Settling a Personal Injury Claim

PI Settlement

In Colorado the insurance for the person who injured you does not have to pay any money until the end of your claim, making it more difficult to settle without the help of a lawyer. However, if you would like to try and settle your own claim, we would like to offer some suggestions for how you can do so. The first issue you will need to address is whether your health insurance carrier, which has been paying for your medical bills, has a subrogation claim against any settlement you have with the other driver’s insurance company. Subrogation means that the health insurance company will need to be reimbursed from your settlement. Not all health insurance companies have this right, but it is important that you find out prior to any settlement. In cases where you have suffered a minor injury and have made a full recovery in a short period of time, you may be able to handle your claim without an attorney. It would, however, be helpful for you to understand your rights and have a general idea of how this process works. Unfortunately, most insurance company representatives may not be motivated to look out for your best interests during this process. Therefore, knowing what to expect will help you obtain a fair and reasonable settlement.

The Following Information May be Helpful If You Choose To Settle Your Claim On Your Own:

What types of claims do I have if the other driver caused the collision? There are two claims to consider and settle with the other driver’s insurance company:

1) Damage to your car: Shortly after the collision, you may be able to be reimbursed for the cost to repair your car or its fair market value if the cost of repairs is greater than the value of the car. If your car is repaired, you may also recover for any decrease in value after the collision, if a body shop or car dealer is able to provide you with a dollar figure of how much your car has depreciated due to the fact that it has been in an collision. If your car is not able to be fixed, it is usually helpful to do some research about its value by looking in the newspaper or talking with car dealers about how much similar cars are selling for. There are very good resources on the internet that provide this information as well. and other sites will give you a good start in determining the market value of your car immediately prior to the collision.

2) Bodily Injury Claim:  The law provides that you may be entitled to collect both economic and non-economic damages from the driver of the car who caused the collision. This is usually paid by their insurance company, up to the policy limits. If the negligent driver was not insured, you should determine if you had uninsured motorist coverage under your own insurance policy at the time of the accident. This coverage will provide for the same recovery as the other driver’s insurance company, had they had any insurance. Economic damages include: lost wages, the amount of your medical bills, mileage expenses,  or any other out of pocket expenses you have incurred as a result of the injuries you sustained in the collision.

When should you settle your claim?

One of the first questions to consider is when is the correct time to settle your claim. In most cases, you should not consider settling your claim until your doctor indicates that you are at maximum medical improvement (MMI) or releases you from care. This usually occurs when you have reached a plateau in your recovery and it is not expected that you will get much better or worse. If you are released from care and have generally recovered from you injuries, you still may have a valid bodily injury claim, but the recovery will probably be fairly small.

What should I do after I am released from care?

Assuming you have generally recovered from your injuries, and you want to negotiate a settlement on your own, you should first make contact with the insurance company of the driver who caused the collision. Once you find out who will be handling your claim, you should ask them what information they will need to evaluate your claim and arrive at a fair settlement figure. At this point, you are not ready to give them an amount that you would be willing to settle for but are simply trying to learn about the process they use to evaluate your claim and what information they will be considering.

Collect your medical records. In most if not all cases, the claims representative will need your medical records. If the insurance company has asked you to sign a medical HIPPA authorization form, they will collect the medical records from your doctors. It is usually advisable to allow the insurance company to do so; however, you should ask them to provide you with a copy of all medical records they receive. If you did not sign an authorization form, you should ask your doctor’s office for a complete copy of your medical records and bills. The doctor’s office must provide this to you, but they may charge a copy fee to do so. You should try to have all your relevant medical records available to you prior to beginning to negotiate with the insurance company.

Prepare a list of your damages. You should try to keep track of your damages, both economic and non-economic, as you go along after the collision. It is sometimes helpful to keep all of your expenses and lost wages listed in a notebook, as well as a summary of how the injuries have affected your ability to continue with your normal daily activities and/or hobbies. When you are ready to settle your claim, you should provide this information to the insurance adjuster through a written settlement letter.

