Rear-ended by tanker truck...

by Susan
(Elmwood, Illinois)

My husband and I were stopped at a red light when we were hit in the rear by a tanker truck. When we recovered from our shock, my husband jumped out and asked the trucker what happened. He immediately claimed his brakes didn't work.

We called 911 and were examined on the scene. We were an hour from home in an unfamiliar city, so we drove home before dark and went to our own emergency room in town.

By the next day, both of us were very sore. I had neck, shoulder, and lower back pain, and my husband had shoulder, arm (from gripping the steering wheel during impact), neck and lower back pain. The pain got even worse over the next couple days.

We saw our healthcare provider who ordered x-rays, pain medication and then later, chiropractic treatment. My husband finished his treatment in six weeks, but my treatment took longer, and the chiropractor referred me back to the doctor for additional physical therapy. I finished up my total treatment in about 3 and half months.

The damage to our automobile was almost $3,000, which they paid in about six weeks. Now I have turned over all of the medical bills and am waiting on their evaluation. I am planning to send a demand letter before he makes his settlement offer, as I have not done so yet, because I have been just trying to recover from the accident.

My question is, should I go ahead and send the demand letter now and ask for about 5 or 6 times my medical bills, and for my husband, since he wasn't injured as badly, four or five times his bills? Or should I wait for them to send me their settlement offer?

My medical bills were close to $7,000 and his were close to $3,000. Also, what kind of settlement offer can we expect if a commercial tanker truck for a large company was involved? Thank you.

Visitor Question:
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ANSWER for "Rear-ended by tanker truck...":

Susan (Elmwood, Illinois):

While you and your husband sustained injuries in the car accident, those injuries don’t appear to be more than "soft-tissue." Soft tissue injuries can include whiplash, strains and sprains to muscles, tendons, ligaments, minor cuts and abrasions, mild concussions, and similarly mild injuries.

Soft tissue injuries are to be distinguished from "hard injuries," which can include fractures, deep gashes requiring stitches, serious head trauma, 3rd degree burns, and similar serious injuries.

Insurance companies hesitate to reimburse injury claimants for extended physical therapy and chiropractic care. In your case, if you had received a few weeks of physical therapy prescribed by your doctor, the insurance company claims adjuster would likely agree to reimburse those amounts.

However, here's the problem... Unless your doctors prescribed the extensive chiropractic care you both received over a period of 3 months, the insurance company will very likely not agree to reimburse you for those costs. The medical and therapeutic treatment must be equal to the corresponding injury.

In most cases, chiropractors have a built-in conflict of interest. The longer a patient treats, the more money the chiropractor makes. If your doctor prescribed physical therapy (chiropractic treatment) and you continued to receive the treatment past the amount prescribed by your doctor, the insurance company claims adjuster will likely discount the physical therapy bills.

Insurance companies take the position that, when left to their own devices chiropractors tend to treat patients endlessly. So if you and your husband continued your chiropractic treatment on your own outside of your doctor’s order, the insurance company will probably ignore those bills associated with that treatment.

You refer to medical bills in the amount of $7,000, and your husband’s in the amount of $3,000. Unless those bills were primarily medical, and not therapeutic, the insurance company will very likely not reimburse you for them.

Insurance companies rarely pay soft tissue claims with a multiplier of 5 or 6x medical bills, especially when the physical therapy is not specifically ordered by the treating physician.

Whether you send your demand letter first or wait to hear from the insurance company is not important. At this point it appears you'll be fortunate to get reimbursed for the full amount of your medical and therapy treatment.

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,

Judge Calisi

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Medical bills
by: Susan

Please note that the medical bills are made up mostly of emergency room visits, x-rays of the spine and neck, and doctors visits. Only 12 percent of the 3,000 is treatment and therapy, and only 45 percent of the 7,000 which includes extensive PT ordered by the doctor after the chiropractor couldn't get me back to 100 percent. But the chiro did not go over the 8 weeks ordered by the doctor.

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