Settling a Medical Claim

**ballmich** · 08-20-2009, 12:02 PM

This is in California.

I was in a car accident just over a year ago. A lady ran a red light and hit me as I entered the intersection and then went on to collide with a second car. Because both myself and the other driver that was hit by the lady have stated to the insurance companies that we had a green light and the lady ran a red light, it was a pretty open and closed case. Her insurance company, GEICO, accepted full responsibility on her part and subsequently paid for repairs to my car and for a rental car while it was in the shop.

As a result from the accident, I sustained a neck sprain, neasua, heachaches, just a lot of neck/shoulder pain. I went to a walk-in clinic at Kaiser (my medical provider), and they took some x-rays and a doctor diagnosed it as a sprained neck. Subsequently, I went to a chiropractor as I had a lot of ongoing pain, which generally improved after about 3-4 months of visits (twice a week). At that point I was plateaued in my improvement, so the chiropracter and that he couldn't keep billing my insurance for the treatments. I still go as much as I can afford to go, but it's on my own dime now.

I never retained a lawyer for this case. Now Geico would like to settle the medical claims and have me sign a release. They've offered to pay all the chiropracter charges + $1k for the Kaiser expense + $2k for my pain/suffering/time.

One question I have is that Kaiser still has not reported to Geico or myself what the total of the doctor visit or x-rays has cost, so I'm not sure how much is reimbursable to them. Geico says the $1k should be sufficient to cover this, but how do I know that? Any thoughts on this?

And on the $2k to be kept by me, is this sufficient? What is typical? My instinct says to never accept the first offer and to counter with something else. But I am also not greedy nor do I want to "abuse the system". But I am continuing to seek treatment, and $2k won't go a long way.

Any suggestions for an amount I should target on the settlement, or thoughts on negotiations?

All help/input is appreciated. Thanks!

**CRJ** · 08-20-2009, 12:18 PM

I would think more than $2000 for pain and suffering that sounds very minimal I would ask seek $5,000 so I guess you need to tell them $10000 and work to $7000 and stop a $5000, but $2000 seems to little.

**ballmich** · 08-20-2009, 12:26 PM

Quoting CRJ

I would think more than $2000 for pain and suffering that sounds very minimal I would ask seek $5,000 so I guess you need to tell them $10000 and work to $7000 and stop a $5000, but $2000 seems to little.

What do I say to GEICO as justification for my $10k request? Just that I will likely have to seek on-going medical treatment for a condition that resulted from the accident and will not likely ever go away?

Also, if the negotiations don't go "well", should I threaten (or even consider) retaining a lawyer? I'd rather not, just to avoid the cost, but is this a legitimate tactic to get them to a higher settlement figure?

**Defendant9** · 08-20-2009, 04:08 PM

Quoting ballmich

What do I say to GEICO as justification for my $10k request? Just that I will likely have to seek on-going medical treatment for a condition that resulted from the accident and will not likely ever go away?

Also, if the negotiations don't go "well", should I threaten (or even consider) retaining a lawyer? I'd rather not, just to avoid the cost, but is this a legitimate tactic to get them to a higher settlement figure?

If you are not willing to seek legal representation, then do a web search for how to write an insurance settlement demand letter. You need as much documentation about your loss as possible to make the insurance company see things your way.

**ballmich** · 08-20-2009, 05:47 PM

Quoting Defendant9

If you are not willing to seek legal representation, then do a web search for how to write an insurance settlement demand letter. You need as much documentation about your loss as possible to make the insurance company see things your way.

It's not that I'm unwilling to seek legal representation, it's just that I'm not sure it's necessary. I'd like to try to do it on my own, and I guess if I run into a roadblock, I could always look for a lawyer at that point.

**ballmich** · 08-24-2009, 01:25 PM

Okay, I've now sent out an Insurance Settlement Demand Letter. I found some examples online and based my format upon those. I faxed it to the number I've used to contact the claims examiner previously, and just now set it in the mail (certified return receipt) as well.

Thoughts on next steps? I'm assuming I just sit back and wait for a response of some sort.