Fractured shoulder from fall...
I was walking my dog though the hallways of my apartment complex late one night because it was cold, wet and dark outside. I caught my toe in a hole in the carpet, fell and sustained two fractures in my left shoulder. It has been a long healing and treatment process.
I am scheduled for another MRI and appointment with the orthopedic surgeon to determine if surgery will be necessary to wire or cement the fractures for stability.
My question is: When do negotiations start for an injury like this? It will probably never completely heal due to resultant arthritis and the potential for frozen shoulder. How long will this process take and how much should I ask for? Any information you can give would be appreciated. Thanks.
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ANSWER for "Fractured shoulder from fall...":
Laine (Albuquerque, NM):
From the facts you present, we assume you've already spoken with the insurance company, or the insurance company’s claims adjuster. At this point in your injury claim, the adjuster has opened a file and a claims number has likely been assigned. You should have that claim number handy, especially when speaking with the adjuster.
Claim adjusters are hired to investigate injury claims and pay out as little as possible. Doing so is not illegal; it’s just business. Adjusters normally don't mind paying out a couple thousand dollars for minor injury claims. However, the same adjusters will do everything possible not to pay out out fair settlement amounts for more serious injury claims.
Adjusters can be like good used car salespeople. Experienced adjusters know how to make victims feel like they’re getting the better side of the deal.
Adjusters will say things like, "that’s all the authority I have.” Or, "I’ll have to speak with my supervisor to see if he (she) will let me go that high.” When in reality, the adjuster knows she has just settled the claim for well below it's worth.
Some personal injury claims can be handled without an attorney. These include “soft tissue” injuries such as sprains and strains, minor cuts, bruises, and abrasions, whiplash, minor burns, and the like. Because these injuries normally don't require lawsuits, where inspection of the at-fault party’s records, memorandums, etc. can be viewed by an attorney, soft tissue injury claims tend to settle rather quickly.
However, more serious “hard injuries” almost always require legal representation. To help you decide whether or not you need an attorney, read this article and this one.
Hard injuries normally include fractures, 3rd degree burns, deep cuts requiring stitches, scarring, head trauma, and the like. These types of injuries are serious and result in substantial medical bills and related expenses.
Serious injuries require serious legal representation. Experienced personal injury attorneys don’t fall for claims adjusters' bargaining tactics. Attorneys know what accident claims are worth, and unlike victims who represent themselves, attorneys have recourse. That recourse is the right to file a lawsuit.
Insurance companies don't like lawsuits. They can eat up thousands of dollars in legal fees. Moreover, lawsuits slow down negotiations. Lawsuits require pretrial discovery such as depositions, interrogatories, motions to produce documents, and even a trial.
As a result, attorneys almost always settle hard injury claims for what they are really worth, leaving the victims with a net settlement much higher than the victim could have gotten him or herself.
If you are determined to negotiate your own settlement, you need to let the adjuster know you are still treating. Don’t settle the claim without first being fully healed, or at a point where further medical care will not substantially improve your condition.
Without knowing the extent of your damages, it's difficult to suggest what amount you should attempt to settle your claim for. The amount of your settlement will depend on the amount of your damages.
Generally speaking, serious injury settlements can be a product of multiplying a victim’s medical and therapy bills by anywhere from 2x to 5x and up. However, this is a simplistic way of determining a serious injury claim settlement.
At a minimum, at least speak with several personal injury attorneys in your area. Bring along your medical and therapy records and bills, receipts for out-of-pocket expenses, and a letter from your employer verifying lost wages (if any).
Fortunately, most personal injury attorneys do not charge for initial office consultations. Once you visit with several attorneys, you will have a better idea of the strength of your claim, the time it may take to settle, and the approximate amount the claim may settle for.
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.
Best of luck,
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