I want to settle my bodily injury claim on my own but . . ??

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Latest post Mon, Apr 17 2017 6:04 AM by JamyeP. 7 replies.
  • Thu, Apr 13 2017 5:59 PM

    • EllenG
      Consumer
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    • Joined on Mon, Apr 10 2017
    • NY
    • Posts 4

    I want to settle my bodily injury claim on my own but . . ??

    - Located in New York

    -MVA-8-30-16. Rear ended while at a full stop in traffic. The impact was so hard it threw my car into the back of the suv in front of me so it was a double impact. $2896 worth of car damage.

    -Ambulance and police called to the scene. Was encouraged to go in the ambulance because I could barely move my next. I did not go because my 2 kids were with me and I didn't want to scare them any further. 

    -Went to ER 1 hour later in serious pain. Diagnosed with cervical sprain, herniated disc. I was given a shot for pain, ibuprofen, muscle relaxers and neck brace. ER dr said i needed to get rest, ice, no lifting, follow up with PCP and I must get an MRI in a few weeks

    -FIled no fault application

    -For the next week I was in excruciated pain, meds from the ER dr was not working. I went to PCP and she immediately ordered an MRI cause I was having severe neck pain and tingling, numbness and weakness in my right arm. MRI revealed a herniated disc and multi level disc bulges. PCP prescribed PT, pain management and more powerful pain meds caure the ER meds wasnot helping the pain at all.

    -Had PT from 9-27-16 to 1-14-17. Did not help whatsoever

    -Had 2 Epidurals on 10-21-16 and 11-15-16. 1st shot wore off after 2 weeks pain came back like a vengence, 2nd shot lasted one week. PCP reffered me to Neuro because headaches had developed and conservative care wasn't working. 

    -IME report was done on 12-14-16 and it stopped further PT, Pain management, etc. But I continued treating anyway cause I never treated with a neurosurgeon

    -Neurosurgeon did another MRI on 12-27-16 and EMG. No change from 1st MRI and positive evidence of radiculopathy in C6-C7. He recommended ACDF surgery. 

    -I had surgery on 1-24-17. Its been 86 days since surgery. I feel better but still stiff. I have had 2 post operative appointments and xrays to see if the fusion is healing right. Dr noted on post operative report that I have a "limited range of motion"

    -My insurer sent my records to a peer review in feb who said my surgery was medically unnessary. So they didn't pay my neuro surgeon or my lost wages. My dr did write a rebuttal with tones of medical evidence and rationale denying the peer reviewers claim. It was submitted for appeal (not arbitration). To date I'm still waiting to see what happens.

    -Medical bills now at 200K. No fault has only paid out $6,400 of 50,000

    -No pre exsisting conditons, no gaps in treatment, no other claims for injuries, they accept full liability

    -Been out of work for 86 days since surgery.

    I am ready to settle the claim and try to get back to some level of a normal life. I did call the at fault drivers company (we have the same insurer) in feb to inform them that I want to open a claim for bodily injury. They did send me there generic authorization but I sent them my own authorization for them to have access to my no fault file. Then they wanted more authorizations for work records, other claims files and any other drs that I treated with despite giving them the no fault file. I sent them seperate authorizations for each but I did put specific dates that pertain to my accident only. I don't want them accessing my entire medical file cause its not there business if we arent in court yet.

    My questions:  Should I send them the demand letter now or wait until they finish with their investigation/evaluations of my medical records? Can you offer any other advice or tips based on my above details?

    Thanks in advance for any help, tips, suggestions, advice.

  • Fri, Apr 14 2017 12:42 PM In reply to

    • Kivi
      Consumer
    • Top 25 Contributor
    • Joined on Sat, Jan 1 2005
    • CA
    • Posts 6,359

    Re: I want to settle my bodily injury claim on my own but . . ??

    It's only been about three months since your surgery so you probably are not "permanent and stationary". I personally would be reluctant to settle a claim like this one so soon after such major surgery. Neither I nor you would really know at this stage whether you will get somewhat better or not, but any injury that has kept you off work for nearly three months is pretty serious. I personally think that you have enough in the way of potential damages that you probaby should not try this one on your own.

