A couple months ago you were toolin' on down the avenue, minding your own business, when out of nowhere, this fumbling, stumbling man by the name of Freddie Fuddle flew through a Stop Sign and plowed into you with a gigantic, rip-roaring, screeching broadside. You were wearing your seat belt but it was still a thundering crash that wrenched and whipped you around the inside of your motor vehicle something fierce!
Now, after a long recovery period, Fuddle’s carrier, Granite Mountain Insurance is clamoring to close the case and they've assigned Claims Adjuster I. M. Strong, to handle your case. You and Strong are sitting at your kitchen table talking about your settlement dollars. It turns out he’s got some hang-up’s regarding your lost income. Well, here are some things you need to know:
Lost wages are one of the most important element's of your damages. Listen to me carefully when I say, "You should not think about the days you missed from work as Lost Time and Earnings. It's not Lost Time and Earnings - - it’s Lost Earning Capacity“
You ask, “What‘s Lost Earning Capacity all about? I thought I could only collect for my Lost Income?” The answer to that is, “In many situations you can claim lost income EVEN IF YOU HAVEN'T LOST ONE SINGLE PENNY “. For example, this can happen when your salary is paid because you've elected to apply for the sick leave that‘s due you, or because of an Accident and Health Policy available for you to take advantage of, or some other such arrangement.
In most instances - - even if you were paid while out of work - - you should still get that money routinely identified as Lost Wages. Why? Because that's your Lost Earning Capacity. Your Lost Earning Capacity is what’s called a Compensatory Damage. Don't let Strong swindle you out of that Compensatory Damage. Even if you’ve received an income, in some other way, you're still entitled to it. Strong will do everything he can to take advantage of you, especially when it comes to getting paid for your Lost Earning Capacity. During the course of every settlement negotiation he gets involved in, he‘ll try that tactic on for size, and it’s mind-boggling how often he gets away with it.
The typical statement made at that point, by the unsuspecting claimant is, “Hey, I understand I’m to be paid for my lost wages.”
Strong answers, “You collected $200.00 a week from your Accident and Health Policy didn’t you?”
“Yeah, but my average weekly income last year was $275.00 a week.”
“Okay”, I. M. Strong flashes a well practiced, winning smile, that tells you he’s a fair insurance claim adjuster, when in his black heart, he knows he isn‘t, “We’ll pay you that $75.00 a week difference. Let’s see, you were laid up and unable to work for 5 weeks. 5 times $75.00 is $375.00. Don’t worry my friend, I’ll see to it you’re paid that $375.00.”
“Wow!” you think, “that’s terrific !.” You’re thrilled to death with this great turn of events.But what you don’t know is that the $200.00 a week you’ve received from your Accident and Health Policy has absolutely nothing to do with your lost income.The bottom line is that Smart has just cheated you out of a thousand dollars! And, worse than that, the $275.00 a week income you lost (for a total of $1,375.00) would have (in a court of law) given your case $4,000.00 to $5,000.00 more value in settlement dollars.
DOCUMENTING LOST INCOME: Ask the company you work for to write a letter on their official stationary declaring your gross salary income and the days you lost from work.
GROSS PAY VS. NET PAY: You should collect the "gross" wage's you lost, not the "net".
TOTAL DISABILITY and/or PARTIAL DISABILITY: For every week of Total Disability (a fact which must be stated in your doctors Final Medical Report) you should use your gross weekly income - - even if you were paid! (For every week of Partial Disability your doctor states in that Final Medical Report, you have the right to claim a substantial percentage of your income, during that period, even if you didn't lose any).
Because the following five points give value to your claim be ready to talk with Smart about and, wherever possible, prove:
(1) If your work demands heavy labor and/or lifting. (2) If you lost any vacation time or sick leave. (3) If there was any possible loss of money you could have earned in the future - - either with your company or maybe other income you've got bubbling and boiling on the side. (4) If you had to forgo any bonuses. (5) If you lost an opportunity that would have led to a better job.
If any of the above five points are true than your claim is worth more money!
THE CRUCIAL MEDICAL REPORT: The Granite Mountain Insurance Company and Adjuster I. M. Strong know that the longer your recovery period, the greater your "pain and suffering", therefore the higher the settlement value of your bodily injury claim. Your Chiropractor or Attending Physician must also note this in his Final Medical Report. Tell him to state exactly how long it will be, before you can get back to routine activities like golf, hunting, fishing and/or rockin' and rollin' with your lady friends.
As long as you have problems keep right on going back to see your doctor, again and again, even if it drives the poor bugger nuts! Do this because the fact that your records show a visit to him, four, eight, or twelve weeks after the accident, proves your injury needed constant attention, therefore you were unable to work. Also because, when you visit your doctor and tell him there's no let-up of your pain, discomfort, stiffness or immobility - - those continuing problems must be written into the Medical Report he'll provide for you when you've finished treatment. That's the one you'll hand to Adjuster Smart when the two of you begin to talk turkey. As he reads it you’ll watch him frown, then blanch as that cocky smile disappears from his face. When you see him do that you‘ll know, "ya got him"!
