My wife and I were in an accident...
April 19, 2005 9:11 PM   Subscribe

My wife and I were struck by a car as we were crossing the street on Monday. We have health insurance, and have no intention of suing the guy, but what should we expect in regards to insurance?

Do we send the hospital bill to his insurance company or his? Any tips on a speedy recovery? I've never been in an accident so I don't really know what to do or expect.
posted by jackofsaxons to Law & Government (25 answers total)
 
What is the extent of your injuries?
posted by ThePinkSuperhero at 9:17 PM on April 19, 2005 [1 favorite]


My wife has 10 staples in her head, 5 in her left elbow, 3 in that hand, 5 under her big toe and some road rash. I have a goose egg on the back of my head, soreness, skin numbness on the lower left side of my back (it feels like there's a baseball in there), my left knee is a bit tweaked, and I Think I may have some bruised ribs and a strained neck...

The doctor has me on 800mg of Ibprofen, and some muscle relaxers, and my wife is on Keflex, the same muscle relaxers and some Hydrocodone...
posted by jackofsaxons at 9:22 PM on April 19, 2005


Did you involve the police? A lot of insurance claims are contestable unless there is an associated police report. Even if you have not involved them, check with the hospital. In a lot of areas, it is regular practise on the part of the hospital to involve the police in any accident related cases.
posted by purephase at 9:24 PM on April 19, 2005


here and here should give you basic info.
posted by peacay at 9:29 PM on April 19, 2005


The easiest thing for you is to use your own health insurance, which will, through a process called subrogation, attempt to recover their costs and your deductible/coinsurance from the responsible party and/or their insurance company. Basically, if there are any problems with extracting the cash from the responsible party, your health insurance company will deal with them.
posted by trevyn at 9:49 PM on April 19, 2005


The police were definitely involved. I have the case file number and the officer that took the report.

Thanks for your help guys :)
posted by jackofsaxons at 10:05 PM on April 19, 2005


I was in a similar accident once, and I got my medical bills covered, the insurance company of the guy also gave me some extra money to settle the case. I took the money, but probably could have gotten more if I had consulted a lawyer on my own. I would think that even if you have no intention of suing the guy that you would be entitled to something for lost work time, etc.
posted by gnat at 10:08 PM on April 19, 2005


Contact your auto insurance company immediately. If you have medpay coverage, you may be able to make a claim through your own policy (yes, even though you weren't in your car...). Ideally you let some insurer chase after the reimbursement, allowing you to focus on healing. Even if your auto or health policy doesn't apply, your auto insurer can advise you and handle some of the paperwork/calls on your behalf.

A word of caution: you don't necessarily know the full extent of your injuries yet. I got hit several months ago, and judging by the first 24 hours I could never have imagined how much whalloping effect it would still be having--physically, emotionally, professionally, financially--all this time later. The initial shock has an amazing ability to cover the true extent of injury. So what feels like just bumps and strains right now might catch you by surprise in the next few days. Take it easy for a few days, and if you notice any new symptoms go back to the doctor immediately.

I hope you both willl be fortunate enough to reach a simple settlement and a quick recovery, but do prepare for the possibility that you'll need help for a while. At a mimium, between the shock and meds and that bump on the head, ASSUME YOU DON'T HAVE 100% SOUND JUDGEMENT RIGHT NOW. So make any signficant decisions or engage in negotiations without a trusted friend at your side, to give you that reality check.
posted by nakedcodemonkey at 10:09 PM on April 19, 2005


So make Don't make...
posted by nakedcodemonkey at 10:11 PM on April 19, 2005


What ncm said about delayed injuries...I developed whiplash (so bad it took me an hour to rise from bed in the morning) more than three weeks after what seemed like a mild accident.
posted by notsnot at 10:33 PM on April 19, 2005


Oh, and meds: make yourselves write down each drug you take, both dosage, and time. Log it right when you take it; no "I'll note it down later..." or "I'll know to do the next one with dinner." The hydrocone and muscle relaxers drop a bit of a fog over your head. Plus you've both got the head injuries. So it's not prudent to be relying on just memory or routine to tell you when you're clear for another dose. Plus it really helps to be able to see concretely that there's 30 minutes left 'til the next Drug A, 2 hours until Drug B, whoops stop you've already reached max daily limit on Drug C. No accidental ODs, no needlessly waiting out the pain.

