How far can you go with the insurance for a settlement? 29 Answers as of January 30, 2013

My husband had back surgery he still in a lot of pain but the insurance wants to settle his case; they are saying they are affording 54% more then what his case is worth. But his doctor wants to put a stimulator for the pain on his leg, so he hasn't release him from his care. What do we do? Help please!

Ask a Local Attorney. 100% Anonymous. Free Answers.

Free Case Evaluation by a Local Lawyer: Click here
Law Offices of Ronald A. Steinberg & Associates | Ronald A. Steinberg, BA, MA, JD
Get your own lawyer. Don't rely on the insurance company to tell you the truth.
Answer Applies to: Michigan
Replied: 1/30/2013
Edward J. Achrem & Associates
Edward J. Achrem & Associates | Ed Achrem
You should never settle your claim without knowing the full extent of your injuries. Dealing with insurance companies without an attorney is also rarely advisable.
Answer Applies to: Nevada
Replied: 1/18/2013
Law Offices of Stanley S. Lopata
Law Offices of Stanley S. Lopata | Stan Lopata
As in all things from lawyers the answer is "it depends". Is your husband's injury due to a work related injury? If not, was it a result of an auto/truck accident? Or a trip and fall in a store or building? Who told you the the offer was 54% more than the case is worth? We would be happy to discuss these issues and more with you.
Answer Applies to: California
Replied: 1/8/2013
Law Offices of Sandeep G. Agarwal
Law Offices of Sandeep G. Agarwal | Sandeep G. Agarwal
It's had to say without knowing the facts of the accident, liability issues, the extent of your husband's injuries, any pre-existing issues related to those portions of his person injured in the accident, etc.
Answer Applies to: California
Replied: 1/8/2013
Paul Whitfield and Associates P.A.
Paul Whitfield and Associates P.A. | Paul L. Whitfield
You need to know what the doctors say about permanency, about future medicals, you need to know what all your bills tote up to, you need to know about the liability aspects. You need an experienced personal injury lawyer to help you. the insurance company will take advantage of you every time their job is not to help you. their job is to save money for the company.
Answer Applies to: North Carolina
Replied: 1/8/2013
    Bulman Law Associates PLLC Injury Law Firm
    Bulman Law Associates PLLC Injury Law Firm | Thomas Bulman
    You shouldn't settle without consulting a lawyer. If the statute of limitations is looming, get an attorney ASAP. The 54% statement is bs.
    Answer Applies to: Montana
    Replied: 1/8/2013
    The Smalley Law Firm, LLC | Cary Smalley
    I would suggest that the case not be settled until treatment has been completed. I suggest you consult with an attorney to discuss the facts of your case and to ensure the best possible outcome.
    Answer Applies to: Kansas
    Replied: 1/8/2013
    Atkins & Fife, LLC | William J. Atkins
    I assume from your question that you do not have an attorney. It is generally a mistake to deal directly with the insurance carrier. It is not their job to be honest with you; it is their job to save their insurance company as much money as possible. If your husband has not been released from care related to his injuries, you should not settle his case. Settling his claim will extinguish any right you may have to make a future claim, to increase your demand, or otherwise to seek recovery for his injuries arising from the incident in question. Speaking of which, you have not indicated how your husband was injured. This response assumes that his injury arose outside of the work place, i.e. it is a personal injury matter, not a workers compensation matter. The law applicable to workers compensation matters is different and would require a different response. I encourage you to consult with a qualified personal injury and/or workers compensation attorney. You should do so immediately.
    Answer Applies to: Georgia
    Replied: 1/8/2013
    Steven Kalishman, P.A.
    Steven Kalishman, P.A. | Steven J Kalishman
    You need an attorney. Even after paying the contingency fee, you will still most likely end up with a lot more money than trying to handle it on your own. I would be happy to speak with you about it for free with no obligation.
    Answer Applies to: Florida
    Replied: 1/8/2013
    Lombardi Law Firm
    Lombardi Law Firm | Steve Lombardi
    Answer: A claim involving back surgery, which I'll assume means spine surgery is an extremely serious claim and one in which a layperson has no business trying to handle on their own. You need to find a personal injury lawyer, with significant experience and resources who can handle the claim properly. It's that simple; if you live in Iowa we would happy to speak with you.
    Answer Applies to: Iowa
    Replied: 1/8/2013
    Law Office of J. Michael Gatien
    Law Office of J. Michael Gatien | J. Michael Gatien
    You should not settle at this point but, be careful of the two-year statute of limitations. The case will require a thorough analysis of the medical history in order to arrive at a valuation.
    Answer Applies to: Ohio
    Replied: 1/8/2013
    Andrew T. Velonis, P.C.
    Andrew T. Velonis, P.C. | Andrew Velonis
    Please rephrase your question. When you say "the insurance wants to settle his case" is this a worker's compensation matter? Worker's compensation calculations are based on disability, not pain. "54% more than what the case is worth." Why do they claim it's really worth 54% less? Why 54%? Why are they offering more than what it's worth, if they think it's not worth as much? Why do you think its worth more? What does your lawyer say? If you don't have lawyer, then that answers the question as to what you should do.
