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!