DISCLAIMER: The only purpose of this claim tip is to help people understand the motor vehicle accident claim process. Neither Dan Baldyga nor Article City make any guarantee of any kind whatsoever; NOR do they purport to engage in rendering any professional or legal service; NOR to substitute for a lawyer, an insurance adjuster, or claims consultant, or the like. Where such professional help is desired it is the INDIVIDUAL’S RESPONSIBILITY to obtain said services.
Saturday, January 10, 2009
Motor Vehicle Accident Insurance Claim Guide
This is a FREE Insurance Claim Guide
Your “Motor Vehicle” can be a truck, car, motorcycle - - you name it! If it’s powered by a motor and has one, two, three, four (or even more) wheels this “Guide” is for you.
The information below is a bare-bones “Guide” for those who have had such a motor vehicle accident. It details the basics of how one should with their property damage and/or personal injury claim.
AFTER IMPACT CHECKLIST
We heartily suggest you make a copy of this "Impact Checklist" to be kept handy within the confines of your motor vehicle. A “Guide” to refer to so you’ll be certain, should an accident take place, that you’ve covered everything.
Other than the fact that one must obtain from the other operator, both their drivers license and motor vehicle registration information, you should also proceed to do the following:
IMMEDIATELY MAKE SPECIAL NOTE OF: Names and addresses of eye witnesses. And later the investigating police officers name and badge number. WEATHER CONDITIONS: Snow, rain, fog, mist, sleet, etc. ROAD SURFACE: Dry, wet, slippery, icy, etc.IMPACT AREA: City, suburban, business, wooded, etc. VISIBILITY: Sunny, cloudy, dusk, night, moonlight, etc. (Was the sun in the other driver’s face)? TRAFFIC CONTROLS: Were there overhead lights? Posted speed limit signs? Stop or warning signs? Hospital or school zone signs? CREATE A DIAGRAM: Driving area: Flat, crowned, straight, curved, macadam, asphalt, concrete, cobblestone, dirt, etc. Indicate the width of street. Show the location of impact, gouge and/or skid marks. CONDITION OF MOTOR VEHICLE THAT STRUCK YOU: Age and general overall condition. Is their state inspection sticker displayed and up to date? Were chains or snow tires needed? AS SOON AS POSSIBLE RETURN TO THE SCENE AND SNAP PHOTOGRAPHS: It’s most important to take pictures of: Skid or gouge mark’s on the road surface plus the damage to both vehicles. PHOTOS OF YOUR BODILY INJURIES: It's crucial to the ultimate value of your claim to snap a multitude of colored photos (up close and from different angles) of your bodily injuries - - especially all black and blue marks or bruises.
INSIGHTS INTO HANDLING YOUR CLAIM (There Are Six Areas You Must Be Familiar With) 1. Out-Of-Pocket Expenses 2. Lost Time From Work - Lost Wages 3. Property Damage Losses 4. What Your Medical Doctor And/Or Chiropractor Reports Should State 5. Medical Payments Coverage 6. What To Do If An Adjuster Refuses To Cooperate
You Should Go Into Detail Regarding These (Below Listed) Six Areas:
(1) OUT-OF-POCKET EXPENSES:These are expenses that can be measured in definite sums of money. They are the foundation of the calculations used to award damages (including that often great and extra amount paid to you for your “Pain and Suffering”) regarding any financial loss flowing directly from the injury you may have sustained.
MEDICAL EXPENSES: Obtain all bills and services rendered. (Prior to their being sent out, you have ever right to ask for and read the crucial Final Reports regarding your physical condition from your Doctor, Chiropractor, “Medical Specialist” and/or Dentist).Medical Expenses Typically Include: Ambulance ~ Emergency Room ~ Hospital or Clinic ~ Laboratory Fees and Services ~ Diagnostic Tests: (X-rays and/or CT Scan) ~ Registered or Practical Nurse Fees ~ Medicine and/or Prescription Medications ~ Prosthetic Appliances or Surgical Apparatus (Canes & crutch, etc.) ~ Physical Therapy ~ Ace Bandages, Gauze & Tape ~ Heating Pads ~ Creams, Ointments, Balms & Salves. As you read them make sure these Medical Reports include the length of time of your “Total Disability” and/or your “Partial Disability”. These are of enormous value because they justify the often HUGE, extra payment made for your “Pain and Suffering” . (Plus this information will also prove your claim for Lost Wages).
NON-MEDICAL DAMAGE EXPENSES. These include: Lost Wages and Earnings ~ Lost Vacation Time and/or Sick Leave ~ Travel Expenses: (Transportation costs incurred getting to and from The Doctor and/or Hospital, etc.) ~ Household Help During Disability ~ Child Care During Recuperation.
