I was involved in a car accident about two months ago. The accident was not my fault. I suffered whiplash and some surface bleeding on my knees and arms ( I believe those were only minor scratches). I was able to walk away from the accident.(my car was a total loss)
I promptly contacted my insurer and I was told by my adjuster at my insurance company that they set aside a dollar amount for my medical treatments ( I believe it is the $10,000 maximum ) I also got contacted by the insurance company of the person who crashed into my car, they wanted to discuss settlement, but I told them I have to wait for the results of my diagnosis from the urgent care and from the chiropractor before I could discuss anything with them.
I went to an urgent care the day after the accident. Now I'm going to chiropractic treatment for my neck / back / spine. (I thought my neck and back was going to feel better with time, they never did, they actually felt worse as time passed.)
My question is about maximizing my settlement amount:
1. Does the chiropractic treatment cost come out of my settlement check? In other words, if my insurer set $10,000 aside for my case, the more I use the chiropractor the less amount I have left for my actual settlement check?
2. If the chiropractic treatment cost does come out of my settlement amount, should I stop the treatment (I'm feeling better at the moment, although not 100% healthy, I would not pay for the treatment any longer if it comes out of my pocket)
3. Do I expect a settlement from my insurer AND the person at fault's insurer OR I will only settle with the insurer of the person at fault?
Any advice and insight is greatly appreciated. Thank you for your time reading this.
Answer
1. Not sure what the set aside is that you mean. If you had PIP or no fault it will pay for 80% of the reasonable medical expenses you incurred including the urgent care. The chiropractor will be paid until the 10K is used up. Be careful as this occurs relatively quickly.
2. Settlements only occur if you have a permanent injury within a reasonable degree of medical probability. Sounds like you have some soft tissue injury for which you will receive a minimal permanent injury rating. Your case will be worth a relatively small amount of money. The 20% of the bills unpaid after PIP and anything over the 10K are your responsibility.
3.There are out of pocket payments Unless you had med pay coverage as well.
4. Your insurer should pay the PIP. If you had UM coverage that would pay if the underlying coverage is insufficient to cover your permanent damages.
5. Hire an attorney familiar with these types of cases, they will handle on a contingency basis and will only be paid if there is a resolution.
Answer
My question is about maximizing my settlement amount:
1. Does the chiropractic treatment cost come out of my settlement check? In other words, if my insurer set $10,000 aside for my case, the more I use the chiropractor the less amount I have left for my actual settlement check?
Correct. The settlement will be for a gross amount. Meaning the at-fault party's insurance company will offer you an amount that will go towards your past medical bills, future medical bills, pain and suffering and lost wages (if any).
2. If the chiropractic treatment cost does come out of my settlement amount, should I stop the treatment (I'm feeling better at the moment, although not 100% healthy, I would not pay for the treatment any longer if it comes out of my pocket)
This is a decision between you and your doctor. At some point, you will reach what is known as maximum medical improvement (MMI), where you may not feel 100% better, but more therapy would not benefit you either. At this point the doctor will assign you a permanent-impairment rating. A good personal-injury lawyer will negotiate down any medical bills you owe.
3. Do I expect a settlement from my insurer AND the person at fault's insurer OR I will only settle with the insurer of the person at fault?
It depends. If the amount of your damages exceeds the amount of coverage available from the at-fault party, and you are able to get the at-fault insurance carrier to tender their policy limits, then you can look to your own insurance company - assuming you have un/under insured motorists coverage.
If you have any other questions, feel free to call 305.931.6666
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