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  1. #1
    Join Date
    Aug 2016
    Location
    WA
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    2

    Default How to Value My Personal Injury Claim

    My question involves an injury that occurred in the state of: Washington state

    Approximately a week ago I was rear-ended while stopped for traffic on a highway, causing a multi-vehicle collision and likely totaling my vehicle. The police issued a ticket to the driver who hit me. Liability is pretty clear. A few hours after the accident occurred, I went to the ER with increasing back pain. No spinal fracture was suspected and I was sent home with a prescription for pain medication. Several days after the accident occurred I had severe abdominal pain. Imaging performed while at the ER showed (minor) internal abdominal bruising consistent with a motor vehicle collision. The best course of action according to the consulted surgeon was to rest.

    My doctor expects I will make a full, but painful, recovery in the 1-2 month time frame by resting and going to physical therapy. My medical bills are being submitted to my health insurance who will request reimbursement (I do not have PIP coverage with my auto insurance). Prior to the collision I was relatively active (including biking 4-6 hours a week as part of my commute and many other activities). For the time being, not so much.

    I am 100% aware that I should not settle anything until I make a full recovery and I am in no particular hurry to settle anything. However, I think it is prudent to start working on a demand letter while everything is still fresh in my mind and ensuring I document everything necessary. I have been reading the NOLO book on personal injury claims and have several questions:

    1. Multiplier - from what I have read, soft tissue injuries with no "proof" of injury result in a value of 1.5-3 times medical. Given that I have imaging proof of injury, this appears to move this claim up to the 3-5x category. Would this be correct? I'm assuming in this bucket I would be in the low to middle end.

    2. Medical costs - my health insurance has discounts. Should I use the pre-discount costs or post-discount costs? The discount will likely be half the costs.

    3. Lost income - First, I receive a performance bonus based on my accomplishments over the year in addition to my annual salary as part of my compensation. Should my last bonus amount be included in my annual pay for compensation purposes? Second, is there any compensation for my time in the ER, doctor's visits, etc... if they occurred outside of working hours?

    4. Documentation - apart from general soreness, my abdominal injuries mean I am in pain whenever I eat anything (like the stomach flu without the flu part). This has caused me to eat less and lose (some) weight. I am also in pain whenever I, for example, drive over a bump as my intestines move, hitting the bruises. Any thoughts on how to document this or highlight this in my demand letter?

    5. Total demand - if I assume medical bills are around $10k, a multiplier of 3x, plus lost income of around $2k, then I should demand double that, so around $64k. Does that sound reasonable for an initial demand? I should assume I would receive no more than around $30k in this example and likely less.

    Apologies for the long list of questions and thank you for any help!

  2. #2
    Join Date
    Mar 2013
    Posts
    18,340

    Default Re: Valuing My Accident Pi Claim

    1. Multiplier - from what I have read, soft tissue injuries with no "proof" of injury result in a value of 1.5-3 times medical. Given that I have imaging proof of injury, this appears to move this claim up to the 3-5x category. Would this be correct? I'm assuming in this bucket I would be in the low to middle end.
    Forget it. The "multiplier" thing is a myth. We were taught that in claims school 40 years ago but it has since gone the way of the buggy whip and each claim is adjusted based on its on merits (or lack of merits). You haven't won the lottery. With minor soft tissue injuries (yes, minor) from which you fully recover in two or three months you might be looking at a thousand or so per month for pain and suffering.

    2. Medical costs - my health insurance has discounts. Should I use the pre-discount costs or post-discount costs? The discount will likely be half the costs.
    You use the gross amounts that the providers bill.

    3. Lost income - First, I receive a performance bonus based on my accomplishments over the year in addition to my annual salary as part of my compensation. Should my last bonus amount be included in my annual pay for compensation purposes? Second, is there any compensation for my time in the ER, doctor's visits, etc... if they occurred outside of working hours?
    That's not too complicated. If you lost income (didn't get paid) for any days or hours you couldn't work because of the injury your compensation for lost earnings will be based on your recent pay stubs. That amount can be figured at a daily rate or an hourly rate so you can compute any hours you spent on medical service as a result of an injury. You can even include a mileage rate going back and forth. On a small claim (yes, small) it isn't any more complicated than that.

