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SETTLEMENTS OF INJURY CLAIMS: Seven Mistakes Lawyers Can Make

Here are seven mistakes injury lawyers can make when settling injury claims:

  1. NOT DISCERNING THE NEEDS OF THE CLIENT
  2. NOT IDENTIFYING CRITICAL EVIDENCE
  3. NOT UNDERSTANDING THE MECHANISM OF INJURY
  4. NOT GATHERING ALL ICD MEDICAL CODES
  5. NOT PRESENTING AN INJURY CLAIM EARLY
  6. NOT CALCULATING THE RANGE OF CLAIM VALUE
  7. NOT EDUCATING THE INSURANCE ADJUSTER

No. 1: NOT DISCERNING THE NEEDS OF THE CLIENT

Seems simple.  A lawyer should find out what his client needs, right?  But often-times, lawyers mistakenly:
  • delegate the initial client interview to non-lawyers
  • delegate client problems to non-lawyers
From the beginning, Mike Burman listens to each client and takes action based on 25 plus years of personal injury and wrongful death case experience.  Mike’s staff is highly trained, and collaborate with Mike and each other to advance the case.  Mike’s case management system is constantly updated for new technologies and best practices.  The Burman Law Client Portal provide a “personal touch” to every client’s case by allowing rapid access to information and documents as the case advances.   Client phone calls, emails, text messages and portal messages are addressed promptly to give real-world solutions.

No. 2: NOT IDENTIFYING CRITICAL EVIDENCE

Many lawyers fail to recognize that technology has radically altered the collection of evidence.  Closed circuit TV, satellite imaging, social media platforms, camera drones and internet databases provide unprecedented amounts of information and documentation.   Because Mike Burman is an experienced personal injury lawyer in charge at the beginning of every injury case, Burman Law preserves and protects critical evidence early in the case, for a strong foundation later in the case.  Burman Law is a self-funding law firm and does not rely on outside financial sources to pay case expenses.  If a case requires increased financial support, the case gets that support.

No. 3: NOT UNDERSTANDING THE MECHANISM OF INJURY

To understand the mechanism of injury, Burman Law examines how the injury is caused by trauma to the human body.  High school anatomy and physics teaches the body is composed of parts, some of which are fixed and some of which are mobile. Stress produces strain. Strain is a measure of of how much the human body deforms as a result of stress caused by trauma. Many lawyers do not examine the mechanism of injury.  At Burman Law, we work with experts to determine exactly which parts of the human body were affected by the traumatic mechanism of injury.  Understanding this aspect of the case helps predict the present and future affects of injury.  Many lawyers over-look this aspect of a case, especially in the area of permanent impairment of bodily function.  Burman Law works with medical doctors to organize important mechanism of injury considerations for the particular case.  With well organized reports from the doctor and other experts, the value of an injury claim increases.

No. 4: NOT GATHERING ALL ICD MEDICAL CODES

ICD medical codes are used in clinical care and research to define medical conditions, study patterns, manage health care, monitor outcomes and allocate financial resources.  Insurance companies use ICD medical codes to value cases, but most injury lawyers do not, and this creates a major “disconnect” between the lawyer representing an injured client and the adjuster representing an insurance company evaluating a claim based on ICD medical codes.  If the injury lawyer does not provide these ICD medical codes, the insurance adjuster is not going to ask for them, or go out and gather them.  That is why insurance adjusters always say, “Based on the information you have given me, this is the offer of settlement.”

Examine any medical bill and it contains medical codes.  These medical codes determine how much is paid on the bill.  Insurance companies use these codes to pay medical bills, so it makes sense that insurance companies use these codes to pay injury claims.  Burman Law gathers all ICD medical codes to prepare a settlement demand that provides everything needed for a full and complete evaluation by the insurance adjuster.

In many cases, proper ICD medical coding will increase the value of an injury claim by 100% or more.