(2) LOST TIME FROM WORK - - LOST WAGES - - YOUR "LOSS EARNING CAPACITY": The weeks, hours and/or days you were unable to work (thus the money you may have lost) is added up and documented on company letterhead. You’re often entitled to compensation for “Lost Time and Earnings” even if you have no actual loss of money ! Such as, for example, if your salary is paid by some other insurance coverage you may have or by taking sick leave or some other similar arrangement. It doesn’t matter if you're employed full time, part time, self-employed, own your own business, retired, unemployed, or a housewife not employed outside the home, you should keep a written record of all household help and/or child care needed during your disability period.
All of these constitute an element of your “SPECIAL DAMAGES” mainly "Lost Wages". Insurance companies usually don't view your time away from work (because of an injury) as “Lost Time And Earnings” but as “Lost Earning Capacity”. In most states one is entitled to compensation for lost time and earnings even if they have no loss of money. For example, when your salary is paid for by another insurance coverage you have or by taking sick leave and/or some other similar type of arrangement. There are specific situations to be considered and called to the forefront when it comes to being employed either full-time or part-time. More detailed information (regarding these above stated area’s of your loss) are found in CHAPTER FOUR “Damages” within the book AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM.
(3) PROPERTY DAMAGE LOSSES: “AGREED COST TO REPAIR”: This figure has been negotiated between your damage repair person and the insurance adjuster. Be sure you know (and possess a written copy of) exactly what that figure is.COLLISION: There's usually a deductible. Read your policy. (If you’re not at fault you should eventually be able to get this money back).PROPERTY DAMAGE LIABILITY: Protects you for damages you do to the property of another (i.e. his or her trees, lawn, shrubs, mailbox, etc.) EXCLUSIONS: These are stated in your policy. A good rule of thumb is, “If it’s not excluded, it’s covered”. Read your policy closely to discover your exclusions and how they apply. TOTAL LOSS: A “Total Loss” is when the motor vehicle damage exceeds the value of the vehicle, as stated within all of the up-to-date and “Official” Property Damage books and/or documents. OTHER PROPERTY DAMAGE LOSSES: Clothing, jewelry, watches, eye or sunglasses, etc. You can also collect for your (or any other individuals) personal property which happened to be in the car and was damaged. (Be sure to have written proof of the cost of each item damaged plus the date it was purchased). Never forget: You’re entitled to be reimbursed for any charges you may have incurred for towing, storage and/or substitute motor vehicle rental, or for that matter - - any other alternate transportation.
The above is a very brief review. For more in-depth information read CHAPTER FIVE: PROPERTY DAMAGE found in AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM.
(4) WHAT YOUR MEDICAL DOCTOR AND/OR CHIROPRACTOR REPORT SHOULD STATE: Each “Injury Evaluation Factor” should be clearly stated within each of your final Medical Reports. For example: That your disability is solely the result of the accident. If there were any pre-existing conditions aggravated by your injuries? What treatments were administered and for what duration? What medications were prescribed, in what amounts and for how long? What symptoms or medical problems were such medications meant to relieve? Were there any adverse reactions demonstrated? Ask to read them before they're sent to the adjuster so you're sure it explains the nature, plus the extent and frequency of the pain that an injury, such as yours, will likely cause.
PROGNOSIS: This is the clearly stated information (regarding your personal injury progress) and should include: The part played by a pre-existing condition, if any? Their prediction of any possible future temporary disability/impairments? Does the individual attending you anticipate any further or future treatments? LENGTH OF YOUR “TOTAL” DISABILITY: Why? Because it's so important (when it comes time to settle) this is clearly stated in weeks and days. LENGTH OF YOUR “PARTIAL” DISABILITY: Again (and for the same reason as above) this too should be clearly stated in weeks and days. (Specific details, regarding both “Partial” and “Total” Disability , and the incredible value it provides for you in your claim, are found in CHAPTER SIX: YOUR BODILY INJURY).
(5) MEDICAL PAYMENTS COVERAGE: If you have this coverage in your motor vehicle policy, it will pay (up to the limits stated) for all medical bills arising out of the accident - - regardless of who’s at fault! (You must read your policy carefully because the “Who”, “Why” and/or “How” of this often differs).
A WORD ABOUT HEALTH INSURANCE PLANS: In certain instances, it may be possible to have your medical bills paid and yet avoid any repayment by tapping into your health insurance coverage, or some other plan you may have. (Yes, this means, under certain circumstances, you may be able to collect twice for the same medical bills)!
(6) WHAT TO DO IF THE ADJUSTER REFUSES TO COOPERATE? These Are Your Usual And Routine Choices: a. Threaten that you're going to obtain the services of a lawyer to represent you. b. Go over the adjuster’s head. c. Resolve your loss in Small Claims Court. d. Contact the proper people (working through the State Department of Insurance) implementing the time honored principle of “Good Faith” vs. “Bad Faith”.
