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Started By
Message
re: Insurance ppl, pain and suffering
Posted on 1/22/21 at 12:28 pm to The Spleen
Posted on 1/22/21 at 12:28 pm to The Spleen
quote:
Former claim adjuster here. What's going on is they want the claim closed. The longer a claim sits open, the more money they have to reserve for payouts. Given you don't have an attorney and it appears you were just treated and released at the hospital, they know the injuries aren't severe. So they offered a settlement to get the claim closed. If you accept, they'll send you an agreement saying that with the settlement you waive any rights to seek additional settlement. SEnding the paperwork may get them to agree to the $1000, but that's no guarantee. Just know the people you're dealing with have been down this road 100s of times and know what they're doing better than you. If you don't have any lingering issues, $500 is more than fair, IMO.
Solid. Basically answered what I wanted to know.
0
Posted on 1/22/21 at 1:09 pm to momentoftruth87
Get what you can. Just be fair and don't be an arse. There is a reason insurance rates are high.
Posted on 1/22/21 at 1:10 pm to TDsngumbo
Very true. I see a lot of people who don’t carry and I have no idea why.
Posted on 1/22/21 at 1:17 pm to momentoftruth87
quote:
I said could you do $500 and she was pretty quick to agree.
quote:
She said 500 w/o med papers.
Hmmm.
Did you think $500 was fair since you asked for it? If not, why would you ask for $500 if you thought that was still to low? If you think $500 is fair, why are you now asking for more?
Posted on 1/22/21 at 1:17 pm to momentoftruth87
Not sure, but it seems like starting low and going up is not the best negotiating tactic.
Posted on 1/26/21 at 11:18 am to TDsngumbo
I was just shocked over how quick they offered money.
Posted on 1/26/21 at 11:20 am to momentoftruth87
You are a scumbag for faking an injury and raising my rates with your bullshite. People like you are the reason Louisiana is such a shithole.
ETA: I’m being sarcastic. Dude gets hit by someone else and he is made to think he did something wrong. Ridiculous.
ETA: I’m being sarcastic. Dude gets hit by someone else and he is made to think he did something wrong. Ridiculous.
This post was edited on 1/26/21 at 11:47 am
Posted on 1/26/21 at 11:26 am to The Spleen
quote:
Former claim adjuster here. What's going on is they want the claim closed. The longer a claim sits open, the more money they have to reserve for payouts. Given you don't have an attorney and it appears you were just treated and released at the hospital, they know the injuries aren't severe. So they offered a settlement to get the claim closed. If you accept, they'll send you an agreement saying that with the settlement you waive any rights to seek additional settlement. SEnding the paperwork may get them to agree to the $1000, but that's no guarantee. Just know the people you're dealing with have been down this road 100s of times and know what they're doing better than you. If you don't have any lingering issues, $500 is more than fair, IMO.
A claims adjuster giving legal advice. I love the OT
Posted on 1/26/21 at 11:31 am to theronswanson
quote:
A claims adjuster giving legal advice
It wasn't legal advice. He asked what the end game was from the adjuster, and I gave my perspective as a former adjuster. Could he get a larger settlement with an attorney? Probably, but he didn't ask that question.
Posted on 1/26/21 at 11:32 am to theronswanson
quote:
quote:
Former claim adjuster here. What's going on is they want the claim closed. The longer a claim sits open, the more money they have to reserve for payouts. Given you don't have an attorney and it appears you were just treated and released at the hospital, they know the injuries aren't severe. So they offered a settlement to get the claim closed. If you accept, they'll send you an agreement saying that with the settlement you waive any rights to seek additional settlement. SEnding the paperwork may get them to agree to the $1000, but that's no guarantee. Just know the people you're dealing with have been down this road 100s of times and know what they're doing better than you. If you don't have any lingering issues, $500 is more than fair, IMO.
A claims adjuster giving legal advice. I love the OT
Everything he said was true, though. The adjuster is just trying to get the claim closed quickly before costs add up. The face value of the costs is not the problem. The problem for the insurance company is the multiplier for pain & suffering used for "fair" settlements. The longer the claim is open, the more follow up visits the doctor will recommend. The more follow up visits he goes to, the higher the costs and multiplier applied to those costs. Also, the doctor visit costs are not his co-pay costs he incurs out of pocket - they are the full non-insurance discount costs that the doctor and facility(s) charge. A normal visit to the doctor may cost him $35 in co-pay charges but in reality, the insurance company may owe $300 or more for that one visit.
Now, it's difficult for average every day people to actually be successful in getting that multiplier applied "fairly", according to the law, but if he just says one day "frick it, I don't have the time to deal with the insurance company anymore" and hires an attorney to work on his behalf, then even a shitty attorney is going to be much more successful than he will be doing it on his own.
That's why they want the claim closed as soon as possible.
Posted on 1/26/21 at 11:48 am to The Spleen
quote:
It wasn't legal advice.
you told him what you thought the value of his case was and that their offer was fair
Posted on 1/26/21 at 11:49 am to momentoftruth87
You just lost out on about 15k minus 33%
Posted on 1/26/21 at 11:51 am to TDsngumbo
His health insurance has a lien on any settlement in Louisana right? That’s how it is in FL. ER bill with a shot would run at least $5k to $8k. The “fairness” of the settlement depends on the meds and the future prognosis.
What if this dude wakes up in 2 years and can’t move because of this injury. $500 lulz
What if this dude wakes up in 2 years and can’t move because of this injury. $500 lulz
Posted on 1/26/21 at 11:58 am to theronswanson
The only value I placed on anything is the pain & suffering aspect of his claim. I'll concede the information he provided is a bit incomplete to really make that determination. That opinion was my personal opinion as I'd take that offer instead of spending my time going back and forth with the insurance company or going to hire an attorney. It wasn't meant as legal advice. My only legal advice to him would be to talk to an attorney.
Posted on 1/26/21 at 12:40 pm to momentoftruth87
quote:
I did go to the hospital and got a pain injection,
I can assure you that if you went to the ER and got a shot, you should be receiving more than $500.
They should be paying the full price of the ER visit, not your insurance co-pay.
Posted on 1/26/21 at 12:50 pm to tigerpimpbot
quote:
His health insurance has a lien on any settlement in Louisana right?
Yes, to an extent. There are ways an attorney can force the health insurer to lower the amount owed but yes, health insurance will demand their share out of the settlement. This is why it sometimes leaves people no choice but to hire an attorney.
quote:
What if this dude wakes up in 2 years and can’t move because of this injury.
Back and neck injuries are notorious for going dormant for a couple years before making a big comeback.
Posted on 1/26/21 at 1:34 pm to Box Geauxrilla
quote:
can assure you that if you went to the ER and got a shot, you should be receiving more than $500.
They should be paying the full price of the ER visit, not your insurance co-pay.
Can’t be. Some former insurance adjuster posted and said $500 was fair for this guys claim. Adjusters don’t like to be told things like “the law” and “facts”
Posted on 1/26/21 at 1:35 pm to momentoftruth87
quote:
I said could you do $500 and she was pretty quick to agree.
No shite.
Posted on 1/26/21 at 1:36 pm to momentoftruth87
Dudley Debosier are the official injury lawyers of LSU Sports
Posted on 1/26/21 at 1:38 pm to tigerpimpbot
quote:
His health insurance has a lien on any settlement in Louisana right?
Only for medical costs - not pain and suffering.
And even then, they will end up only taking a fraction of that cost.
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