What type of letter do I need to send to a third party claims manager?

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What type of letter do I need to send to a third party claims manager?

My sister fell in a store from water on the floor and broke her wrist during the summer. The amount the claims adjuster is offering is only $8000 and her expenses from the injury are $8619.90. Someone had told us in these cases it is usually 3X the amount of the expenses that is to be asked for due to pain and suffering. What should we do?

Asked on December 28, 2011 under Personal Injury, Alabama

Answers:

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

Answered 9 years ago | Contributor

Your sister can tell the adjuster that the settlement is rejected. 

Your sister can either continue negotiations by making a counteroffer or can just file a lawsuit for negligence against the store.

There isn't any mathematical formula for determining compensation for pain and suffering.  I would ask for quadruple the medical bills to compensate for pain and suffering, but NOT expecting to get that.  This would just be a starting point in negotiations with the insurance carrier.  However, in your sister's case the amount being offered by the insurance carrier is too low since it doesn't even cover the medical bills assuming that figure you mentioned is for the medical bills.

Your sister's claim filed with the insurance company should have included compensation for the medical bills, compensation for pain and suffering and if applicable, compensation for wage loss.  Compensation for the medical bills is straight reimbursement.  Compensation for wage loss is straight reimbursement.  The medical reports document the nature and extent of your sister's injury and are used to determine compensation for pain and suffering, an amount in addition to the medical bills.

If your sister is dissatisfied with settlement offers from the insurance company, she should reject the settlement offers and file a lawsuit for negligence against the store.  If the case is settled with the insurance company, NO lawsuit is filed.  If the case is NOT settled with the insurance company, your sister will need to file her lawsuit against the store prior to the expiration of the applicable statute of limitations or she will lose her rights forever in the matter.


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