Your “Motor Vehicle” can be a truck, car, motorcycle - - you name it! If it’s powered by a motor and has one, two, three, four (or even more) wheels this “Guide” is for you.
The information below is a bare-bones “Guide” for those who have had such a motor vehicle accident. It details the basics of how one should with their property damage and/or personal injury claim.
AFTER IMPACT CHECKLIST
We heartily suggest you make a copy of this "Impact Checklist" to be kept handy within the confines of your motor vehicle. A “Guide” to refer to so you’ll be certain, should an accident take place, that you’ve covered everything.
Other than the fact that one must obtain from the other operator, both their drivers license and motor vehicle registration information, you should also proceed to do the following:
IMMEDIATELY MAKE SPECIAL NOTE OF: Names and addresses of eye witnesses. And later the investigating police officers name and badge number. WEATHER CONDITIONS: Snow, rain, fog, mist, sleet, etc. ROAD SURFACE: Dry, wet, slippery, icy, etc.IMPACT AREA: City, suburban, business, wooded, etc. VISIBILITY: Sunny, cloudy, dusk, night, moonlight, etc. (Was the sun in the other driver’s face)? TRAFFIC CONTROLS: Were there overhead lights? Posted speed limit signs? Stop or warning signs? Hospital or school zone signs? CREATE A DIAGRAM: Driving area: Flat, crowned, straight, curved, macadam, asphalt, concrete, cobblestone, dirt, etc. Indicate the width of street. Show the location of impact, gouge and/or skid marks. CONDITION OF MOTOR VEHICLE THAT STRUCK YOU: Age and general overall condition. Is their state inspection sticker displayed and up to date? Were chains or snow tires needed? AS SOON AS POSSIBLE RETURN TO THE SCENE AND SNAP PHOTOGRAPHS: It’s most important to take pictures of: Skid or gouge mark’s on the road surface plus the damage to both vehicles. PHOTOS OF YOUR BODILY INJURIES: It's crucial to the ultimate value of your claim to snap a multitude of colored photos (up close and from different angles) of your bodily injuries - - especially all black and blue marks or bruises.
INSIGHTS INTO HANDLING YOUR CLAIM (There Are Six Areas You Must Be Familiar With) 1. Out-Of-Pocket Expenses 2. Lost Time From Work - Lost Wages 3. Property Damage Losses 4. What Your Medical Doctor And/Or Chiropractor Reports Should State 5. Medical Payments Coverage 6. What To Do If An Adjuster Refuses To Cooperate
You Should Go Into Detail Regarding These (Below Listed) Six Areas:
(1) OUT-OF-POCKET EXPENSES:These are expenses that can be measured in definite sums of money. They are the foundation of the calculations used to award damages (including that often great and extra amount paid to you for your “Pain and Suffering”) regarding any financial loss flowing directly from the injury you may have sustained.
MEDICAL EXPENSES: Obtain all bills and services rendered. (Prior to their being sent out, you have ever right to ask for and read the crucial Final Reports regarding your physical condition from your Doctor, Chiropractor, “Medical Specialist” and/or Dentist).Medical Expenses Typically Include: Ambulance ~ Emergency Room ~ Hospital or Clinic ~ Laboratory Fees and Services ~ Diagnostic Tests: (X-rays and/or CT Scan) ~ Registered or Practical Nurse Fees ~ Medicine and/or Prescription Medications ~ Prosthetic Appliances or Surgical Apparatus (Canes & crutch, etc.) ~ Physical Therapy ~ Ace Bandages, Gauze & Tape ~ Heating Pads ~ Creams, Ointments, Balms & Salves. As you read them make sure these Medical Reports include the length of time of your “Total Disability” and/or your “Partial Disability”. These are of enormous value because they justify the often HUGE, extra payment made for your “Pain and Suffering” . (Plus this information will also prove your claim for Lost Wages).
NON-MEDICAL DAMAGE EXPENSES. These include: Lost Wages and Earnings ~ Lost Vacation Time and/or Sick Leave ~ Travel Expenses: (Transportation costs incurred getting to and from The Doctor and/or Hospital, etc.) ~ Household Help During Disability ~ Child Care During Recuperation.
(2) LOST TIME FROM WORK - - LOST WAGES - - YOUR "LOSS EARNING CAPACITY": The weeks, hours and/or days you were unable to work (thus the money you may have lost) is added up and documented on company letterhead. You’re often entitled to compensation for “Lost Time and Earnings” even if you have no actual loss of money ! Such as, for example, if your salary is paid by some other insurance coverage you may have or by taking sick leave or some other similar arrangement. It doesn’t matter if you're employed full time, part time, self-employed, own your own business, retired, unemployed, or a housewife not employed outside the home, you should keep a written record of all household help and/or child care needed during your disability period.
