Insurance adjuster offer on pain and suffering for my auto (motorcycle) accident.

UPDATED: Jun 21, 2009

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Insurance adjuster offer on pain and suffering for my auto (motorcycle) accident.

The liable parties insurance adjuster is basing my pain and suffering on the medical bills paid out by my health insurance. In other words my health insurance “contracted” rate as opposed to the full amount that was billed by the hospital, hospital and radiology doctors, personal physician and chiropractor.I live in the Texas and I would like to know if this is appropriate. I was told by a friend who is an attorney in California that the pain and suffering should be partially based on the full amount billed, not my health insurance contracted rate. Where would I find this info?

Asked on June 21, 2009 under Personal Injury, Texas


L.M., Member, California Bar / FreeAdvice Contributing Attorney

Answered 13 years ago | Contributor

I'm not sure where you would find this information.  There is no rule of thumb for insurance companies to follow when it comes to evaluating a case for pain and suffering.  They typically offer around three times the medical bills, but that is not set in stone.  I've never heard of them basing it on the contracted rate, though.  That's a new one.  How would they even have that information?  They should have copies of the original billing statements, not the statements sent to you after they were submitted to the insurance company.  It sounds like they are trying to take advantage of you.  You would be wise to have an attorney write them a demand letter based on the full amount of the medical bills.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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