Personal injury, unhelpful insurance company
Discussion
A friend of mine was rear ended nearly three years ago, car damaged but repaired no issue with the repair.
She banged her knee quite badly and needed physio, there was an ambulance there for other people in the crash (caused by confused elderly driver), she threw up from the shock etc. as is normal and I think there was a statement from the ambulance people that she'd been hurt. In other words personal injury genuine claim, other drivers insurance. Her knee is not right now, three years later.
The insurance company has been achingly slow doing anything financially about the injury. Eventually after about 18 months there was an interim payment which covered the physio and other costs (about £1,500, physio cost was £500). There's been a couple of medical examinations.
The process seems to be being handled by a claims management company, is that right? Their final "offer" to my friend is a total of £3,000, to cover "The Losses recovered and payable to other parties (e.g treatment, insurer outlay, hire, contractual sick pay, other agreed deductions)". I think the actual injury part was £1,000 or so.
One of the particular points she's disputing is that she has ongoing knee pain, in the final doctor consultation which I think was recorded over the phone, my friend was asked "do you understand what the doctor is saying". She has some medical training and rather over thought the question, so she said "yes".
She never said that she "AGREED" with what the doctor was saying (that the knee injury was minor and temporary) and she has explained this to the claims management company twice in writing without a specific reply. On my advice she has raised a formal complaint with the claims management company to at least try to get them to acknowledge that "understanding what the doctor is saying" is not the same as "agreeing with the diagnosis". She awaits a reply.
She has two fairly snotty letters recently from different people at the claims management company recently saying that the time limit for taking court action concerning personal injury is fast approaching (middle of next month), and they advise her to take the money offered now, or she might get less in court. There's a threat that they will charge their fees (£2,000) to her if she doesn't take the offer.
She isn't well off and the pennies do count. Seems to me the claims management company is aggressively pushing her to settle so they can get their money. I feel the offer is too low for the injury (£1,000), can't see how they've done any negotiating at all on her behalf. She's waiting on a formal response to her complaint this week.
Just asking for advice really. What's going on. Is it reasonable? she needs the money but I think she's being stiffed. If she didn't need the money she'd be taking the court action route. Cheers
She banged her knee quite badly and needed physio, there was an ambulance there for other people in the crash (caused by confused elderly driver), she threw up from the shock etc. as is normal and I think there was a statement from the ambulance people that she'd been hurt. In other words personal injury genuine claim, other drivers insurance. Her knee is not right now, three years later.
The insurance company has been achingly slow doing anything financially about the injury. Eventually after about 18 months there was an interim payment which covered the physio and other costs (about £1,500, physio cost was £500). There's been a couple of medical examinations.
The process seems to be being handled by a claims management company, is that right? Their final "offer" to my friend is a total of £3,000, to cover "The Losses recovered and payable to other parties (e.g treatment, insurer outlay, hire, contractual sick pay, other agreed deductions)". I think the actual injury part was £1,000 or so.
One of the particular points she's disputing is that she has ongoing knee pain, in the final doctor consultation which I think was recorded over the phone, my friend was asked "do you understand what the doctor is saying". She has some medical training and rather over thought the question, so she said "yes".
She never said that she "AGREED" with what the doctor was saying (that the knee injury was minor and temporary) and she has explained this to the claims management company twice in writing without a specific reply. On my advice she has raised a formal complaint with the claims management company to at least try to get them to acknowledge that "understanding what the doctor is saying" is not the same as "agreeing with the diagnosis". She awaits a reply.
She has two fairly snotty letters recently from different people at the claims management company recently saying that the time limit for taking court action concerning personal injury is fast approaching (middle of next month), and they advise her to take the money offered now, or she might get less in court. There's a threat that they will charge their fees (£2,000) to her if she doesn't take the offer.
She isn't well off and the pennies do count. Seems to me the claims management company is aggressively pushing her to settle so they can get their money. I feel the offer is too low for the injury (£1,000), can't see how they've done any negotiating at all on her behalf. She's waiting on a formal response to her complaint this week.
Just asking for advice really. What's going on. Is it reasonable? she needs the money but I think she's being stiffed. If she didn't need the money she'd be taking the court action route. Cheers
Bill said:
How much does she think she should get?
IMO £1k seems reasonable enough. Presumably the accident management firm know there's a decent chance she'll be awarded less and their payment will have to come from somewhere.
According to various sources re typical payouts and national guidance on injury compensation, for a chronic knee injury it shouldn't be below £5,000. IMO £1k seems reasonable enough. Presumably the accident management firm know there's a decent chance she'll be awarded less and their payment will have to come from somewhere.
