I was a car accident. The at fault driver did not have insurance at the time of the accident, so I am using my own uninsured motorist policy. I sustained neck, back, and foot injuries. I will miss 3 weeks of work and i have 6 weeks if rehab. My bodily injury limit is 25,000. My insurance company wants me to sign a medical release...do I have to? Can i give limits to what they can see? can i say they can see only records regarding the accident? My insurance company says I'm obligated to comply. I want to represent myself but not sure if I need a lawyer at this point. They are using colossus, how can I estimate my own claim?
Colossus is a loathsome project set up by insurers to underpay and deny injury claims. You have already made a gigantic mistake in talking to your insurer at all. Every conversation will be used against you. On average, people without attorneys see results 70-80% worse than people who promptly retain counsel. You need a lawyer ASAP to assess and review your claim. Until you hire one, do NOT say a word to your insurance company and do NOT sign releases.
Colossus is designed to reduce your medical bills to some lowest common denominator that is not fair value. Further, most people find real permanent injuries turn great lives into good ones and good lives into tough ones. Pain and suffering, sacrifice and the like aren't accounted for by any computer or cynical adjuster.
I know you want to handle it yourself, but in this day and age, it's foolish. Lawyers get higher settlements and negotiate bills lower. And the sooner you are protected and not subject to the bullying deceit by some claims representative who considers you just a file on his desk.
Hire a lawyer. We'd be happy to help. It sounds like a good claim. Regardless, stay away from the large advertisers and the inexperienced. They are no better than colossus.
Every experienced attorney who reads your question is going to be familiar with Colossus. It has been the subject of a great deal of controversy in personal injury practice, and has gotten at least one major insurance carrier into hot water over its use.
I would venture a guess that you have Allstate as your UM insurer, based upon what you said.
I agree with the others. You will do yourself a huge favor by retaining an attorney. You will likely achieve a higher settlement and be better able to negotiate your bills downward, especially if you do not have health insurance or another source to pay them. The insurance company, though your own insurer, is not your friend in this matter. Do not be fooled by the jovial, humorous, somewhat sanctimonious insurance company commercials that are all over the television these days. While there are some good companies and some good adjustors, the cynical and unreasonable ones will make whatever arguments they can to convince you to take less than your case is worth. And you will not really have any good idea what the case is worth on your own.
Even though this is your own insurance carrier, to whom you pay premiums, the claims department typically does not care about that. They are not involved in marketing, developing business, or customer satisfaction. Their job is to keep claims costs down. Even with their own insureds. This is why there is a bad faith statute in Georgia applicable to property damage claims and bodily injury claims against one's own insurance company; they don't play fair a lot of the time with their own insureds.
This forum, though great for conveying general knowledge and answers, does not lend itself well to specific questions like valuation of a particular case. There are too many factors involved in valuation, some of which are entirely subjective. Even knowing the full amount of lost wages and medical expenses you suffered is only the beginning, and you did not mention those amounts specifically. Of course, you don't know the full amount of your medical expenses yet.
The insurance adjustor knows how to handle these cases, and adjustors handle them all day every day. Unless you have handled cases like this before, you will very likely make honest mistakes in dealing with them that they will be able to use against you later. Everything that you tell them is a potential piece of information that they can attempt to turn in their favor.
If you continue with this on your own, tell them as little as possible, and do not discuss your injuries. As far as the release question, unless your UM policy specifically requires providing one to them, which is unlikely, I would not give it to them. I do not provide insurance companies with releases like that for my clients. Instead, I provide them with the records and bills themselves, which I gather.
Good PI attorneys offer free consultations, and you should talk to some, from this service, or elsewhere, to get an idea of why you would benefit from retaining one. I offer free consultations, as virtually all of us do, and any of us would be happy to talk to you about your case.
DOUGLAS F. KALEITA, P.C.
First, be aware that colosus is a complicated program with many algorythyms. Avvo is not a place that can give you the legal education you would need to understand and respond to its nuances. When u make an uninsured motorist claim your insurance company basically stands in for the insurance company the other driver should have had. Even though it is "your" insurance co. you are now proceeding in an adversarial manner against them and their job is to pay you as little as possible. If your policy states that in a UM situation you must supply an unlimited med. release to them, then you probably have to, although HIPPA may afford some protection. If they want your records, then as an adversarial opposing party they can always subpoena the records ang get them through discovery. You could then file a motion and supporting brief to quash the subpoena but you can already see that you are in way over your head. Better to hire a lawyer to maximize your recovery and minimize any damage you may cause trying to represent yourself.
You ask: how do you "make sure [you] receive a proper claim settlement." THe answer is to retain a lawyer to handle your claim. I see my job as getting my client more money than they would be able to get on there own. Many studies show, including those done by the insurance industry, that someone with an attorney will net significantly more money than a person handling their own claim.
Colossus--Allstate right?--as you know is some computer program that estimates the value of your claim--comes up with some figure that represents how this injury impacts your life. Does that sound like something a computer can do and something designed to ensure you are fairly compensated for your loss? When the adjuster tells you that the computer says the value of your case is x dollars, what do you say?
You are obligated to cooperate with your insurance company including allowing them access to your medical records. Yes, there can be limits on what records are disclosed--again something better suited to an attorney to negotiate. For instance, suppose you had your gall bladder removed 10 years ago--do you think that has anything to do with your neck and back injury? Probably not. What if last year you had heart surgery, is that any business of the insurance company to see in this case involving a neck, back, foot injury? Well what if you are claiming there are many things you cannot do today or do as well because of the injuries you suffered in the car wreck. The insurance company will want to see those heart related records so they can argue you are really slowed down by your heart condition and not the car wreck. They are probably entitled to those records and if they can mount a "strong" similar argument with regard to those gall bladder records they probably can get those also.
You also say the uninsured driver is at fault. Don't be too sure that the insurance company will not try to place at least some of the blame on you. They are professionals at this. THey are trained to ask questions in a way to make you look responsible.
Retain a lawyer. Even with the fee you will still net more than if you try and go it alone.
It sounds like you really need to hire an attorney. You are not required to sign anything and should not. Do not give a phone interview either unless it's too late. Anything you tell an adjuster or anything they ask for is designed to reduce the value of your claim. They want to pay you the least amount of money possible.
There are also various damages you are entitled to that they are not accounting for. You really need someone with your best interest in mind to handle the insurance adjuster.
There could also be additional insurance money you are not aware of that a lawyer will know how to find.
You are asking questions on this post that need to be answered by an attorney. You have injuries and are trying to hold another person accountable. It's very important that you not speak to the insurer directly. Even though it's technically your insurance because you paid for it, your Uninsured Motorist Coverage immediately becomes adversarial the moment you make a claim against it. The insurer now has the at-fault driver's interests to consider, not yours. It is a very complicated area of insurance law, and one mistake can jeopardize your entire claim. There is usually no up-front cost to retaining an attorney to handle a personal injury claim. The attorney or law firm is paid a percentage of whatever you recover. Hire one now, instead of poking around on the internet trying to get answers to basic questions every lawyer doing this type of work will know.
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