All of these constitute an element of your “SPECIAL DAMAGES” mainly "Lost Wages". Insurance companies usually don't view your time away from work (because of an injury) as “Lost Time And Earnings” but as “Lost Earning Capacity”. In most states one is entitled to compensation for lost time and earnings even if they have no loss of money. For example, when your salary is paid for by another insurance coverage you have or by taking sick leave and/or some other similar type of arrangement. There are specific situations to be considered and called to the forefront when it comes to being employed either full-time or part-time. More detailed information (regarding these above stated area’s of your loss) are found in CHAPTER FOUR “Damages” within the book AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM.
(3) PROPERTY DAMAGE LOSSES: “AGREED COST TO REPAIR”: This figure has been negotiated between your damage repair person and the insurance adjuster. Be sure you know (and possess a written copy of) exactly what that figure is.COLLISION: There's usually a deductible. Read your policy. (If you’re not at fault you should eventually be able to get this money back).PROPERTY DAMAGE LIABILITY: Protects you for damages you do to the property of another (i.e. his or her trees, lawn, shrubs, mailbox, etc.) EXCLUSIONS: These are stated in your policy. A good rule of thumb is, “If it’s not excluded, it’s covered”. Read your policy closely to discover your exclusions and how they apply. TOTAL LOSS: A “Total Loss” is when the motor vehicle damage exceeds the value of the vehicle, as stated within all of the up-to-date and “Official” Property Damage books and/or documents. OTHER PROPERTY DAMAGE LOSSES: Clothing, jewelry, watches, eye or sunglasses, etc. You can also collect for your (or any other individuals) personal property which happened to be in the car and was damaged. (Be sure to have written proof of the cost of each item damaged plus the date it was purchased). Never forget: You’re entitled to be reimbursed for any charges you may have incurred for towing, storage and/or substitute motor vehicle rental, or for that matter - - any other alternate transportation.
The above is a very brief review. For more in-depth information read CHAPTER FIVE: PROPERTY DAMAGE found in AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM.
(4) WHAT YOUR MEDICAL DOCTOR AND/OR CHIROPRACTOR REPORT SHOULD STATE: Each “Injury Evaluation Factor” should be clearly stated within each of your final Medical Reports. For example: That your disability is solely the result of the accident. If there were any pre-existing conditions aggravated by your injuries? What treatments were administered and for what duration? What medications were prescribed, in what amounts and for how long? What symptoms or medical problems were such medications meant to relieve? Were there any adverse reactions demonstrated? Ask to read them before they're sent to the adjuster so you're sure it explains the nature, plus the extent and frequency of the pain that an injury, such as yours, will likely cause.
PROGNOSIS: This is the clearly stated information (regarding your personal injury progress) and should include: The part played by a pre-existing condition, if any? Their prediction of any possible future temporary disability/impairments? Does the individual attending you anticipate any further or future treatments? LENGTH OF YOUR “TOTAL” DISABILITY: Why? Because it's so important (when it comes time to settle) this is clearly stated in weeks and days. LENGTH OF YOUR “PARTIAL” DISABILITY: Again (and for the same reason as above) this too should be clearly stated in weeks and days. (Specific details, regarding both “Partial” and “Total” Disability , and the incredible value it provides for you in your claim, are found in CHAPTER SIX: YOUR BODILY INJURY).
(5) MEDICAL PAYMENTS COVERAGE: If you have this coverage in your motor vehicle policy, it will pay (up to the limits stated) for all medical bills arising out of the accident - - regardless of who’s at fault! (You must read your policy carefully because the “Who”, “Why” and/or “How” of this often differs).
A WORD ABOUT HEALTH INSURANCE PLANS: In certain instances, it may be possible to have your medical bills paid and yet avoid any repayment by tapping into your health insurance coverage, or some other plan you may have. (Yes, this means, under certain circumstances, you may be able to collect twice for the same medical bills)!
(6) WHAT TO DO IF THE ADJUSTER REFUSES TO COOPERATE? These Are Your Usual And Routine Choices: a. Threaten that you're going to obtain the services of a lawyer to represent you. b. Go over the adjuster’s head. c. Resolve your loss in Small Claims Court. d. Contact the proper people (working through the State Department of Insurance) implementing the time honored principle of “Good Faith” vs. “Bad Faith”.
Handling Your Motor Vehicle Accident With Your Own Insurance Company
This “How To” article is crucial, up-to-date information concerning what to do if your insurance company is giving you a hard time (regarding your own motor vehicle accident claim with them) and you’re positive it’s “Legit”. If there’s some problems with whatever position they’ve taken regarding your Property Damage Loss (or any other coverage-questions they may be ducking/stalling/ignoring and/or disputing) you don’t have to sit back and take it!
