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How should I proceed with Insurance Co?
Albany, NY
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Posted 4 months ago in Car / Auto Accident
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I was involved in an car accident in NY in 7/08. Other driver admitted 100% liability. she was driving while taking meds and was advised not to. I suffered head, shoulder, and neck soft tissue injuries. I received PT for a little over 2 months, had CT scans, brain MRI, and saw an ortho. medical bills totaled $5,000 (cost pd. by my insurance co.) and lost wages were $1,000. I recently sent a demand letter to her insur. co. for 25K and received a low ball offer of $3,000. Reason stated my injuries lasted less than 90 days Adjuster stated this was NY law. He also told me that my medical bills were pd by my insurance co. and I am not entitled to recoup them, which I believe is false. Based on the facts I've given you, what is the ballpark value of my claim and what role does DUI play
Answers (2)
Clifford Douglas Gabel
This attorney is licensed in New York.
Posted 4 months ago.
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First, the adjuster told you the truth about the ability to recover your medical bills. No-Fault insurance (your carrier) pays the first $50,000 in medical bills and lost earnings (up to $2,000 per month for up to 3 years after the accident). That's called "basic economic loss" and you cannot recover that in a lawsuit for personal injuries in New York.
You can recover for your pain and suffering, which includes your injuries but only if you can prove you have a "serious injury" as that term is defined under the Insurance Law. Since you don't have a fracture (a broken bone), or anything more serious like death or dismemberment, you don't automatically have a serious injury, and your case can be dismissed if you're not careful. On the other hand, if handled properly, your case can be worth more than the $3,000 they're offering you. The problem is the insurance company has you over a barrel. What did the CT-Scan show? Why were your bills so high with only 2 months of PT, or was that the amount the doctors overbilled the insurance company? You may have boxed yourself in by demanding only $25k, unless, of course, that's the limit of the other vehicle's insurance coverage. Also, did you have a policy with more coverage? If so, you may be able to bring a claim for Underinsured motorists coverage, but only if you obtain the full policy limit from the other vehicle. As you can see, making a claim for bodily injuries from an auto accident is no simple matter. The DUI plays little or no role, as the real issue here is the seriousness of your injuries, not the other guy's liability. He'll concede the accident is his fault. The real question is whether you have a serious injury, and frankly, if you don't settle your case or get a lawyer soon, the insurance carrier can pull the offer off the table and you may get nothing. If you'd like to speak with me more about it, or if you'd like a recommendation for an attorney in your area, please feel free to shoot me an e-mail directly, and I'd be more than happy to talk with you further. 
Michael Howard Joseph
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