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  1. #1
    Join Date
    Mar 2008
    Posts
    2

    Default What's It Worth?

    I am in Ohio and my wife was in an accident last year.

    We've been in contact with the other insurance company and finally got a counter-offer to our request, which was (expected) much lower than our request. Here are the details:

    Other driver was at fault.
    Rear-end auto accident, pushed into the car in front.
    Our vehicle was totalled, and settled.

    The main question I have is what can I consider "special damages" when making a settlement offer? I used the total medical charges, plus lost wages, as total special damages. During the whole process, our medical insurance company processed the medical bills and paid their share as if they were normal claims.

    So now we're trying to settle. I figured out that the total submitted charges for her medical bills was $6,596.70. The insurance gave its discounts/adjustments, bringing the allowed total to $3,544.38, which they paid to the doctors. After all of that, we were left with total out-of-pocket expenses and lost wages of $877.79.

    I used the total submitted amount of medical bills to calculate my offer. So I took the medical bills, lost wages, and future bills (estimate) and came up with ~$7000. I multiplied that by 4(ish) to come up with a nice round offer of $30,000. From that we would pay back the insurance company.

    The other insurance company, however, used our out-of-pocket bills *only* to calculate a counter-offer. They have already reimbursed our health insurance company for the $3500, and claim that our total special damages are only $877.79. Based on that, they offered $3000 for pain and suffering, for a total of $3877.79.

    Now, I'm not a lawyer, but when determining total special damages, doesn't make sense that the total medical bills should be used, not just what we paid out-of-pocket? It seems like we're getting low-balled, which is expected.

    Any help is appreciated!

  2. #2
    Join Date
    Jan 2006
    Posts
    38,867

    Default Re: What's It Worth?

    read this info page from Expert Law

    http://www.expertlaw.com/library/damages/damages.html

    The damages you are seeking have no actual formula to calculate them. They are a matter of negotiations and, if requested in court, a matter of similar situations and their awards of record.

  3. #3
    Join Date
    Mar 2008
    Posts
    2

    Default Re: What's It Worth?

    Well, I understand that there is no *real* formula that you can plug numbers into and get an amount, but there are guidelines. From my research, the guidelines are to expect 2 to 4 times your special damages as a settlement for pain and suffering. It actually seems that the offer is in that range (877.79 damages, offer of 3000.00 for pain and suffering). However, I think they are using the wrong numbers to calculate their offer (of course, that's their job). They should be using the higher $7000 figure to calculate an offer.

    Thanks.

  4. #4
    Join Date
    Jan 2006
    Posts
    38,867

    Default Re: What's It Worth?

    since there is no statutory formula and the only one is a "typical" or common formula (the 3X thing), everything else is left to negotiations and there is no statutory support for it either way it goes.



    You cannot force them to give you anything and if they have become frozen on the amount offered, there isn;t much else to do other than go to court or a mediator to deal with this.

  5. #5
    Join Date
    Jul 2006
    Location
    Burbank, CA
    Posts
    31

    Default Re: What's It Worth?

    There are economic damages (medical bills, rental car, loss of wages) and non-economic damages (pain and suffering).

    The carrier already paid the medical bills. Your only remaining economic damages total $877.79, correct?

    The carrier has offered to pay those remaining economic damages (877.79) plus non-economic damages in the amount of $3000.

    The carrier has reasoned their offer is really $3544.48 (previously paid medical billing) plus $3877.79 = $7422.27

    Without knowing what injuries were incurred, the offer may be reasonable.

    Forget about multipliers of 2, 3, or 4 times the medical billing. Here in Los Angeles, juries are giving non-economic damages equal or less than the total medical specials. Economy is down so jury awards go down also.

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