You DO have options to settle your dispute and you should proceed as follows:
#1. FIRST, LET YOUR AGENT KNOW YOU’RE UNHAPPY: Ask them to go to bat for you. If they sit on their butt (afraid or “too busy” to get “involved” with your “problem”) find out the name and phone number or your insurance companies nearest Claims Department. Contact them and ask for help. (Never forget, you’re their insured, your premium’s pay their salary). If the person you’re talking to attempts to handle your problem with uncaring indifference, just like your agent has, than find and talk to that individual’s boss - - The Vice President of Claims and/or whomever.
#2. BE PREPARED TO SUPPORT YOUR CASE: Have ready all documents, plus a covering letter (to snail mail to that person your finally talking to) proving your point and explaining why you’re not satisfied. (Send it to them PERSONAL AND CONFIDENTIAL - - with a signed “Return Receipt” requested).
#4. CONTACT YOUR LOCAL INSURANCE DEPARTMENT: If you’ve followed your insurance company’s rules for resolving a dispute, and you’re still not satisfied, your own Local Insurance Department can help you. You can reach them by phone, or mail, or often online.
WHAT THEY CAN DO FOR YOU: Many insurance departments offer on-the-phone assistance to help resolve the “Problem” without requiring you to file a formal “Written Complaint“. Most post their complaint forms on their Web sites, allowing you to print out the document, complete it at home, and mail it to them. (If they don’t have a web site ask that they snail mail their “Written Complaint” form right out to you) !
After you provide them with all the necessary information (including your policy or claim number and supporting documentation) they will notify the insurance company (or agent) you’re complaining about. The company (or agent) is then required to respond to the department within a certain amount of time, usually between 10 to 30 days, depending upon the area where you live.
Upon receiving a reply, Insurance Department officials will dig deeper, trying to determine what can and should be done. This process usually takes about 30 days.
If the Insurance Department decides against the agent or the insurance company (which is clearly stated - - and one both your insurance company and your agent know to be a fact of their business life they‘d prefer not to get hung up on - - nor be forced to deal with) the Insurance Department has the power to levy a variety of penalties, ranging from a fine to actually revoking the license of the agent or company. (When it comes down to the nitty-gritty, these departments have all the power they need to penalize companies that are deliberately ducking or dragging their feet).
After reading the above, you may want to consider hiring an attorney to represent you because it can get complicated! If you do, find one who specializes in Auto Insurance. Attorney’s work either at an hourly rate or on a “Contingency-Fee Basis“, depending on the type of case. If you decide to go that route be sure to get your lawyer’s “Fee Structure” in writing. And (to remain current on the progress of your claim) insist that you receive copies of all correspondence. PLUS: Be sure your lawyer knows that he or she must have your agreement - - before committing to any settlement!
You DO have options to settle your dispute and you should proceed as follows:
#1. FIRST, LET YOUR AGENT KNOW YOU’RE UNHAPPY: Ask them to go to bat for you. If they sit on their butt (afraid or “too busy” to get “involved” with your “problem”) find out the name and phone number or your insurance companies nearest Claims Department. Contact them and ask for help. (Never forget, you’re their insured, your premium’s pay their salary). If the person you’re talking to attempts to handle your problem with uncaring indifference, just like your agent has, than find and talk to that individual’s boss - - The Vice President of Claims and/or whomever.
#2. BE PREPARED TO SUPPORT YOUR CASE: Have ready all documents, plus a covering letter (to snail mail to that person your finally talking to) proving your point and explaining why you’re not satisfied. (Send it to them PERSONAL AND CONFIDENTIAL - - with a signed “Return Receipt” requested).
#4. CONTACT YOUR LOCAL INSURANCE DEPARTMENT: If you’ve followed your insurance company’s rules for resolving a dispute, and you’re still not satisfied, your own Local Insurance Department can help you. You can reach them by phone, or mail, or often online.
WHAT THEY CAN DO FOR YOU: Many insurance departments offer on-the-phone assistance to help resolve the “Problem” without requiring you to file a formal “Written Complaint“. Most post their complaint forms on their Web sites, allowing you to print out the document, complete it at home, and mail it to them. (If they don’t have a web site ask that they snail mail their “Written Complaint” form right out to you) !
After you provide them with all the necessary information (including your policy or claim number and supporting documentation) they will notify the insurance company (or agent) you’re complaining about. The company (or agent) is then required to respond to the department within a certain amount of time, usually between 10 to 30 days, depending upon the area where you live.
Upon receiving a reply, Insurance Department officials will dig deeper, trying to determine what can and should be done. This process usually takes about 30 days.
If the Insurance Department decides against the agent or the insurance company (which is clearly stated - - and one both your insurance company and your agent know to be a fact of their business life they‘d prefer not to get hung up on - - nor be forced to deal with) the Insurance Department has the power to levy a variety of penalties, ranging from a fine to actually revoking the license of the agent or company. (When it comes down to the nitty-gritty, these departments have all the power they need to penalize companies that are deliberately ducking or dragging their feet).
