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Traffic Accident Insurance Claims Article
By Dan Baldyga
It’s been well over a over a year now
that Fred Fuddle smashed into you broadside doing several
thousand dollars Property Damage to your motor vehicle and
causing you to suffer a Personal Injury. Fuddle was cited
by the police for running a Stop Sign. You and the insurance
adjuster I. M. Smart, who represents Fuddles carrier, The
Rock Solid Insurance Company, have jostled each other around
long enough. You’ve returned to work and your Ole’
Doc “Comfort” has released you from any further
treatment. The time has come to settle your claim plus to
be reimbursed for the days, weeks and/or months of “Pain
and Suffering” you’ve had to endure.
So now, let’s consider the 7 most important
Personal Injury Claim areas you must take into account - -
so you’ll end up with the tallest pile of settlement
dollars possible:
#1. LIABILITY: Don’t let Smart go on and
on about “Contributory Negligence” Re: Who’s
a fault? You tell him you’ve read and learned that in
the majority of motor vehicle accidents statistics prove fault
can easily be determined, and the records show that in 83
percent of accidents it’s clear who was at fault. End
your response with, “Look, your boy was nailed for running
a Stop Sign, so let’s cut out the fault stuff and get
down to brass tacks”.
#2. TYPE OF INJURY: If there are severe injuries
(which are the result of only 10 to 13 percent of all motor
vehicle accidents) you should obtain the services of an attorney.
But, if you’ve had minor to moderate injuries like for
example: Whiplash, bumps, bruises, sprains and/or strains,
you can and should settle the claim yourself without being
forced to hand a lawyer 1/3 (some states even more) of your
recovery for doing little or nothing to earn it.
THE FOLLOWING ARE FOUR SPECIAL CATEGORIES
REFERRED TO (AND UTILIZED) IN PERSONAL INJURY
LITIGATION
(a) TEMPORARY TOTAL DISABILITY: This is the seriously injured
person who was temporarily hospitalized, (or perhaps impaired
at home for awhile) but expected to eventually regain full
function.
(b) TEMPORARY PARTIAL DISABILITY: This comes
to pass when, following the initial period of complete impairment
of the seriously injured party (that period of “Temporary
Total Disability”) one must recover from and are able
to resume some (but unfortunately not all) of their formal
activities.
(c) PERMANENT TOTAL DISABILITY: This describes
a condition (usually in the most severe cases) in which the
injury produces a total impairment to the body as a whole
- - again, placing the emphasis both on the extent of the
functional impairment, and its duration.
(d) PERMANENT PARTIAL DISABILITY: This is when
the injured party still retains some substantial body function
or earning capacity. The emphasis here is centered on the
extent of the functional impairment itself.
MEDICAL BILL COVERAGE’S
Be sure to review your Motor Vehicle Accident Insurance Policy
to discover if you have what is usually identified as “Medical
Payments” coverage. Also check all your non-automobile
insurance policies. You may have coverage(s) to pay your medical
bills - - regardless of who was at fault. If you have a Health
Insurance policy and/or Health Plan of some sort, read the
fine print. Your policy many not require you to pay back the
medical payments made to you from them - - even when you later
collect from Rock Solid Insurance!
#3. TYPE OF PERSON YOU ARE: Rate yourself, and
be brutally honest. You’re most likely Mr. Average Joe,
living a normal life. However, if you enjoy your shots and
beers and that often gets your posterior in a sling (a fact
well known to the local police) you’ll have to take
that into consideration when forming expectations about the
amount of dollars Rock Solid is willing to pony up to settle
your claim. If Smart gets into that you should respond with,
“Look, what you’re telling me has nothing to do
with what we’re talking about here. Your guy ran a stop
sign. This case is never going to court and you know it. We’re
not discussing who's at fault here - - only how much money
you should pay me to settle my claim. So, let’s get
on with it. Just do the right thing. I got creamed and you
owe me some big bucks.”