P.S. Did the doctor explain about applying head and cold? They make a noticeable difference, but it's important to know which to do right now and when to switch to the opposite.
posted by nakedcodemonkey at 11:15 PM on April 19, 2005


*groan*
head and cold heat and cold
posted by nakedcodemonkey at 11:17 PM on April 19, 2005


My wife has 10 staples in her head

Omigod, that must have been horrible. Best wishes for a speedy recovery from the physical pain and the emotional stress of the accident. First, I'd call my health insurance company and listen to what they have to say. Second, I'd call a personal injury lawyer. Most importantly:

DO NOT SIGN ANYTHING FROM AN INSURANCE COMPANY WITHOUT SHOWING IT TO A LAWYER FIRST.

While I understand your hesitance to go the lawsuit route, that doesn't mean you shouldn't involve a lawyer in the process as soon as possible. You owe it to your wife and yourself to find a professional to discuss the case with you, and it *will* make a difference in how the insurance company treats you, and the amount of money you receive to cover your medical expenses and lost work time. Every injury lawyer I know does a first consult for free with no obligation, laying out options and offering useful information to get the most out of the insurance settlement. Rest assured the insurance company will almost certainly try to low-ball you on the first offer; it's what the beancounters in the central office order the agents to do, knowing that an astonishing number of folks will take a tiny lump sum just to be done with it, even before they know the true extent of their medical bills.

Don't be those people. It's not sleazy to stand up and make sure you're taken care of properly. In the USA, in this case, that means talking to a lawyer immediately.

And for your own sake, don't discount the idea of a lawsuit as a bargaining chip, even if you have no intention of filing one, until you see what the insurance company offers, and check the offer with a lawyer who has experience in many of these cases. Without good legal advice, you won't have a clue whether you're being taken advantage of in a moment of high stress. You simply cannot make an informed decision about what to do in this kind of situation just by talking to insurance companies.

wow, two answers in a row that recommend lawyers. what's gotten into me?
posted by mediareport at 11:34 PM on April 19, 2005


The insurance company will probably offer you a pain-and-suffering settlement. I took the first one that was offered to me when a driver ran a stop sign right into my bicycle, but I probably should have negotiated.

My injuries completely healed within a year and a half, with no permanent damage so far as I can tell, but I now think I was unwise to take such a small settlement so quickly. Because things could have turned out differently. And I guess I still can't lift as much weight on that part of my body as I could before, but that probably has more to do with not spending enough time in the gym.
posted by grouse at 12:01 AM on April 20, 2005


The insurance company will probably offer you a pain-and-suffering settlement.

If it's not large enough that you would at least seriously consider being willingly hit by a car to get it, it's too small. Mr. Run-you-over and his insurance company's job is to make you no worse off for having been hit.
posted by ROU_Xenophobe at 12:30 AM on April 20, 2005


This is some great advice you all are giving me.. I wrote about the experience in my blog, here's a link if you all are interested.
posted by jackofsaxons at 12:43 AM on April 20, 2005


The police were definitely involved. I have the case file number and the officer that took the report.

As long as the report clearly indicates what happened, gets as close (or actually) assigns fault to the other party (which it definitely sounds like it should) then the upper-hand is almost assuredly yours.

As mediareport mentioned, prior to signing anything by either the other parties lawyer, or an insurance company, have your own lawyer look the documents over. Also, as grouse pointed out, they will start low. Remember, insurance companies and/or accident lawyers have a lot experience in dealing with these sorts of situations and usually know how to dazzle the affected parties. Your primary concern is about you and yours. Hire someone else to take care of the rest in your interests.
posted by purephase at 5:00 AM on April 20, 2005


Let me emphasize what others have said about delayed injuries. An ex-girlfriend of mine was in a minor car accident and had what seemed like a minor case of whiplash. Initially we only had her hospital bills and some meds to cover. But over the next six months, the whiplash lingered and she wound up having to see several specialists and get more meds. Luckily, I had done some research and had not settled quickly, so we were avble to get all of her bills taken care of, plus pain & suffering. Based on this experience (IANAL), here is my advice:

1) Remember that you are under no obligation to settle immediately. The insurance company will not only try to low-ball you, they will try to settle as quickly as possible. Don't do it until you are sure that you have a good idea of what your current and future expenses will be. The minute you sign a form, you have essentially agreed not to try to seek any more damages, including future medical bills related to your injuries.

2) Take into account possible future medical expenses when negotiating. Sounds like you had a minor concussion; this could lead to additional symptoms down the road.

3) Document everything. Keep receipts and copies of prescriptions and diagnoses. Keep a pain diary. All of these will assist in your negotiations with the insurance company.