After reading the above, you may want to consider hiring an attorney to represent you because it can get complicated! If you do, find one who specializes in Auto Insurance. Attorney’s work either at an hourly rate or on a “Contingency-Fee Basis“, depending on the type of case. If you decide to go that route be sure to get your lawyer’s “Fee Structure” in writing. And (to remain current on the progress of your claim) insist that you receive copies of all correspondence. PLUS: Be sure your lawyer knows that he or she must have your agreement - - before committing to any settlement!
Insights Into Your Med-Pay Insurance Coverage
While Legal Romantics would like to characterize the trial of a lawsuit as a “Search For Truth” that’s not a reality!
Cases are decided on the evidence. When reviewing cases before them, judges invariably use the phrase, “The evidence shows”, rather than, “The truth of the matter is”. That first phrase is a reality that filters from the courtroom down to the objective evaluation of each case tried.
If Fred Fuddle is the town drunk, or if his conduct at the accident scene was provably abnormal than the value of your case should increase. If your injuries are visible and/or demonstrable, it’s likely your settlement will be larger. The conduct of both Fuddle and you before the accident may be significant. If you had been at a bar drinking heavily or raising holy hell out on the highway before the accident, you’ll get less regard from the jury than if you were driving to your house of worship with your family.
So, the circumstances of your behavior before, during, or after the accident increases or decreases the value of your settlement.
THE SIX MOST IMPORTANT ELEMENTS IN THE “EVALUATION PROCESS”: To be fully informed, you must know and understand the six primary evaluation elements that figure into the process of evaluation. They are as follows:
(1) THE FACTS (2) THE EVIDENCE (3) THE LAW (4) YOUR INJURY (5) SPECIAL DAMAGES (6) THE INTANGIBILITIES.
(1) THE FACTS: The gathering of the provable factual information is the first step in the evaluation. If you try to evaluate a claim without as complete a file of facts as possible, it’s like going hunting for a lion with a slingshot.
(2) THE EVIDENCE: You must weigh all factual evidence known to you against the actual evidence you can produce to substantiate it. No matter what information you’re aware of, your position will always be stronger if you have the evidence to back you up.
For example: You can talk until the cows come home about the unsightly black-and-blue marks you had on your face, ribs, and hips, the scar on your forehead, or the 75 feet of skid marks Fred Fuddle’s auto left on the highway before he smashed into you, but Adjuster I. M. Smart will never adequately comprehend, (nor want to believe you) unless you provide him with photographs.
Providing Smart with the proof-positive of photographs will cause his Supervisor’s eyes to bulge as he inhales a deep breath of resignation and declares, “Hey, this one’s gonna cost us” .
QUESTION: “How can Dan be so sure about that”? ANSWER: “Because before Dan retired, after spending over 30 years on that firing line, he was an Insurance Adjuster, Supervisor, Manager and Trial Assistant. He’s been there, saw that, plus heard (and felt) that many thousands of times”!
Whenever possible you must help Adjuster I. M. Smart justify the settlement figure he wants to get approved by his immediate superior at Granite Mountian Insurance Corporation.
(3) THE LAW: As proved in over 83% of the accidents in the United States in 2003 the impact you were subjected to is clearly the fault of “Fumbling” Fred Fuddle, so the law is on your side.
Armed with the information found in my third book AUTO ACCIDENT PERSONAL INJURY (How To Evaluate And Settle Your Loss) plus THE BASE FORMULA (The Baldyga Auto Accident Settlement Evaluation Formula) you’ll be able to do that. THE BASE FORMULA will correctly evaluate your “Pain and Suffering”. Because of this, you can settle your own claim without handing a huge percentage to an attorney. A lawyer who has done nothing more than have his secretary send Fuddle a letter of representation and then think it’s perfectly acceptable (after many moths, sometimes years, of hiding/stumbling/fumbling and verbally pitching his well-practiced answer when you asked, “Hey what’s going on with my claim?” with an answer like, “I’m right on top of it, hang in there, old friend and I‘ll make it come out right”, and then proceed to take a huge portion of your settlement dollars, for doing little or nothing to earn it.
(4) INJURY TO YOU: The seriousness of your injury has to be considered. (Ole’ Doc Comfort, your attending physician’s Medical Report, should go into detail about that).Your age will have an effect on the time it takes you to recover. The time you lost at work will have a direct bearing on the length of your recovery.
(5) SPECIAL DAMAGES: All of your direct and tangible losses are prime factors to be implemented in the consideration of the value of your claim.(Clearly stated details regarding Damages are found in Chapter Four of my book).
(6) INTANGIBLE ELEMENTS: These include your reasonableness, your economic status, your standing in the community, the obvious sentiment conjured up when one considers the degree of the seriousness of your injury, plus the attitude of Fred Fuddle (and often your witness) regarding your case.
Sympathy will come into play if you’re a widow or a highly respected Little League Coach, in contrast to your being identified as a raucous bum with a history of getting into scrapes with the law.
