Like we mentioned recently, we recently finalized a settlement from a car accident and used a lawyer to do so. We didn’t start out thinking we would want or need a lawyer (you may remember that Mrs. PoP is kindof anti-lawyer), but in the end decided that we were much better off for having used auto accident injury lawyer.
Also, as we go along in this story, I’m going to define vocabulary that we learned as we went along, but were pretty essential in understanding all the moving parts of settling a case like this.
Immediately Following The Accident
Crash, bang, ouch. I was rear ended while stopped at a red light on my way to work. Nice way to start the day. From the Emergency Room, Mr. PoP called our insurance company to file a claim. This is where we started to learn some details…
Drivers in Florida (and a number of other states according to Wikipedia) have PIP auto insurance.
PIP (Personal Injury Protection) Insurance: also called no-fault insurance. Here’s what matters in Florida.
- No matter who caused the accident, your insurance company starts picking up 80% of the immediate bills (subject to cap)
- If you have optional Med-Pay coverage, they also cover the remaining 20% (subject to a different cap)
What did that mean to us? Basically, we dealt with our own insurance company and focused on me getting better. Which was really nice.
But You Weren’t At Fault!
Too true. That’s part of the beauty of PIP. You start getting care immediately and don’t have to fight to get it. The at-fault party (or their insurance company) does pay eventually, and that’s what subrogation is for. Subro-what?
Subrogation: the right for your insurance company to go after the at-fault party’s insurance company to get back what was paid out on your behalf. Basically it takes you out of the legal equation and streamlines the process.
Our insurance party started the subrogation process pretty early on to resolve claims with the at-fault party. Within a few weeks of me getting my car back, they closed the vehicle damage claim with the at-fault insurance party. It required almost no work on my part.
For 12 Months, I Worked Hard At Getting Better
The first year after the accident, I worked solely with my insurance company and doctors and kept waiting for my back to stop hurting. Sadly, after about 12 months of treatments, my chiropractor said I had reached MMI, which was both disappointing and relieving.
MMI (Maximum Medical Improvement): is a certification that your doctor provides which basically says, “This is as good as it’s going to get and your remaining injuries are likely permanent.” Most MMI certifications come with a letter that outlines recommended future palliative care to minimize and treat pain, even if they can’t fix the permanent injuries.
On one hand, reaching MMI was heartening because it signified closure. I now knew how much pain I’d have to deal with, and could move forward and put this chapter behind me. On the other hand, reaching MMI when you’re still in pain is frustrating because you have to face the realization that this is how much pain I’d have to deal with – probably FOR-E-VER.
So We Could Settle Now, Right?
Luckily for me, I worked with pretty honest insurance reps. They all specifically told me that I shouldn’t even consider settling until I had reached MMI.
So when I reached MMI, I called up the at fault party’s insurance company. It wasn’t a tiny outfit. It’s one of the big ones with fancy commercials that talk about how much they care for people. I’m here to tell you that’s BS.
The At-Fault Party’s Insurance Company Is Not Your Friend
PIP is a little deceiving when the accident isn’t your fault. Your insurance company is your BFF and is happily paying for all of your medical bills, taking your phone calls, and just generally being really pleasant and kind. (“Don’t forget to write down how many hours of work you missed so we can reimburse you lost wages!” “Fax over that bill and we’ll take care of it today.”) Seriously!
The other insurance company is NOT your friend. They are the class bully. And they want to kick you and make you cry even though your back already hurts.
When I reached MMI, I had a nice letter from my doctor that said I would need chiropractic treatments 2-4x per year for the rest of my life. Beyond that, pain meds and anti-inflammatories would also be needed. So my test for understanding the value of any settlement offer was taking the value and dividing it by the cost of an average chiropractic treatment.
What was our settlement offer? $700. That’s just over 2 chiropractic treatments based on what our chiropractor was billing. Or about 6mos – 1year of continuing care for an injury that I would have FOR-E-VER. (Do we need the video again? I think we do.)
I used reason and logically explained to the adjuster for the other insurance company why I didn’t think this settlement was enough, and was basically told, “Well, that’s great that you think your feelings and pain matter, but they don’t. This is all you’re getting.” Then they basically stopped responding to my calls.
It’s pretty hard to continue to negotiate when the other party ceases all contact. So what choice did we have? We needed professional help.
Picking A Lawyer And Getting A Settlement
We didn’t know what to look for in a personal injury lawyer, so we went with what we usually do when looking for new service providers. We checked Angie’s List. But sadly, they don’t currently publish ratings for attorneys. =(
So we started asking friends, colleagues, and neighbors for suggestions and ended up going with one of them based on a couple positive reviews from those sources. The fees were the same at all the offices we called, and this one had worked well for others.