    I am not going to comment further because I am not an attorney and I am not in your state. But the fact that the insurance company appears to be giving you "the runaround" would be enough for me to consult an attorney or two in your state for more specific advice. Most personal injury attorneys work on a "contingency fee basis" for their fees, so there is usually little financial "downside" to consulting with one or two and then hiring one to handle your case. Contingency fee means "no recovery, no fee". 

     

     

  • Fri, Apr 14 2017 2:29 PM In reply to

    Re: I want to settle my bodily injury claim on my own but . . ??

    EllenG:
    Can you offer any other advice or tips based on my above details?

    Yes.

    Get yourself a personal injury attorney right now.

    You're in way over your head and the other driver's insurance company will eat you for lunch.

     

    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
  • Fri, Apr 14 2017 7:53 PM In reply to

    • EllenG
      Consumer
    • Not Ranked
    • Joined on Mon, Apr 10 2017
    • NY
    • Posts 4

    Re: I want to settle my bodily injury claim on my own but . ...

    Thank you for your reply Adjuster Jack but can you elaborate more on why they would "eat me alive"? What details did I give that makes you say that? Thanks again

  • Fri, Apr 14 2017 7:57 PM In reply to

    • EllenG
      Consumer
    • Not Ranked
    • Joined on Mon, Apr 10 2017
    • NY
    • Posts 4

    Re: I want to settle my bodily injury claim on my own but . ...

    Thsnk you for your reply Kivi. That makes sense and I will do a few consults

  • Sat, Apr 15 2017 7:35 AM In reply to

    Re: I want to settle my bodily injury claim on my own but . ...

    EllenG:
    What details did I give that makes you say that?

    ALL of them.

    You have a complicated case with serious medical issues.  The problem with spine injuries is that as you age MOST people have some sort of bulging disc or even a herniated disc or two.  Proving that the accident alone caused all of the problems can be difficult and the insurance company has tipped their hand by denying payment saying it was medically unnecessary surgery.  You are going to need an expert opinion (at great expense) that the insurance company deterination is wrong among other issues and it is best to leave that to an attorney.

    If you hire a GOOD personal injury attorney it will be well worth the expense.  They can handle all of these details and it may just go faster in settling the matter if the insurance company realizes they are dealing with a skilled attorney vs a consumer who does not know all their rights and responsibilitites.  

    DO NOT hire any lawyer with commercials on TV, billboards, or bus stop signs that has a catchy rhyming slogan you see every 5 seconds on the airwaves.  Use the "Find A Lawyer" feature on this site and choose a five star PEER rated attorney who is interested in your case and best interests NOT the fastest route to their getting a little bit of money.

    "That's just my opinion, then again I might be wrong."  Dennis Miller

     

  • Mon, Apr 17 2017 4:37 AM In reply to

    • EllenG
      Consumer
    • Not Ranked
    • Joined on Mon, Apr 10 2017
    • NY
    • Posts 4

    Re: I want to settle my bodily injury claim on my own but . ...

    Thanks for your reply ClydesMom. Yes, I can see them going after degenerative disease if thats my case and even then they would be conceding their insured aggravated a preexsisting disease. Also, I should add that when the doctor took out the herniated disc in my neck there was shattered pieces in my spinal space that had to be removed. I highly doubt I was walking around for years with that kind of damage and excruciating pain. But hey if they don't want to settle then I will lawyer up as you all have said.

  • Mon, Apr 17 2017 6:04 AM In reply to

    Re: I want to settle my bodily injury claim on my own but . ...

    Insurance will want to settle but it will be for far less that you will be expecting.  They already have lawyers.  You would be wise to hire counsel NOW.  The longer you wait, the less insurance is going to offer because they know you only have up to the statute of limitations to file suit and they will drag it out.  The longer you wait to hire counsel, the less time that attorney has to get up to speed.

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