Settlement Question

[Angie Thomas]

I was injured in a car accident in January. The damage to my car was about $19,000. The lady who hit me had no insurance
So my insurance paid $25K (the limit) under PIP. My own health insurance (Medicare) paid around $13K. The insurance agent said underinsured will cover the $13K owed to Medicare plus pay me for pain and suffering.
I never thought it would add up to $38k or I might have used one of the 30 attorneys that bombarded me with mailings.
Can someone give me an approximate number they will offer me. They said it would be “normal-usual-customary” I’d like to have some idea and if it’s to low, I’d like to be able to tell them. Whether a lawyer would take this case or not, I’m not interested in using one unless I have to.
I get my final release on Tuesday, and then the settlement offer will be presented within a week, I was told.
Thanks Angie

 

[adjusterjack]

Your car should have been taken care of in January with your Collision coverage.

It's not your Underinsured Motorists Coverage, it's your Uninsured Motorists Coverage that applies. There's a difference. Read your policy.

Can someone give me an approximate number they will offer me.

I presume that the other driver was at fault.

I can help you with that. Whatever they "offer" will be low ball. Don't wait for an offer. Write up the amount that you want to get and present it to them.

What is the per person limit of your Uninsured Motorists Coverage?

To help you determine an asking amount for pain and suffering I want you to write me a comprehensive story about your injuries.

There are numerous personal injury demand letter samples for you to read online:

personal injury demand letter at DuckDuckGo

Read a bunch of them and get a feel for how the injury portions are presented before you write up yours.

Also include whether you lost any income if you were unable to work as a result of the injury.

If you want to keep your injuries private, feel free to send me a message with the story.

Understand that you won't be offered much money if you don't tell a good, comprehensive story about your injuries and what they've done to your life. Don't make the mistake of thinking that your insurance company will throw dollars at you out of sympathy.

 

[fed up]

Make sure to get copies of EVERY medical bill. Hospitals often wont forward Bill's from the ER physician or the xray department. You might have to ask 2-3 times to get ALL bills.

 

[adjusterjack]

The surgeon and anesthesiologist may also bill separately from the hospital.

 

[Angie Thomas]

Thank you very much for the replies. They paid the car repairs directly to the body shop. The body shop waived half of my $500 deductible when I asked.

 

[somarco]

This Medicare info is regarding "no fault" car insurance but the way your claim is/was handled may be similar. Read the entire page to gain a better understanding regarding Medicare as a secondary payer.

Sounds like this is you vs. your insurance carrier + their attorneys. You really need competent legal advice and you won't find it on a public forum.





No-fault insurance or liability insurance pays first and Medicare pays second.

No-fault insurance pays for health care services resulting from injury to you or damage to your property in an accident, regardless of who is at fault for causing the accident. Types of no-fault insurance include:

Automobile insurance
Homeowners' insurance
Commercial insurance plans
Liability insurance protects against claims for negligence—inappropriate action or inaction that results in injury to someone or damage to property. Types of liability insurance include:

Homeowners' liability insurance
Automobile liability insurance
Product liability insurance
Malpractice liability insurance
Uninsured motorist liability insurance
If the no-fault or liability insurance denies the medical bill or is found not liable for payment, Medicare pays the same as it would if it were the only payer. But, Medicare only pays for Medicare-covered services; you're responsible for your share of the bill—for example coinsurance, a copayment or a deductible—and for services Medicare doesn't cover.

If doctors or other providers are told you have a no-fault or liability insurance claim, they must try to get payments from the insurance company before billing Medicare. But, this may take a long time. If the insurance company doesn't pay the claim promptly (usually within 120 days), your doctor or other provider may bill Medicare. Medicare may make a conditional payment to pay the bill, and then later recover any payments the primary payer should have made.

If Medicare makes a conditional payment, and you get a settlement from an insurance company later, the conditional payment from your settlement needs to go to Medicare. You're responsible for making sure Medicare gets repaid for the conditional payment.

If you have an insurance claim for your medical expenses, you or your attorney should notify Medicare as soon as possible. If you have questions about a no-fault or liability insurance claim, call the insurance company.

If you file a no-fault insurance or liability insurance claim, you or your representative should call the Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627 (TTY: 1-855-797-2627).

The BCRC will gather information about any conditional payments Medicare made related to your no-fault insurance or liability insurance claim. If you get a settlement, judgment, award or other payment, you or your representative should contact the BCRC. The BCRC will determine the final repayment amount (if any) on your recovery case and send you a letter asking for repayment.
How Medicare works with other insurance | Medicare