    Answer Applies to: New York
    Replied: 1/8/2013
    Barry Rabovsky & Associates
    Barry Rabovsky & Associates | Barry Rabovsky
    Hire an attorney.
    Answer Applies to: Illinois
    Replied: 1/8/2013
    Richard B. Jacobson & Associates, LLC | Richard B. Jacobson
    Find an experienced personal injury right away. Do not believe what the insurance company says without independent review. They have different interests from yours.
    Answer Applies to: Wisconsin
    Replied: 1/8/2013
    David F. Stoddard
    David F. Stoddard | David F. Stoddard
    You should probably think about retaining an attorney. The insurance adjuster is not on your side and has no obligation to be fair. He cannot honestly say that he is offering 54% more than it is worth because there is no formula for what a case is worth and no one can be that precise (it is about as subjective as judging a beauty contest). Furthermore, until you are finished with medical treatment, it is premature to settle. You have three years from the date of the accident to file suit, two years if it against the government. Below are some things to consider: I am often asked by individuals who have been injured in an accident to give an opinion as to what would be a fair settlement in their case. Often, they give me a brief description of their injury, such as, ?I suffered two broken ribs, or ?I am now suffering back pain?, or ?I hurt my leg and had to have surgery? and give no further details. I cannot possibly give an opinion as to the value of their case without more information. I find myself repeating over and over some of the information set out below. The information below is an attempt to shed some light on what an accident injury victim should consider in determining a fair settlement. However, presenting damages to an insurance adjuster, and ultimately to a jury, is an advanced and complicated task. It not adequate to simply say ?I?m hurt?, describe your injury, and then hold out your hand and ask for money. I have practiced law since 1985, and still attend seminars and read books on the subject of presenting personal injury damage claims to juries. The information below will not be enough to make you a personal injury attorney, but hopefully will enlighten you regarding some factors that should be considered on evaluating your claim. Maximum Medical Improvment First, one needs to understand the concept of Maximum Medical Improvement (MMI). MMI is the point at which the condition of an injured person is stabilized. No further recovery or improvement is expected even with additional medical intervention. Basically, a condition is at maximum medical improvement if it is not believed that the condition will change or progress. In laymen?s terms, this is often referred to a ?being released by the doctor?. This term is most often used in the context of a worker?s compensation claim. An inquired employee usually receives temporary benefits until reaching maximum medical improvement. However, it also has significance in general personal injury cases. Insurers for at fault drivers, manufacturers of unsafe products, owners and operators of unsafe premises, and doctors guilty of malpractice do not normally make incremental payments as medical bills and lost wages are incurred. Rather, these insurers normally settle claims with one payments, which represents the final settlement. For this reason, the accident victim must have evidence of all past and future damages to present to the adjuster. This means it is premature to begin evaluating your claim before you reach MMI because you do not yet know how much your medical bills will be, nor do you know how severe the injury will ultimately be - which is the main factor in damages for pain and suffering ? until after you have reached MMI. After you have reached MMI, four basic factors that should be considered in evaluating your case are 1) special damages, also known as tangible damages, 2) severity of the injury, 3) duration of the injury, and 4) insurance coverage. Special Damages Special damages which are also sometimes called tangible damages include the cost of medical treatment (medical bills) and lost wages. Special damages are somewhat objective and easily ascertainable. You simply add up your medical bills and determine what wages you would have earned had you not been out of work due to your injury. The insurance adjuster or opposing attorney may quibble over some of your numbers, claiming that you have been overcharged by your doctor, or that some medical procedures that you are including in damages were not caused by the accident. The adjuster or opposing attorney may argue that you missed more work than was required based on your injury. Nonetheless, both sides can at least agree that you were actually billed x number of dollars by medical provides, and that you would have earned x dollars had you been at work. A personal injury settlement demand should begin with the amount of special damages, that is, medical bills and lost wages. Intangible Damages Intangible damages are often the most important component of your damages case. Intangible damages include such things as pain and suffering, mental anguish, and loss of quality of life. Two important factors influence a fair settlement: the severity of your injury, and the duration of your injury. Severity of the Injury By severity of the injury, I am talking about the degree of pain and discomfort you suffer, along with how the injury affects your life and ability to engage in activities. On one end, you have relatively minor injuries that result in moderate pain and do not significantly interfere with your ability to do things. On the other end, you have injuries that result in severe pain and significantly interfere with your ability to engage in activities. An injury that is moderate in pain and its affect on your life would indicate a settlement on the low end of the range of fair settlements. An injury that results in a great deal of pain and significantly interferes with your ability to do things would indicate a settlement at the high end of the range of settlements. The low end might be in the thousands of dollars whereas the high end might be in the tens of thousands of dollars (at this point, I am only talking