They will virtually all agree to have a sit down consultation before requiring you to sign on as a client. Do this. It helps. Even if only to ease your mind.
The way we looked at it, if we couldn’t get any further with the other company’s insurer than we had already, a legal fee of 33% of the current offer was just a couple hundred bucks. So the downside to hiring someone and getting stuck paying them out of that small settlement was pretty low. But the potential upside was probably worthwhile and having representation would allow us to be better informed about the whole process.
What the Lawyer Did To Change the Game In Our Favor
Required Me To Get An MRI And See A Neurologist
Maybe I was uninformed in this whole process, but going to see a neurologist never occurred to me. My head didn’t hurt! My brain seemed fine! But to a neurologist I went to get a prescription for an MRI on my lower back to look for soft tissue damage. The neurologist also hooked me up with a Rx for a topical NSAID that is still the only (non-narcotic) thing that helps my back on days when it’s really bad.
The reason for getting an MRI comes down to tangible proof. When I spoke with the other insurance company, there was no tangible proof of my pain other than the word of a chiropractor, which really comes down to my word. There was no picture to point to damage since the x-rays of my back and CT scan of my neck done immediately following my accident showed no damage.
The MRI of my lower back was a different matter. It very clearly showed a disc tear and protrusion in one of the discs in my lower back. Precisely at one of the pain points that I had been struggling with since the accident.
Informed Me That I Could Continue Treatment Even Though I Was “MMI”
Once I had hit MMI, I stopped going to the doctor. I assumed that my insurance company was done paying and that I needed to reach a settlement before my health insurance would pick up the tab. So when my SI joint popped out again (the other lingering pain point), I was cringing and dealing with the pain hoping we would settle soon. Not much fun.
Then the lawyer said, “You’re in pain. Go back to the doctor. Get treatment. MMI doesn’t mean you’re done FOR-E-VER.”
(Okay, I promise we are done with that clip. I just love the Sandlot!)
“In Florida, with PIP if you need treatment you get it.”
“What about holistic treatments? Can I try rolfing?”
“If you wanted a Shaman to perform a spiritual healing ceremony, your PIP would cover his fees.”
So I went back to the chiropractor and got adjusted when I needed to. Which has been about once every 3-5 months. (Funny, that’s about what my honest chiropractor said I’d likely need…)
Negotiated On Our Behalf and Was Very Clear About the Potential Risk/Reward of Litigation
Seeing as the other party’s insurance company was particularly mean and unresponsive to my previous attempts at negotiation, this was really the primary reason we hired a lawyer. But the one we got was VERY good about explaining the laws to us, particularly an important one called Offer Of Judgement.
Offer Of Judgement: a tort reform law that encourages settlement without unnecessary lawsuits. Basically if a settlement offer is made prior to litigation, but rejected and the case goes to court, the party that rejected the settlement can be on the hook for the other party’s legal fees even if they win.
What does this mean in practice? That it’s actually possible to go to court, convince 6 (yes 6 for a civil trial here, not 12!) jurors of your injuries, win an award, and if your lawyer’s fees and the opposing counsel’s fees are bigger than your settlement, actually OWE money.
Our lawyer was really clear that if we went this route, joint assets held by both Mr. PoP and I (and really, all of our money is combined), would be at risk. It felt like a big gamble because the other insurance company doesn’t have a lot of incentive to keep costs down if they’ve had an offer refused.
Negotiations went back and forth and the whole process took almost another year. But the final settlement ended up netting us about 10x what the original offer did, even after accounting for paying the lawyer’s fees as well as reimbursing med-pay expenses that our insurance company had paid out.
Downside to Having Legal Representation
Having a lawyer wasn’t all roses and kittens. The biggest downside to having legal representation is that it puts your insurance company on the defensive. All of the easy contact and getting bills taken care of ASAP went out the window as soon as I got a lawyer as all communication had to go through my “legal representative”.
To be honest, that delayed a few reimbursements as we had to pay out of pocket for the rolfing treatments and be reimbursed after the fact. Yet another powerful reason for having a solid emergency fund/buffer as at a couple different points we were out $500 – $1,500 that we had to pay out of pocket while waiting for reimbursement.
But overall, the benefits of having representation far outweighed the negatives for us, and if (heaven forbid) something like this happens again, we will probably follow a similar path. Though perhaps we’d try and get an MRI and figure out if there’s tangible proof of soft tissue damage and see where that gets us in the negotiation process…
What has your experience been like after a car accident? Did you get legal representation? How did your settlement process work?
Disclaimer: Laws and circumstances vary widely. What worked for us may not work for everyone, so do your own research and consider consulting with professionals in order to be sure of your rights and responsibilities in a civil matter such as an auto accident.