Visitor Question

How can I get compensated if I don’t have billed medical costs?

Submitted By: J. H. (Madison, WI)

I was injured in a car/bicycle crash. The car driver was totally at fault and was cited by the police. My bicycle was totaled ($600+ depreciated value). I was knocked to the pavement and pinned under the bicycle/car bumper. I don’t have billed medical costs because I went to my college health center where I was evaluated and x-rayed for soft tissue injuries to my arm, leg and torso.

I have sent a demand letter to the driver’s insurance company asking for the value of my bike and an amount for pain and suffering, which I definitely had/have. They countered with what I consider a low ball amount for the pain and suffering and sent me a check for the full value of my bicycle.

How should I proceed since I don’t have actual billed medical costs to factor in to any multiplier for total damages? How can I press my case with the insurance company? Thank you.

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.

Answer

Dear J. H.,

Fortunately, the insurance company fully reimbursed you for your bicycle. While you have no actual medical bills, fairness would dictate you be compensated for your pain and suffering.

Today, most insurance companies rely on proprietary software when analyzing injury claims. These programs take into account factors related to almost every variation of a personal injury accident. One of the best known of these programs is Colossus.

With Colossus, as with other similar personal injury claim software, the insurance company’s adjuster simply feeds information into the program, and Colossus then assigns a “point value” to the injured party’s claim. The point value guides the adjuster in making an offer to the injured claimant to settle the claim.

Here are just some of the factors a program like Colossus takes into account:

  • Is the claimant represented by an an attorney?
  • If so, does the attorney have a history of settling cases, or does the attorney litigate the claim when doing so would be beneficial to the client?
  • How much similar injury claims have traditionally settled for, or have been awarded by a jury.
  • The likelihood of an attorney agreeing to represent the claimant.
  • If the attorney has a history of filing lawsuits, how successful the attorney has been in trial, and the amount of compensation his or her client ultimately received.
  • What area of the country the claimant lives in? (Juries in more conservative areas of the country tend to award lower amounts to injured claimants, while juries in other parts of the country tend to award more.)
  • Does the claimant have a preexisting condition which might have exacerbated his or her injury?

Because most injured parties do not have access to a program like Colossus, they are left to analyze their own claims. You are in that category. While not scientific, a reliable way to establish an amount to demand for pain and suffering would be to add the total amount of the medical bills (“medicals”).

In your case, those amounts might be the costs of the x-rays and any other costs of treatment, whether you had to paid them or not, and multiply them by 3.

For example, if the costs of your medical tests and doctor’s care amounted to $2,000, you might make a demand upon the insurance company for a settlement amount of $6,000. However, don’t be too optimistic. In reality, insurance companies offer very little to settle soft tissue injury claims like yours. While you would not be wrong to demand 3 times the medicals, you may only be able to convince the insurance company to offer you 1½ times the medicals.

The insurance company claims adjuster knows you have little, or no leverage. While they may banter with you about the settlement amount, when it comes down to it, you will ultimately be left in a position of “take it or leave it.”

If you don’t agree to their offer, you might consider suing the owner/driver in one of Wisconsin’s Small Claims Courts. However, if you do, you can be sure the owner/driver insured will be represented by an attorney provided by the insurance company. Almost all car insurance policies require insurance companies to provide a legal defense to their clients at no additional charge, up to the policy limits.

In your case, you may have a difficult time finding an attorney to agree to represent you. The profit margin in such a clam might not be worth an attorney’s time and effort. However, that doesn’t mean you can’t try. Fortunately, most personal injury attorneys do not charge for initial office consultations. If you would like a legal opinion, contact several personal injury attorneys in your area and visit them.

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,

Published: October 19, 2017

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