Emotional factors often have considerable weight in the evaluation of your claim. Whatever the intangible elements may be, you must force yourself to investigate and then evaluate them just as objectively as possible. So, if what’s being contended is incorrect, you can deny them (plus you must prove the conclusions not to be true) when and where it becomes appropriate to do so.
Cases are decided on the evidence. When reviewing cases before them, judges invariably use the phrase, “The evidence shows”, rather than, “The truth of the matter is”. That first phrase is a reality that filters from the courtroom down to the objective evaluation of each case tried.
If Fred Fuddle is the town drunk, or if his conduct at the accident scene was provably abnormal than the value of your case should increase. If your injuries are visible and/or demonstrable, it’s likely your settlement will be larger. The conduct of both Fuddle and you before the accident may be significant. If you had been at a bar drinking heavily or raising holy hell out on the highway before the accident, you’ll get less regard from the jury than if you were driving to your house of worship with your family.
So, the circumstances of your behavior before, during, or after the accident increases or decreases the value of your settlement.
THE SIX MOST IMPORTANT ELEMENTS IN THE “EVALUATION PROCESS”: To be fully informed, you must know and understand the six primary evaluation elements that figure into the process of evaluation. They are as follows:
(1) THE FACTS (2) THE EVIDENCE (3) THE LAW (4) YOUR INJURY (5) SPECIAL DAMAGES (6) THE INTANGIBILITIES.
(1) THE FACTS: The gathering of the provable factual information is the first step in the evaluation. If you try to evaluate a claim without as complete a file of facts as possible, it’s like going hunting for a lion with a slingshot.
(2) THE EVIDENCE: You must weigh all factual evidence known to you against the actual evidence you can produce to substantiate it. No matter what information you’re aware of, your position will always be stronger if you have the evidence to back you up.
For example: You can talk until the cows come home about the unsightly black-and-blue marks you had on your face, ribs, and hips, the scar on your forehead, or the 75 feet of skid marks Fred Fuddle’s auto left on the highway before he smashed into you, but Adjuster I. M. Smart will never adequately comprehend, (nor want to believe you) unless you provide him with photographs.
Providing Smart with the proof-positive of photographs will cause his Supervisor’s eyes to bulge as he inhales a deep breath of resignation and declares, “Hey, this one’s gonna cost us” .
QUESTION: “How can Dan be so sure about that”? ANSWER: “Because before Dan retired, after spending over 30 years on that firing line, he was an Insurance Adjuster, Supervisor, Manager and Trial Assistant. He’s been there, saw that, plus heard (and felt) that many thousands of times”!
Whenever possible you must help Adjuster I. M. Smart justify the settlement figure he wants to get approved by his immediate superior at Granite Mountian Insurance Corporation.
(3) THE LAW: As proved in over 83% of the accidents in the United States in 2003 the impact you were subjected to is clearly the fault of “Fumbling” Fred Fuddle, so the law is on your side.
Armed with the information found in my third book AUTO ACCIDENT PERSONAL INJURY (How To Evaluate And Settle Your Loss) plus THE BASE FORMULA (The Baldyga Auto Accident Settlement Evaluation Formula) you’ll be able to do that. THE BASE FORMULA will correctly evaluate your “Pain and Suffering”. Because of this, you can settle your own claim without handing a huge percentage to an attorney. A lawyer who has done nothing more than have his secretary send Fuddle a letter of representation and then think it’s perfectly acceptable (after many moths, sometimes years, of hiding/stumbling/fumbling and verbally pitching his well-practiced answer when you asked, “Hey what’s going on with my claim?” with an answer like, “I’m right on top of it, hang in there, old friend and I‘ll make it come out right”, and then proceed to take a huge portion of your settlement dollars, for doing little or nothing to earn it.
(4) INJURY TO YOU: The seriousness of your injury has to be considered. (Ole’ Doc Comfort, your attending physician’s Medical Report, should go into detail about that).Your age will have an effect on the time it takes you to recover. The time you lost at work will have a direct bearing on the length of your recovery.
(5) SPECIAL DAMAGES: All of your direct and tangible losses are prime factors to be implemented in the consideration of the value of your claim.(Clearly stated details regarding Damages are found in Chapter Four of my book).
(6) INTANGIBLE ELEMENTS: These include your reasonableness, your economic status, your standing in the community, the obvious sentiment conjured up when one considers the degree of the seriousness of your injury, plus the attitude of Fred Fuddle (and often your witness) regarding your case.
Sympathy will come into play if you’re a widow or a highly respected Little League Coach, in contrast to your being identified as a raucous bum with a history of getting into scrapes with the law.
Emotional factors often have considerable weight in the evaluation of your claim. Whatever the intangible elements may be, you must force yourself to investigate and then evaluate them just as objectively as possible. So, if what’s being contended is incorrect, you can deny them (plus you must prove the conclusions not to be true) when and where it becomes appropriate to do so.
Subscribe to:
Posts (Atom)
