Any Auto/Injury Insurance Gurus?

"MooseKnuckles" (andyschenk) 07/26/2016 at 11:05 • Filed to: None

0

6

In April 2015 I was rear-ended, I was stopped waiting to enter a round-a-bout, person behind came to a stop, then nudged me at ~5km/h. I have a hitch on so there would be zero damage to my truck. I got out just to take pics and tell them no biggie as long as they accept fault and we move on with our day. Got out, walking down the side of my truck towards them, they freak out, smash through the rear end of my truck and swerve back and side swipe my truck with me pinned in between the sides of each vehicle. I was crushed between vehicles and then dragged and ended up in the round-a-bout about 15 feet in front of my truck. They fled, hit a light pole, car died and they took off on foot.
Person was a low level drug dealer and likely tweaking.

Anyways, I had pretty bad soft tissue damage to my legs, and a gibbled ankle. Tendons and ligaments damaged, no breaks.

Between insurance and my work benefits my physio and what not was covered. Since the accident I’ve had issues with running/jogging, definitely can’t play sports, and put off snowboarding this past winter. In my day-to-day I have no issues, I can do leg workouts with calf raises and have no issue. But cross country running can be an issue depending how my foot lands and if i’m twisting/turning. I can run 5km and be fine one day, but have pain the next. On long drives where my foot stays in basically the same position it gets stiff and I sometimes get sharp pain in two places, which is resolved by stretching and working the ankle.

So that’s where I’m at now.

I’ve been talking with my insurance company, I have just shy of $10k left of usable claim for this injury. Which means if I want to start physio again I could basically do it once a week, every week, for years. It’s on their schedule though, I need to meet their demands for attending physio. Which is tough because I work on average 55hr weeks and am in and out of town at a moments notice. I cant remember exactly what the criteria is, but I remember if I miss a certain amount of appointments the insurance company will lose their shit.

Or they said I can settle the claim and they pay out the $10k, tax free.

Now $10k in my pocket sounds appealing, but I have reservations, especially since it’s an insurance company just ‘handing’ over money. My work covers 50% of physio up to $500.00 a year, which is about 15-20 physio sessions each year before I pay full price on my own. So that $10k would go even further if my work is covering that 50% too. And appointments would be on my schedule and terms.

But what else does that $10,000 mean to the insurance? If i settle the claim I can’t get any more from them in regards to this injury. But what are they trying to avoid by offering to settle the claim? The claim would otherwise expire 10 years from the date it was opened, so 8.5 years from now. Are they worried about potential surgery? Ligament surgery in Canada can’t be more than a couple thousand. And between vacation time, 5 paid sick days, and medical leave of absence the recovery wouldn’t affect me financially too greatly from missed work.

SidewaysOnDirt still misses Bowie > MooseKnuckles 07/26/2016 at 11:09

4

Not an expert, but it sounds to me like they’re anticipating higher long-term cost based on the types of injury so are trying to settle now.

MooseKnuckles > SidewaysOnDirt still misses Bowie 07/26/2016 at 11:14

0

That was my thought, but I’m 28 now, the claim expires when I’m 36. I could see costs when I’m 60+, but the claim expiry is still relatively short term.

Matt Nichelson > MooseKnuckles 07/26/2016 at 11:26

1

Former claims adjuster here. So to put it nicely, you’re a liability. Yes, it may expire in 8.5 years and that may not seem very long, but it is to an insurance company who may have to fork over more than $10k during that time. Settling is their easy way out and would absolve them from further responsibility. A lot can happen in 8.5 years, so really weigh your options before making that decision.

wafflesnfalafel > MooseKnuckles 07/26/2016 at 11:52

0

I’m not entirely sure what you mean by “have just shy of 10k left of usable claim”. I’m guessing the other guy had no insurance. If that is the case then you are almost certainly using your Uninsured Motorist Bodily Injury limit. Once that has been exhausted then the carrier is off the hook anyways. The carrier certainly always has an incentive to settle as quickly as possible - but if you have nearly burned through that limit they may simply be giving you the option to cash out now since it’s not much different to them if they pay you $10,000 now or over the next couple years.

MooseKnuckles > wafflesnfalafel 07/26/2016 at 12:06

0

The claim limit, for this specific claim, was $12000.00, I used ~$2500.00. Leaving ~$9500.00. My insurance company would cover up to $12k for costs related to the injury, so like you said once that’s burned through the insurance company won’t cover any more for this claim.
I’m just confused as to why they are willing to just pay out the remaining balance.
They either give it to me all now (and i decide what to spend it on), or slowly pay it out over the next 8 years, but over those 8 years I may not actually even need half that amount... And even if I need it all, then it doesn’t change the total cost to them. And in that case how the money is used is controlled by them.

wafflesnfalafel > MooseKnuckles 07/26/2016 at 12:17

1

got it - so that $12,000 “claim limit” is almost certainly under your total UIMBI limit available - it is what the carrier has determined what the claim should be worth. If that is the case, then there is incentive on your part not to settle early in case further developments should arise in the future because that “claim limit” would be flexible should other issues arise.