonRed
Premium,MVM
join:2000-07-06
Bloom County
reply to Tim co
Get a lawyer to cover yourself - no need to tell the insurance company you have a lawyer but have the lawyer check everything over. You don't necessarily need a ambulance chaser lawyer - a good competent one that will charge you for the time he spends looking over the documents and answering your questions.
--
Brian

"It drops into your stomach like a Abrams's tank.... driven by Rosanne Barr..." A. Bourdain

tcope
Premium
join:2003-05-07
Sandy, UT
kudos:2
said by CylonRed:

Get a lawyer to cover yourself - no need to tell the insurance company you have a lawyer but have the lawyer check everything over. You don't necessarily need a ambulance chaser lawyer - a good competent one that will charge you for the time he spends looking over the documents and answering your questions.

At best this would be next to impossible to find. If an attorney is to be paid an hourly rate they will want that money up front. Most likely this would be a few thousand dollars. There is next to no money in an injury attorney working hourly. Seriously, an attorney will send about 2-5 hours on an injury case and take 33%. I'd say this would usually be around $5000. That is $1000/hour. Why would injury attorneys want to change the system and get paid $200 instead? Doing this would ruin the good thing injury attorneys have set up.


CylonRed
Premium,MVM
join:2000-07-06
Bloom County
No need to get a personal injury lawyer as I said in the post. A good general lawyer should be able to help easily and affordably. I had a general attorney look over a separation contract for a job - no money needed up front and took very little time. Gave me his opinion on the document and told me what he would do.
--
Brian

"It drops into your stomach like a Abrams's tank.... driven by Rosanne Barr..." A. Bourdain

Bigmanco

join:2014-01-16
Granby, CO
reply to Tim co
I think tcope is right but also agree the rest of u have a point. I think right now i need to wait before highering an attorney. Im not dumb enough to just start signing stuff and i think they know whst their gonna have to pay and pay if. Or they really think im dumb or need a quick low payout. Which i dont i can wait as long as i need to.
Personally i think they relize their going to pay far more just in medical bills then what it would take to pay me off now

billydunwood

join:2008-04-23
united state
kudos:2
said by Bigmanco:

I think tcope is right but also agree the rest of u have a point. I think right now i need to wait before highering an attorney. Im not dumb enough to just start signing stuff and i think they know whst their gonna have to pay and pay if. Or they really think im dumb or need a quick low payout. Which i dont i can wait as long as i need to.
Personally i think they relize their going to pay far more just in medical bills then what it would take to pay me off now

Wait for the offer from the adjuster which you said she was working on, and think about it yourself and post it here too. Im sure tcope can help and if its too much, worse we can do is to tell you to get an attorney after we hear the offer.
--
No Victim=No Crime

Bigmanco

join:2014-01-16
Granby, CO
Update!!!

Ok i talked to my adjuster. She said since the doctor is saying i need surgery they cant settle till after the sugery. I told her i was weighing the options of if it was in my best interest to have surgery or not. Basically told her what my doctor told me option A i have surgery (costly) sugery therapy (costly) and it will be better or could be worst or option B i have pain and a disability in my hip and continue taking a large dose of oxycontin probably likely for ever

She said if i decided i don't want to risk the surgery but i need it they will take that into account and settle now.
Here is my thought and id like ur opinions on it.
Tomorrow at my doctor appt. ask him if he will write a letter saying that in his recommendation i need surgery to correct the damage in my hip from the accident or will have a life long hip injury and be on pain meds. Then call her back say i dont feel the surgery is in my best interest at this time and tell them i want the 25000 bodily injury limit or im going to get a lawyer and reconsider the surgery option.
I dont see why they would not go along with this. With surgery rehab and such my med bills would easily pass the bi coverage and probably the under insured motorist coverage. So i would think they would realize its 25000 now or up to 50000 in a few months.

What do u all think

AsherN
Premium
join:2010-08-23
Thornhill, ON
Last thing you want is to be on pain meds for a prolonged period of time. If the condition is correctable with surgery, get the surgery.

Bigmanco

join:2014-01-16
Granby, CO
I do agree with you my concern is aftermath of surgery ik a few people who had hip surgery and was worst after. After my second knee surgery the pain and issues were worst. I told the doctor i want off the shit. I plan on diving this summer and narcotics and scuba dont go together

AsherN
Premium
join:2010-08-23
Thornhill, ON
What kind of surgery?

Look at the choices.
1) surgery, good chance of living pain free. Not 100%, but pretty good.
2) no surgery. Pain meds for the rest of your life.

Not to mention the other damage you will be doing to other parts of your body as you compensate for the pain.

I had a hip replacement 6 months ago. It took me 4 months to learn to walk without a limp again. All of a sudden my lower back and sciatica pain also went away. My body was so twisted to compensate for the hip pain that I was completely out of alignment.


Caddyroger
Premium
join:2001-06-11
To the west
Reviews:
·Comcast
reply to Tim co
A guy I used work to with had a lot of pain from his hip. At first he did not want the surgery. He was afraid about the after effect of the surgery. Finally he decided to get his hip replacement surgery done. After about 6 months or so he returned back to work. He was not lipping like he was before and said that he did not have any pain now.
My advice is get the surgery done. Living on pain pills is not good. After a while the pain pills may not work and the insurance may denial any thing for surgery.
--
Caddy

tcope
Premium
join:2003-05-07
Sandy, UT
kudos:2
reply to Bigmanco
said by Bigmanco:

What do u all think

See my last post... the one with all of the questions I recommend you ask... but it appears you did not.

According to your posts the other person's limits are $25,000. So you can ask for $50,000, $25,001 or a million... with what I see they will only be offering $25,000. But _again_ the issue I see is that your medical bills are about this much already so I fail to see why they would not simply be offering the $25,000. The situation does not make any sense.

Hence the reason why I recommended you ask the adjuster the questions I mentioned.