No. 5: NOT PRESENTING AN INJURY CLAIM EARLY ENOUGH

Every case goes through phases.  The first phase – the acute trauma phase – begins when the injury occurs.  In the acute trauma phase, the patient is rushed to the Emergency Room. But over time, as medical professionals provide quality treatment, an injury case evolves from the acute trauma phase, into the medical plateau phase.  In the medical plateau phase, all injuries are identified and all injuries are relatively stable. Maximum medical improvement, or MMI for short, is an insurance term that insurance adjusters use.  It is not a term favored at Burman Law, because MMI takes too long to reach in most cases.  Many injury lawyers wait for maximum medical improvement rather than medical plateau. For many injured people, MMI means a full recovery with no restrictions.  And so, what does the insurance adjuster say at MMI?  The insurance adjuster says, “The claim is not worth much because the injured person has fully recovered.” Burman Law, on the other hand, does not wait for MMI.  Once medical plateau is reached, we finish gathering information and supporting documentation to establish:
  • diagnostic codes
  • medical bills for past charges
  • prognosis (how the injury will progress over time)
  • impairment (how the injury will affect physical function)
  • lost earning capacity (how the injury will affect future income)
  • future medical expenses (how much future medical services will cost over time)
After gathering the above information and documentation, a settlement demand letter is prepared for the case and all documentation is attached to this demand.  A settlement demand letter outlines the claim for the adjuster in charge.  The settlement demand letter sets forth, in writing, the legal basis for the claim, the medical evidence of injury, and proof of damages resulting from the injury while the injury is still “fresh.”

No. 6: NOT CALCULATING THE RANGE OF CLAIM VALUE

Many injury lawyers have no objective way to determine case value, relying only on experience, or the Jury Verdict Reporter showing jury verdicts for the state where the injury occurred.  But how do jury verdicts and experience provide an objective method for valuing every type of injury claim for every type of injured person? Burman Law’s methodology for determining case value relies on specialized software from a third party vendor to provide an objective range of values for a particular case.  Thus, there is no guessing when the insurance company has offered full and fair compensation.  Burman Law advises each client when the offer is “within the range of reasonable outcomes.”  Further, we prepare our clients to say “no” when the insurance company offer is not full and fair based on the facts of each particular case and the range of reasonable outcomes.

No. 7: NOT EDUCATING THE INSURANCE ADJUSTER

Educating the insurance adjuster is the most crucial part of settling a personal injury claim.  Educating the adjuster requires:
  1. Knowing what the adjuster knows
  2. Making sure the adjuster understands what the adjuster knows
  3. Ensuring the adjuster has properly evaluated the claim
  4. Identifying “new” information for the adjuster to consider
Many lawyers try to educate an insurance adjuster the same way they educate another lawyer, with legal arguments and facts.  This will not result in the highest and best settlement because an insurance adjuster does not think like a lawyer.  An insurance adjuster has a completely different perspective based on the rules set by the insurance company that hires the insurance adjuster. Mike Burman is trained to think like an insurance adjuster, with settlement methods tested over 25+ years.  Mike follows best practices taught by a former insurance company executive with years of experience in adjusting claims.  Mike Burman is  trained to understand how insurance adjusters evaluate cases by applying sophisticated computer programs that run algorithms based on “multipliers” and “value drivers.” An insurance adjuster is never going to explain how to get the highest and best value for a case.   Most adjusters handle between 500 to 700 claims at any one time.  An insurance adjuster will rarely take the time to go out and look for all the evidence that supports a case.  And so, honestly educating the adjuster, with supporting documentation, makes a huge difference in the outcome of a case.
AUTOMOBILE FAIR MARKET VALUE

“TOP DOLLAR” WHEN YOUR VEHICLE IS A TOTAL LOSS

This article is a must-read when your vehicle is a total loss after a collision caused by an at-fault driver whose insurance adjuster is trying to settle with you.  In this article you will learn:

  • First Steps to Take
  • “Top Dollar” Helpful Hacks
  • Communicating with the Adjuster
  • Dealing with the Adjuster’s Reluctance to Pay
  • Understanding What You Sign

vehicle-appraisal-form-burman law

First Steps to Take for Your Property Damage Claim:

  1. Print off the above Vehicle Appraisal Form here and fill it out to get started.
  2. Determine if your vehicle is repairable or if your vehicle is a total loss because the cost of repair exceeds the fair market value of your automobile before the collision.  Most auto body shops can make this determination free of charge to you.  Your auto insurance company may help you with this determination.
  3. If you have not done so, find the name and contact information for the at-fault party insurance company.  Contact that insurance company and ask to set up a claim for the property damage (total loss) of your vehicle.  Keep good notes.  The at-fault insurance company will assign an adjuster to contact you to discuss a settlement of your property damage (total loss) claim.  You can request a rental vehicle while you are discussing a settlement.
  4. The person hired by the at-fault insurance company to settle with you is called an adjuster.  When you ask the adjuster to settle with you, you are making a property damage claim.  When you and the adjuster reach an agreement on what your claim is worth, that is called a settlement.   For a deeper dive into the world of insurance and claims involving automobiles, click here.

“Top Dollar” Helpful Hacks

To value your total loss, insurance adjusters use a database of some kind.  The database is usually composed of thousands of individual buy/sale transactions.  And so, the database compresses all those transactions into a “range of values” for a vehicle similar – but not exactly like – your vehicle.  To secure “top dollar” you must 1) be patient with the adjuster, and 2) offer evidence that proves the adjuster’s value is lower than the actual value of your vehicle.  The database is based on the fair market value of thousands of willing  buyers purchasing from thousands of willing sellers.  buyers selling to willing buyers values similar to yours  Thus,   Patiently proving your vehicle is not  is better thanwill bring you to “top dollar” for your total loss.  What do I mean by patiently Provingur claim is to show real value.  Here are some helpful hacks:

  • Recent photos showing your vehicle clean and polished
  • After collision photos free of trash in the floor board
  • Receipts for after-market improvements
  • Maintenance records you kept or the dealer
  • No.# 1 Hack…read the below section on Communicating with the Adjuster!

Communicating with the Adjuster

The golden rule is a pretty good way to live.  Treat people how you would like to be treated.  Yes, you did not ask to have your automobile destroyed by a careless driver, but the adjuster is not a fault for causing the collision, so be careful not to blame the adjuster for something done by the at-fault driver.  The adjuster is there to settle your claim, and by law, must work with you honestly and in good faith.  You should do the same.  Be honest and accurate.  Treat the adjuster with respect, even if the adjuster does not do the same to you.  Listen to what the adjuster says, and take good notes.  BE RESPECTFUL and in almost every case, this will result in a higher recovery on your claim.  An adjuster is not going to throw a pile of money at you just to make you happy.  But the adjuster will pay you for what you can prove with reasonable evidence, so send the adjuster the sources of fair market value to prove your property damage claims.  Over the years, I have found adjusters will favor people they like.  So be likable and patient with the adjuster.  If you cannot get the adjuster to call you back or communicate professionally, take notes of calls and dates and the unprofessional behavior and call the insurance company and ask to speak to the adjuster’s supervisor, giving the supervisor the benefit of your notes and efforts.

Your Property Damage Claim Includes:

  • The fair market value for your vehicle,
  • plus the taxes and title on a vehicle of like value,
  • plus reasonable rental (loss of use),
  • plus personal property in your automobile destroyed by the collision/impact.

When you request a rental vehicle, see if your auto insurance provides insurance on your rental vehicle; otherwise, the rental car company will charge you for separate auto insurance which you want to have the at-fault insurance company agree to pay before you start driving the rental.  Usually, the length of your rental is equal to the time it takes to find a replacement vehicle, or, the time it takes to pay you a settlement for the total loss of your vehicle.  Property damage includes damage to your vehicle, or its contents, even clothing or glasses you were wearing.  Actual cash value is also commonly called fair market value or FMV.  The law defines fair market value as the amount of money a willing buyer will pay a willing seller for your vehicle before the crash occurred. The determination of FMV includes facts like the year, the make, the odometer mileage, any previous damage and the general condition of your vehicle before the crash.  Dealer service receipts, parts receipts and maintenance records are useful when trying to establish vehicle value.

Sources of Fair Market Value To Prove Property Damage Claims:

  • Kelly Blue Book
  • NADA Used Car Guide
  • Recent Sales of Similar Vehicles
  • Ads from Newspapers or Auto Trader websites
  • Internet search for “automobile appraiser” (be sure to know what you will be charged)
  • Statements from a dealer or car salesman familiar with your vehicle
  • Photographs of the vehicle in emails to the adjuster to show the condition of your vehicle

Tax, Title and License Fees in Kentucky and Tennessee:

For Christian County (and all other counties in Kentucky) the cost of a title is $9.00.  To license a vehicle, you pay a 6% sales tax on what Kentucky says the vehicle is worth.