#4. TYPE OF PERSON FRED FUDDLE IS: The better
Fred Fuddle looks, or the better the “entity”
of the owner of the vehicle (Fuddle’s business or company,
etc.) appears, the better for Rock Solid. But, if Fuddle is
the town drunk and a first rate trouble maker, Rock Solid
is up to their eyeballs with settlement problems. On the other
hand, if Fuddle is a well-loved philanthropist, that can be
a plus for Rock Solid. And, if the “entity” that
smashed into you was a van driven by Pastor Fuddle, and the
named insured is The Fuddle Camp For Lost Sols, that can come
down on the plus side of the scale for Adjuster I. M. Smart
and the people who pay his salary, The Rock Solid Insurance
Company.
Plus: If the motor vehicle that hit you was
a dilapidated junk pile on wheels operated by a stumbling,
stammering, whacked-out Fred Fuddle and the named insured
is identified as The Fuddle Slam-Bang Refuse Company, that’s
a huge minus for Rock Solid.
When there’s a question of liability (who
was at fault) these factor’s often come into play. However,
in this (above) particular example, Fuddle ran a Stop Sign
and was cited for it. Whatever may be negative, and happens
to crash down on your side of the scale, is meaningless, when
it comes to placing a value on your ”Pain and Suffering”.
#5. DAMAGES: There are 3 areas here that must
be addressed: “Medical Special Damages”, Non-Medical
“Special Damages” and “Property Damages”.
(a) MEDICAL “SPECIAL DAMAGES”: These
include cost of Ambulance, Emergency Room Care, Hospital or
Clinic charges, Doctor, Chiropractor, Specialist and/or Dentist,
Over-the-Counter Drugs, and/or prescription Medications, Laboratory
Fees and Services, Diagnostic Tests (X-Rays and CT Scan),
Prosthetic Appliances or Surgical Apparatus (Canes & Crutches),
Physical Therapy and/or Practical Nurse Fees, Ace Bandages,
Gauze and Tape, Heating Pads, Creams, Lotions, Ointments,
Balms and Salves.
When it comes to listing your Medical Special
Damage “expenses” don’t overlook one single
dollar because, when it comes time to settle your claim, that
dollar can increase the value of the payment made for your
“Pain and Suffering” by three or even five times
that!
QUESTION: What exactly does that mean? ANSWER:
It means that a $10.00 “Special Damage” bill is
worth $30.00 to $50.00 more, in your pocket, from Rock Solid
at settlement time. That’s a fact of life in the business
of insurance claims. Take it from Dan who battled his way
through and within America’s insurance claim program/system
for over 30 years. Believe me when I say, “You can take
this to the bank”!
(b) NON-MEDICAL “SPECIAL DAMAGES”:
These typically include Lost Wages and Earnings, Lost Vacation
Time and Sick Leave, Travel Expenses (car rentals, public
transportation - - also any expenses incurred getting to and
from the doctor and/or hospital) plus Household Help during
disability and even Child Care.
LOST WAGES AND EARNINGS: This is an area where
adjusters often take terrible advantage of people because
most know so little about it. Although Smart will never tell
you, Commissions and/or Overtime can be of great advantage
to you. Don’t let him heap a snow job on you about this
particular situation. Obtain a documented letter of proof
from your employer (which must include all “other”
payments that would have been made to you, for any other income
lost, during that same period). This can make a huge difference
in the value of your claim. Don’t let Smart twist the
facts regarding this additional lost income. The time you
lost from work (including within it all the extra dollars
you may have also lost) is calculated and this element constitutes
what is know as “Lost Wages”, or “Lost Wage
Verification”. (Smart may attempt to go to battle with
you over this but you must stick to your guns. He’s
only trying to manipulate you with one of his typical, and
often most successful, “Con-Jobs“).
Did the injury necessitate a change of job or
employment at a lesser rate? Or, did the injury allow you
to return to work but only on a part-time basis? If the answer
to either one of those question’s is “Yes”,
ask your employer to document these facts on his letterhead.
