Over a year ago, I was hit on the backside of my upper arm by a car going about 55 mph. I was a pedestrian. No broken bones, but I had a partial tear in my rotator cuff. I ended up with 6 weeks of physical therapy, several orthopedist visits, and chiropractic visits for the past year.
I still can’t lay on either of my sides for more than a few minutes without having pain in my shoulder. And I still get pain doing activities that require my arm to be raised chest level or higher for more than a couple minutes.
I know this is a soft tissue claim, and based on your previous replies to other questions, I would use a 1-3x multiplier. Since there is permanent damage, would I then use a higher multiplier, or would it still be within that range?
Just checking because they only offered me 1/2 of the cost of my medical bills for pain and suffering. Any thoughts? Thanks.
Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.
If, by referring to “medical bills” you are including 6 weeks of physical therapy, several orthopedist visits, and chiropractic visits for the past year, then the insurance company’s agreement to pay you twice the amount of these costs is quite reasonable.
Insurance companies greatly discount chiropractic treatment and resulting costs. Unfortunately, when it comes to extensive and protracted treatment, insurance companies often take the position the services provided by chiropractors represent not much more than glorified massage sessions.
Many insurance adjusters believe extensive and protracted chiropractic treatment is tantamount to “running up the bill,” or worse, “padding the bill.”
Experienced chiropractors know that when it comes to car accidents, they rarely get paid the full amount of their charged services. Knowing this, they are often content to receive two-thirds, or even half of what they charged. It’s just the way the system works.
To negotiate a higher settlement amount will require a licensed physician, and not a chiropractor, to write a medical narrative confirming your pain will be permanent, or that the pain is likely to persist for a substantial period of time. Or, the medical narrative can state you will likely need surgery to repair the partial tear in your rotator cuff.
If that is the case, you should not consider settling your claim until the surgery is completed, or until your physician, and not your chiropractor, states you have achieved a level of maximum medical improvement, when further treatment will not substantially improve your condition.
If your physician is unable to support a need for surgery, or state your pain and discomfort will persist for a substantial period of time, then accepting two times the amount of your total medical and therapy bills is a great settlement.
However, there is no reason you can’t continue to argue your case, and demand 3 times medicals. You have nothing to lose, and doing so is certainly not unreasonable.
Learn more here: Pedestrian Accident Claims
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney.
Best of luck with your claim,
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