For Montgomery County, Tennessee the title costs $16.00. To license a vehicle purchased from an individual, the cost is $94.00 for a title and plate plus sales tax, which is usually 9.5%. If there is another lien holder, there is an extra $11.00 charge. If purchased from a dealer in Tennessee, you pay $94.00 without having to pay the sales tax.

In Tennessee, each county has a different “wheel tax”, so you will need to contact the government body where you want to register your vehicle to get a full breakdown.

 

Dealing with the Adjuster’s Reluctance to Pay

If an adjuster will not pay you fair market value for your loss, do not get mad…ask for reconsideration.  Remember that word…reconsideration.  Find out what facts the adjuster considered.  Ask the adjuster, “What facts did you consider in valuing my claim.  Help me understand all the facts you took into account.”  Carefully determine the facts where you and the adjuster have an agreement.  And make good notes during all this.  Write down the agreed facts, the date you agreed to these facts, and how much you agreed was fair.  Then, identify the facts you do not agree on.  Identify these disputed facts carefully.  The adjuster is required by law to have reasons for accepting certain facts and disputing others.  Find the reasons and write those down.  Provide the adjuster all documentation to support your facts, and ask the adjuster to do the same.  Do not give the adjuster any wiggle room because the adjuster claims “twenty years of experience,” rather ask the adjuster to back up all facts with documentation and evidence.  Tell the adjuster that “20 years of experience should be supported by documentation collected over 20 years.”  You can do this in a respectful but firm way.  As you go through this process of sifting out the facts that are in dispute, you will likely find the adjuster needs additional information.  When that happens, get the adjuster what is needed and ask the adjuster for reconsideration, and documentation to show why your facts are not accurate.

Understanding What You Sign

Read before you sign.  Make sure any documents you sign or checks deposited are for property damage claims ONLY.  Make sure the document you sign clearly intends to include property damage claims and nothing more.

Contact me if you have any questions.

repair

REPAIR ESTIMATE- HOW TO GET PAID

“Under Kentucky and Tennessee law, the at-fault driver’s insurance is responsible for your collision repairs.  This article gets you started.  For more information, select “Repairs, Rental and Replacement of Your Vehicle.”  Mike Burman

Start with the Police Report:  Look at the police report.  On the police report, find a box that names the insurance company for the the at-fault vehicle.

Call the At-Fault Insurance Company:  When you call, keep notes on who you talked to and what you are told.  Get a claim number and the telephone number to an insurance adjuster.

Call the At-Fault Insurance Adjuster:  Again, keep notes.  If asked, tell the adjuster you were injured but do not discuss your injuries.  Just tell the adjuster you are calling for help with your vehicle repairs.  Talk to the adjuster about:

  1. Tow truck bills and fees
  2. Repairs to your vehicle
  3. What happens if the body shop finds more damage
  4. Rental vehicle

Use a Reputable Auto Body Shop:  A good body shop professional can walk you through the process and work with the insurance adjuster.  But a good body shop is usually busy, and so, keep notes on the date your vehicle will be repaired.  Understand the costs and what will be repaired.  Get a copy of the complete repair estimate.

Once Repaired, Check for Quality Repairs:  Check your vehicle carefully for repairs done to your satisfaction.  Pull the vehicle into the sun and look at any new paint.  Does the new paint match the original paint?  Are gaps between metal parts aligned and straight?  Point out concerns to the body repairman.  Do not pay until you are fully satisfied.

Make Sure the Release is for “Property Damages Only”:  When the insurance company pays for the repairs, the adjuster will ask you to sign a release.  A release is a contract that says you will not ask for any more money to repair your vehicle.  Make sure you read the release carefully. Do not sign anything that says “damages resulting from the accident” or “in full and final settlement” because that type of release could affect your personal injury case.  Only sign a release that specifically states “for property damages only.”

“If you are not sure what you are signing, then contact me.” Mike Burman.