If you’re salaried you should obtain a
statement of lost earnings, or “Time Lost Verification”,
on your employer’s letterhead. (This is absolutely “Legit“.
Don’t let Smart tell you it’s not)!
LISTEN CLOSELY TO THIS ONE: In some states you’re
still entitled to compensation for time and earnings, even
if you have no actual loss of money! Such as, for example,
when your salary is paid for by your own insurance or by taking
sick leave, or a similar arrangement. If Smart gives you an
argument on this (and he probably will) you tell him you’ve
read up on it and he’s dead wrong!
IF YOU’RE SELF-EMPLOYED: To prove your
lost income you’ll probably have to assemble your routine
bookkeeping for Smart to review. If you balk at the idea of
submitting personal documents to him (in the privacy of your
home or office) your only alternative will be to produce them
in front of a judge and/or jury in the wide-open environment
of a courtroom. Under normal circumstances, if you want to
prove your damages and collect the compensation that’s
due you, this is your only alternative.
IT’S ABSOLUTELY CRUCIAL FOR YOU TO KNOW:
Even if you’ve been paid while out of work, you can
still compute your lost time from work as “Lost Wages”
to discover what your “Pain and Suffering” is
worth.
#6. PROPERTY DAMAGE EXPENSES: These include
auto repair, damaged clothing, broken glasses, cost of substitute
car rentals, plus towing, etc. Keep the originals of all bills.
Be sure to have all documents in your possession when you
and Smart finally hunker down to ”Talk Turkey”.
Photocopies are sufficient to give him.
#7. YOUR AGE: Motor vehicle accident victims
between the ages of 3 or 5 and into their pre-teens, generally
have outstanding settlement results. Those between the ages
of 20 and 55 have a fair case because they’re generally
considered to be at the height of their physical stamina.
Those in their late 60’s (and over) often fare extremely
well! This is due to the sympathy they often invoke, from
a judge and/or jury, when it comes to generalized attitudes
regarding frailty and the elderly.
NEVER FORGET: Adjuster’s like I. M. Smart
play a crucial role when it comes to the evaluation of your
case. So, “Be nice”! Don't underestimate the importance
of his impressions and conclusions! What Smart feels and reports
about you, his insured Fred Fuddle, and/or possible witnesses
(in addition to the evidence you’ve documented for him)
has a heavy influence on his superiors (those individuals
back in the Claims Department at The Rock Solid Insurance
Home Office, reading Smarts memos, as they come flowing in
over the many months of his negotiation talks with you) and
then finally, when it comes to placing a value on your claim.
>> Return
to traffic accident insurance claims articles
DISCLAIMER:
The purpose of this article "YOUR
MOTOR VEHICLE ACCIDENT CLAIM" is for all readers to understand
the motor vehicle accident claim process. Neither Dan Baldyga,
Scott Baker, I GOT HIT, LLC, and/or the Accident Resource
make any guarantee of any kind whatsoever, NOR do they purport
to engage in rendering any professional or legal service;
NOR to substitute for a lawyer, an insurance adjuster, or
claims consultant, or the like. Where such professional help
is desired it is THE INDIVIDUAL’S RESPONSIBILITY to
obtain said services.
Dan Baldyga’s third and latest book,
AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM (How To Evaluate
And Settle Your Loss) can be found on the internet at http://www.caraccidentclaims.com
or http://www.autoaccidentclaims.com.
This book reveals “How To” handle your property
damage claim so you won’t be taken advantage of. It
also goes into detail regarding BASE (The Baldyga Auto Accident
Settlement Evaluation Formula). THE BASE FORMULA explains
how to determine the value of the “Pain and Suffering”
you endured - - because of your personal injury !
Copyright (c) 2004 By Daniel G. Baldyga.
All Rights Reserved.
Dan Baldyga - Author
dbpaw@comcast.net
AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM
(How To Evaluate And Settle Your Loss)
http://www.autoaccidentclaims.com
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