Good luck!
posted by googly at 6:09 AM on April 20, 2005


I want to third (fifth?) what everyone else has said about speaking with a lawyer. If you feel bad about this, try to remember that its not the guy who hit you that you need the lawyer to deal with, but the insurance company.

I, too, was in an accident and always swore that I wouldn't get a lawyer -- that I wasn't that kind of person -- until the other party's insurance company attempted to get out of paying anything by claiming the accident was my fault, when it clearly was not (per 10 witnesses and the police report). At that point, I had done and said so many "wrong" things (like trying to be nice and helpful, and not documenting every conversation that I had with them) that it was tough to get a settlement of any kind.

Unless the guy who hit you was drunk, or was arrested for gross negligence when he hit you, his insurance company will try to get out of paying for as little as possible -- they will try to settle quickly and for a very small amount. The whole experience will be one more stressful thing you don't need in your life right now. Please, please get a lawyer.
posted by anastasiav at 7:02 AM on April 20, 2005


I've also been in a bike vs car situation. Yes--get a lawyer. Do not talk to the other guy's insurance company at all until you do; after that, just say "talk to my lawyer." I was contacted the morning I was released from the hospital; I had already retained a relative as my lawyer, and told the insurance guy "you'll have to talk to my lawyer"--I could almost see his crestfallen expression over the phone, and he actually said "I try to get to people before they have a lawyer."

The other guy's insurance company has two objectives: settle quickly, and settle cheaply. Unless you're on a vendetta, your objective is to extract enough money to cover every contingency. In my accident, I was at some risk (which never materialized, knock wood) for complications that might take five years to appear. Obviously that's too long to wait, so I wanted to account for that in the settlement.

The other party will probably offer a structured settlement, say, $10,000 total, with $5,000 payable now, and the remainder paid in monthly installments over the next 20 years. Obviously this doesn't work to your benefit (the net present value of the settlement winds up being more like $7000), but even worse, you could actually wind up out of pocket on your initial medical expenses: your insurance company is subrogating the claim, so they'll expect to get theirs up-front. A halfway competent lawyer won't let this happen to you, but be forewarned.

If you want to contact me offline about this, you're welcome to.
posted by adamrice at 7:58 AM on April 20, 2005


I want to second, third, or fourth a few things already said here (and I am a lawyer):

(1) You must talk to a lawyer about your options. You will most likely not have to sue anybody, but you may need a lawyer to negotiate with the insurance cos.

(2) Do not speak to anyone representing the guy who ran you over or his insurance co. They are not on your team, even if they act very very friendly. For example, if you tell them "I'm doing much better now," (a natural thing to say) you could very well hear that quoted back to you months later as a reason why they won't pay your bills.

(3) I would refrain from blogging any more details about the accident. Anything you write in the blog that might be misconstrued to mean that you were somehow careless, had a few drinks, were not hurt all that bad, etc. etc. could also come back to haunt you.
posted by Mid at 12:03 PM on April 20, 2005


You don't need to sign with a lawyer, but you should talk to one. Flip through the yellow pages and fine one that looks cool. Call them, ask them if they'll give you a free 1/2 hour phone consultation. Talk to them. Ask them questions. Get what you need from them. If you want, you can sign with them, and they'll get you more money than you'd be able to get on your own. REMEMBER in cases like this, YOU ARE NOT SUING THE KID WHO HIT YOU, YOU ARE SUING THE INSURANCE COMPANY REPRESENTING HIM WHO IS TRING TO PAY YOU AS LITTLE AS POSSIBLE. Regardless of what happens, the kid will not go to jail (unless there was a crime...) or in any other way be "hurt" by you suing or not suing.
posted by pwb503 at 1:26 PM on April 20, 2005


Thanks again for all of the good advice. I should be talking tomorrow to a lawyer who is a family friend.

Ask.Mefi is the best thing ever. Thanks again guys.
posted by jackofsaxons at 6:09 PM on April 20, 2005


After reading this thread and reflecting a bit, I'd like to modify part of my first statement above. I would *not* contact my own health insurance company first; I would talk with a personal injury lawyer first. I'd also recommend *against* nakedcodemonkey's suggestion to contact an auto insurance company until *after* you've spoken with a personal injury lawyer.

(Insurance companies are insurance companies, is what I'm thinking.)
posted by mediareport at 9:16 PM on April 20, 2005


Regardless of what happens, the kid will not go to jail (unless there was a crime...) or in any other way be "hurt" by you suing or not suing.

Unless you're suing for more than his insurance coverage, which could be as low as a few thousand dollars per person if he has the legal minimums.
posted by trevyn at 8:52 PM on April 21, 2005


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