Let me start by complimenting you for the information you provide on this site. It has been very helpful.
I am negotiating, representing myself, with an insurance company for settlement on a personal injury claim from an auto collision. There is no dispute that the other driver was at fault, my husband and I were rear-ended. I received treatment for pain by a medical doctor and took medication for pain and muscle relaxers during my treatment over 148 days.
I have been a Realtor for 11 years. I am an Independent Contractor and I make my own schedule. There were days I was not able to perform job duties due to pain and side effects from medications I was taking. The collision occurred at the end of May 2015, and I recorded on my schedule that I did not work 31 days through the months of June, July and August 2015.
I did not have income/sales transactions in May, June, July of 2014 as during those 3 months I sold my home and relocated to another state. I was not licensed to practice Real Estate in the new state until October 2014. That greatly affected my income in 2014.
I presented proof of income/sales transactions over May, June, July of 2013 to calculate a daily wage, multiplied it by 31 days, and got a solid number for my lost income demand. I had other supporting articles from Realtor publications about summer months and seasonal real estate sales.
I explained all of this in writing to the insurance adjuster. The adjuster offered me $500 for lost wages and stated if I disagreed with the offer, additional documentation is needed, including, but not limited to my past 5 years of tax returns and a note from my doctor excluding me from work.
Is 5 years tax returns necessary to provide for lost income demand? Is there another way for me to present my income other than tax returns, for example, 1099’s and monthly commission transaction reports from my Broker? Or my CPA preparing something?
Even if I submitted this information, my real estate sales income is greatly varied over the last 5 years and does not show consistency that I assume the adjuster is looking for.
I am not comfortable submitting my tax returns. They are complicated, I have other income, investments and legal deductions that greatly vary my tax returns. In addition, earlier this year, I received damages from a BEL Claim due to the Deep Water Horizon oil spill on April 20, 2010.
What’s the best way for me to explain that I do not want to submit my past 5 years of tax returns? What should I provide the adjuster to support my lost income considering all of these variables in my income over the last 5 years?
Also, concerning the doctor’s note, the doctor told me, “see how you feel” and told me to use my judgement concerning my activities. I presented documentation from the pharmacy with the medication side effects supporting that I was compromised to drive and did not feel that I had the mental capacity to perform my fiduciary duties to my clients on the days that I took medication.
I have already provided the doctors notes to the adjuster. What other information does my doctor need to provide to help me support the days I did not work and lost income?
Thank you for any information you can provide.
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.
Under the Texas Insurance Code, insurance companies must act in good faith when dealing with their insured and with third party beneficiaries like you. The Texas Insurance Code is voluminous in its scope. However, the following section of the Code is applicable in your case.
Under Section 541.060 of the Texas Insurance Code it is illegal for an insurance company to require a third party claimant (You) to produce his or her tax returns in the pursuit of a settlement. However, there are exceptions. The insurance company cannot demand as a condition of settlement the production of a claimant’s tax returns unless:
(A) a court orders the claimant to produce those tax returns;
(B) the claim involves a fire loss; or
(C) the claim involves lost profits or income.
Inasmuch as your injury claim includes reimbursement for lost wages, the insurance company has the right to demand your income tax returns. Whether 5 years is reasonable is debatable, but the Texas Insurance Code does not seem to address the 5 year time limit.
The insurance company has a right to demand the medical proof they require to settle your claim. Generally accepted proof is a written medical narrative describing the injuries, their cause and required treatment. Unfortunately, “Doctors Notes” aren’t normally sufficient evidence to support an injury claim.
Documentation from a pharmacy showing a medication’s side effects, contraindications, and admonitions against driving is real evidence in support of your claim, however, it is really up to the insurance company to determine if that is sufficient proof.
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.
Best of luck,
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