The following items are usually included in a settlement letter:

  1. A brief description of the collision and what happened to your body upon impact.
  2. Any aggravating factors about the collision; i.e., was the other driver drinking, did he/she leave the scene, etc.
  3. A summary of your medical treatment including the number of visits to each doctor and an itemized cost of all treatments.
  4. A summary of how the collision has affected your ability to engage in any hobbies, social activities, etc.
  5. An itemized breakdown of all lost wages with supporting documentation from your employer.
  6. A list of any other out-of-pocket expenses including mileage to medical appointments.

How do I determine how much my claim is worth?

There is no easy way to determine specifically how much any claim is worth. The first place to start is to determine all of your economic damages, as noted above. This amount will be added to your non-economic damages (pain and suffering, loss of enjoyment of life, permanent impairment, emotional distress). It is assumed for purposes of this material that your damages have not been very severe and that you have either fully recovered or are very close to full recovery and expect that you will do so shortly. As a very general guide, you can probably expect an insurance company to offer to pay you $2,500 – $7,500 for a muscle or ligament injury to your neck or back which has healed within about 3-6 months after the collision, plus any out-of-pocket expenses or medical bills needing to be reimbursed. This amount may vary depending on whether the insurance company believes that your were partially at fault for the collision, or the medical records/other documentation do not substantiate your claim. You should ask the insurance adjuster to explain to you what type of documentation would be helpful to increase the value of your claim.

How do I negotiate my claim?

Once you have collected all of the information discussed above and put it in writing for the insurance representative, you are ready to begin negotiations to resolve your claim. One way to think about this process is to consider it very similar to buying a car. When you buy a car, you are dealing with someone who wants to make as much money as possible. You of course want to spend as little as possible. On some occasions, the more information you have about the car you want to buy and the process the better the deal you can get. The same is true for settling your claim. If you followed the above process, you will be better prepared to negotiate your claim, and the insurance representative will take you more seriously. In this negotiation, the representative would like to give you as little as possible, and you may want to collect as much as possible. As with car-buying process, you will generally start higher than what you expect to get, and the insurance representative will start lower than they ultimately will pay. It is not unusual to go back and forth 3-6 times before the adjuster will say they are not able to settle for any more. It is also fairly common for an adjuster to eventually double their initial offer prior to indicating that they will not pay any more money. In most cases, the adjuster has discussed your case with his/her supervisor and possibly with a claims committee to arrive at a value. It is also possible that they have used a computer program to determine the value of your claim. It is always appropriate to ask the adjuster if they have done so and try to go over the factors they put into their program to determine the value. It is also helpful if you ask the adjuster to give you their best offer prior to you giving any amount of money you would settle for. You will then be able to respond, but you should not be too offended if they start low, since they probably will increase their offer once they hear from you how much you are willing to accept. Sometimes, you can increase your settlement by getting the adjuster to include additional information that he/she did not include in the original evaluation. You may also be able to increase the settlement offer by providing more documentation about either your economic or non-economic losses.

What happens after we agree to a dollar amount?

The insurance adjuster should send you a check and release within 3-7 days, although it is usually helpful to ask specifically how long it will take for them to send this to you. Once you receive the release, you should read it to make sure it indicates what you and the adjuster agreed to. Most releases are not very easy to read, but they generally indicate that in exchange for your receiving a certain amount of money, you will never be able to bring a claim for any other damages from that collision against either the person at fault for the collision or the insurance company. It generally covers both known and unknown injuries and damages and specifically states that you can never reopen your claim or ask for any more money for any reason. You will need to sign the release (sometimes in front of a notary) and return it to the insurance company. In some cases, the adjuster may ask you to sign and return the release prior to them sending you a check. If you’re married, it is likely that the release will require both your and your spouse’s signatures.

If you have a permanent injury and do not want to settle your own claim, contact The Webster Law firm, LLC, today for a free initial consultation.