    4. Documentation - apart from general soreness, my abdominal injuries mean I am in pain whenever I eat anything (like the stomach flu without the flu part). This has caused me to eat less and lose (some) weight. I am also in pain whenever I, for example, drive over a bump as my intestines move, hitting the bruises. Any thoughts on how to document this or highlight this in my demand letter?
    Google "personal injury demand letter" and/or "personal injury demand package." Plenty of samples will turn up that will show you how to write one.

    5. Total demand - if I assume medical bills are around $10k, a multiplier of 3x, plus lost income of around $2k, then I should demand double that, so around $64k. Does that sound reasonable for an initial demand?
    I was waiting for that.

    $64K is delusional.

    I should assume I would receive no more than around $30k in this example and likely less.
    A lot less.

    Out of your $10K in medical bills, a large part of that is emergency room and/or diagnostic which has nothing to do with the extent of your injury, which is why the multiple theory doesn't count anymore.

    You'll get your $10K reimbursed easily enough (unless you spent a lot of money on a chiropractor) plus your $2K loss of earnings but if you recover from your painful, yet minor, injury in three months you are probably looking at a $15K settlement, so ask for $20K and negotiate from there.

    Feel free to come back for additional discussion AFTER you have fully recovered and can quantify your costs. We can go into details more thoroughly and adjust the amounts accordingly.

    In case you're wondering, I no longer work in the insurance industry and I am no toady to it. I'm giving you the reality of minor (yes, minor - have I emphasized that enough) personal injury claims.

    Sure, everybody will tell you get a lawyer and you'll get lots of money but, hey, the lawyer gets a third plus expenses and you get peanuts after the medical insurance gets reimbursed.

  3. #3
    Join Date
    Aug 2016
    Location
    WA
    Posts
    2

    Default Re: Valuing My Accident Pi Claim

    Thanks Jack. Honestly, what you wrote makes sense and I have no expectation that I have "hit the lottery" ($64k sounded completely ludicrous to me). You're right, most of the bills will be diagnostic. Based on past bills, I'm guessing $9k in ER (including imaging), $1k in doctor's visits, and $2.5k in PT. Personally, I'm glad they didn't need to do any treatment since surgery is not fun.

    I agree these are minor and non-permanent injuries and I'm glad they're only minor. And I have no expectation that a lawyer can improve on what I can get. The one (reputable-sounding) one I talked to said as much - he thought he could get me at best 2.5-3x medical costs. So if I had $10k in medical, he'd get me $25k - 1/3 for the lawyer and fees which puts me right at $16k total.

    A few questions on lost income:

    - You mentioned that if I "lost income" I can request that. My understanding is that if I take sick days from work, that still counts as "lost income", correct?

    - I have read that compensation for time spent at medical appointments can be requested at 1.5x normal hourly pay (overtime). Is that correct?

    - I'm guessing the best way to keep track of time spent at medical appointments is to simply keep a log. The long visits (ER) should be corroborated pretty well by the records.

    I think this should get me going and I can come back in a few months to come up with some final numbers. Thanks again for your help!

  4. #4
    Join Date
    Mar 2013
    Posts
    18,340

    Default Re: Valuing My Accident Pi Claim

    You mentioned that if I "lost income" I can request that. My understanding is that if I take sick days from work, that still counts as "lost income", correct?
    Yes.

    That's compensable because you've lost the ability to take the paid days in the future.

    I have read that compensation for time spent at medical appointments can be requested at 1.5x normal hourly pay (overtime). Is that correct?
    Yes and no. It's not that simple.

    Let's say at one point you are back to work and have a doctor's appointment. You leave work, takes you 15 minutes to get there, an hour for the appointment, 15 minutes back. You are entitled to the hour and a half. That might look like you are getting 1.5X normal hourly pay but if you went to 4 doctors in the same medical complex and were there 3 hours, you would get 3.5 hours to include the half hour travel time. That's not 1.5x.

    You don't get a bonus for going to the doctor.

    There's a lot of misinformation on the internet about personal injury claims. Take it with a grain of salt.

    I'm guessing the best way to keep track of time spent at medical appointments is to simply keep a log.
    Yes. A contemporaneous one where you also record your starting and ending odometer readings so you can compute the mileage later.

    The long visits (ER) should be corroborated pretty well by the records.
    True.

    I think this should get me going and I can come back in a few months to come up with some final numbers.
    Yes. Find this thread and revive it. Adding a post to the discussion brings it to the active list and I'm here every day. I'm happy to help refine your submission when the time comes.

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