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In my last post, I talked generally about different factors that go into a settlement calculation. In this post, we will develop a hypothetical situation to discuss specifics. The scenario where most people will find themselves dealing with an insurance adjuster is after an injury in a car wreck. For our discussion, then, let's develop that scenario. We will assume that Jane Wilson is a self-employed mother of two whose husband is disabled. She is a beautician with a good book of clients. While stopped at a red light on the way to the grocery store, she is rear ended by a delivery truck. Though she only felt a slight twinge when she was hit, two weeks later her doctor tells her that the MRI revealed a ruptured disk. Repairing that will require surgery. She does not have any medical or disability insurance and the family's savings are equal to one month's bills.

The delivery company's insurance carrier has called and asked her what she thinks a fair settlement would be. She has no idea. A friend who previously hired our firm recommends her to us. The first meeting with her reveals the following:

  • Her doctor has told her that he won't be finished treating her until three months after her upcoming surgery (next week).
  • Because being a beautician requires a lot of standing and use of the arms, she will have to start back at work slowly and only after she has successfully completed physical therapy.
  • The estimated cost of her medical treatment (including surgery) and physical therapy is about $15,000.
  • The doctor has told her that she will have a hard time in the future pursuing her one true hobby – playing softball.

There is good news and bad news here.

  • Good – She is being treated by a very good orthopedic surgeon who has had great results with this procedure on other patients.
  • Good – Although she won't be back at work full time for another six months, the doctor thinks that she will recover well enough to pursue her career as a beautician.
  • Bad – Even though she will be able to go back to work, she has a permanent injury and she will periodically have to take a week or so off of work when she overdoes it.
  • Bad – Softball is probably out for good.
  • Bad – From any recovery, she will have to pay her medical bills. Thank goodness he is willing to do the surgery without getting paid up front. Most won't.
  • Bad – She can't settle her case until the doctor is finished treating her and has released her.
  • Really Bad – The family's only source of income is her husband's disability. They will soon have to start living on credit cards.
  • Good – The delivery company that rear ended her has plenty of insurance to cover the loss.

We end her appointment with this advice:

  • Start keeping a daily journal that says at the top – Confidential: For my Attorney Only.
  • Assemble her business records and tax returns for the past 3-5 years so that we can start working on her lost wage claim.
  • Sit down with your husband and see where, if at all, the family can cut expenses for the next several months. Evaluate her debts. Are there any creditors that will hold off if they get a letter from me? Are there any extended family members who might be able to provide short term financial help?
  • Follow the doctor's orders to the letter. Goal number one is to get back to work as soon as possible. The best way to do that is to do exactly what the doctor ands the physicalk therapist say to do.
  • We can't really evaluate the value of her case because we need more information. How does she repond to the surgery? Does her doctor see any future medical procedures? Where do her medical bills end up? How much will she have lost in wages when she finally gets back to work.

In my next post, we will evaluate Jane's situation after the doctor releases her and it's time to talk real dollars with the adjuster.

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