about severity of the injury, not the duration). Duration of the Injury ? Temporary vs. Permanent Injuries The next factor you must consider is the duration of your injury. Some injuries are temporary, others are permanent. Many injuries completely heal and resolve within months or a year. Some injuries are permanent and you still experience pain and some interference with your daily activities after you have reached MMI and have been released by a doctor. Temporary injuries might indicate a settlement on the low end of the range of settlements, whereas permanent injuries would indicate a fair settlement on the high end. An temporary injury that is severe in pain and interference with daily activities might indicate a settlement in the middle between the low and high range of settlements. An permanent injury that is moderate in pain and interference with daily activities might also indicate a settlement in the medium range. However, an injury that is severe in pain and its effect on daily activities and is also permanent would indicate a settlement in the high range. I have been mentioning ?low range? and ?high range? settlements. When it comes to intangible damages, what is fair is a grey area, and there is a great deal room to argue up or down. When I speak of ?ranges?, an attorney or insurance adjuster might say a particular injury has a settlement value of between $25,000 and $75,000 based on the factors I have discussed above. Temporary injuries that are moderate might indicate a settlement for intangible damages in the thousands of dollars, that is, less than $10,000.00. Temporary Injuries that are severe, or permanent injuries that are not severe, may indicate a settlement in the medium range, which could be in the tens of thousands of dollars. Injuries that are both severe and permanent could indicate a fair settlement in the hundreds of thousands of dollars and even exceeding a million dollars. Million-dollar settlements are somewhat rare. Nonetheless, multimillion-dollar settlements are not unheard of. Each case is different, and each case should be valued based on a
    Answer Applies to: South Carolina
    Replied: 1/8/2013
    Ferguson & Ferguson
    Ferguson & Ferguson | Randy W. Ferguson
    Hire an attorney to get what the case is worth.
    Answer Applies to: Alabama
    Replied: 1/8/2013
    Lewis B. Kaplan | Lewis B. Kaplan
    Hire an attorney.
    Answer Applies to: Illinois
    Replied: 1/8/2013
    Maurice L. Abarr  Lawyer, Inc.
    Maurice L. Abarr Lawyer, Inc. | Maurice L. Abarr
    I am assuming this is a Workers' Compensation claim. If he has exhausted his Temporary Disability benefits (2 years max) and does not think he will improve, he may want to settle IF he is not also receiving Social Security Disability benefits. If he is receiving SSDI benefits, or is likely to be receiving them in foreseeable future (because his disability is so great and he has limited or no transferable job skills) then he cannot settle until there is a Medicare Set Aside analysis done. All of this is quite complex and, in all sincerity, you cannot manage this kind of case without legal counsel. We are available if you are near Orange County.
    Answer Applies to: California
    Replied: 1/8/2013
    LAW OFFICE OF ROBERT T. DURBROW, JR. | Robert T. Durbrow, Jr.
    Like many other inquires on this site, it sounds to me that you need to consult with an experienced personal injury lawyer. They should be able to advise you what to do after you provide them with the details of your husband's injury. A lot of times what you can or should do depends on responsibility. Is someone else responsible for your husband's injury? Do they have liability insurance? Answers to these kind of questions would assist an experienced attorney in advising you what you should do about your husband's injury.
    Answer Applies to: California
    Replied: 1/8/2013
    Adler Law Group, LLC
    Adler Law Group, LLC | Lawrence Adler
    The insurance company will pay as little as they can. You should consult with an attorney asap. They will pay you far more with an attorney who can properly build the case a pursue litigation . Feel free to call us for a free consultation.
    Answer Applies to: Connecticut
    Replied: 1/8/2013
    WEISSMAN LAW FIRM | I.Donald Weissman
    It would be helpful to know what type of case this is: workers compensation for an on the job injury or a personal injury claim against another. In either case it may be too soon to settle. The full nature and extent of an injury should be know, including a prognosis for the future from the doctor, before settling any claim. Consult with an attorney as soon as possible. Have available medical reports and investigative materials of the cause of the accident and the injuries received. It is the best way to proceed.
    Answer Applies to: California
    Replied: 1/8/2013
    Law Office of Malosack Berjis
    Law Office of Malosack Berjis | Malosack Berjis
    First of all, I am sorry to hear about you and your husband are dealing with. Secondly, and very importantly, whatever you do, do not accept any settlement amount, from this insurance company, without first consulting with a local personal injury attorney. Thankfully, some personal injury attorneys, like myself, offer free consultations, in reality, you have nothing to lose by talking to an attorney before taking another step in this matter. The reason for this is that and, many attorneys will agree with me on this you should always have an attorney on your side when dealing with insurance companies (and their adjusters). It is amazing how differently they handle claims when dealing with an attorney, as opposed to an individual with no knowledge of their legal rights (at no fault of their own). Please do not hesitate to contact us if you have any other questions or concerns.
    Answer Applies to: California
    Replied: 1/8/2013
    Greer Jackson Tisinger, LLC | John Jackson
    It would be a mistake to settle this without talking to an attorney. The insurance company is always trying to save money. There are also other coverages you may not have considered.
    Answer Applies to: Georgia
    Replied: 1/8/2013
Click to View More Answers:
12 3 4 5 Free Legal QuestionsConnect with a local attorney