Monkeylegend said:
The fact that she is not well off is irrelevant and makes it seem like it might not be a genuine claim so probably best not to mention this to the insurance co.
A cynic would say she sees this as an opportunity
I've set out the facts fairly and I know how much pain she's been in. A cynic would say she sees this as an opportunity
Edited by Monkeylegend on Tuesday 18th January 09:34
Ok cheers she will look into a examination by a specialist.
The immediate worry as I say is the threat from the claims management company to charge their £2,000 for time spent to her.
Is this likely?
If she gets an examination proving ongoing disability can she say to the claims management company "you haven't conducted your business with due skill and care etc. no valuable consideration etc." and refuse to pay, how would that play out?
The immediate worry as I say is the threat from the claims management company to charge their £2,000 for time spent to her.
Is this likely?
If she gets an examination proving ongoing disability can she say to the claims management company "you haven't conducted your business with due skill and care etc. no valuable consideration etc." and refuse to pay, how would that play out?
Durzel said:
Not being funny, but did she not look at the terms of what she signed up for? It would all be explained in there.
I'm sure the terms will say if you don't take up the offer etc. BUT that has to be in return for a valuable consideration, a service. I can't see what value the claims management company has added, certainly not £2,000 worth of value. Following an RTC or other traumatic event leading to possible compensation, there's a significant correlation between the severity and persistence of reported pain, and the perceived discrepancy in the expected vs offered amount of financial payout. The correlation is even stronger in the absence of physical evidence of injury/following full recovery.
The best thing your friend can do is forget about the whole thing and get on with her life. It's amazing how mindset affects pain, recovery and physical state. For example, for some, part of the problem will be a tendency to limp, or to exaggerate the limp. The issue with that is that limping disrupts the way the body is set up to walk, the forces are not transmitted through the joints as they should so the joints, muscles and ligaments can be further damaged on both the injured side and the uninjured side prolonging or even preventing the recovery. Then there are a whole host of complex nerves, neurotransmitters, neural networks, etc. Therefore, even if she does have residual physical injury, which I doubt since the chances of an injury that only required physiotherapy and no surgery, immobilisation or brace still being present after 3 years is extremely unlikely, she still should just get on with her life.
The best thing your friend can do is forget about the whole thing and get on with her life. It's amazing how mindset affects pain, recovery and physical state. For example, for some, part of the problem will be a tendency to limp, or to exaggerate the limp. The issue with that is that limping disrupts the way the body is set up to walk, the forces are not transmitted through the joints as they should so the joints, muscles and ligaments can be further damaged on both the injured side and the uninjured side prolonging or even preventing the recovery. Then there are a whole host of complex nerves, neurotransmitters, neural networks, etc. Therefore, even if she does have residual physical injury, which I doubt since the chances of an injury that only required physiotherapy and no surgery, immobilisation or brace still being present after 3 years is extremely unlikely, she still should just get on with her life.
Is she claiming through her own insurance or is this the other party's Accident Management Company?
When my wife was hurt in a no-fault crash, she certainly didn't have to pay anything for the physio up front - it was covered by the insurer directly.
When my wife was hurt in a no-fault crash, she certainly didn't have to pay anything for the physio up front - it was covered by the insurer directly.
Edited by NDNDNDND on Tuesday 18th January 12:13
NDNDNDND said:
Is she claiming through her own insurance or is this the other party's Accident Management Company?
Is that a thing? Never had to do this (fortunately), but I was under the impression that AMCs only came into play from one's own insurance company rather than a third party.BertBert said:
NDNDNDND said:
Is she claiming through her own insurance or is this the other party's Accident Management Company?
Is that a thing? Never had to do this (fortunately), but I was under the impression that AMCs only came into play from one's own insurance company rather than a third party.Largechris said:
Monkeylegend said:
The fact that she is not well off is irrelevant and makes it seem like it might not be a genuine claim so probably best not to mention this to the insurance co.
A cynic would say she sees this as an opportunity
I've set out the facts fairly and I know how much pain she's been in. A cynic would say she sees this as an opportunity
Edited by Monkeylegend on Tuesday 18th January 09:34
Monkeylegend said:
I know and the emphasis in your first post is how much she needs the money rather than how debilitating her knee injury is.
In the OP, I said she'd had an interim payout of £1500, which included paying for a physio etc. so she doesn't have that as cash.And that if she doesn't agree to the final £1500 payout settlement the claims management company may charge her £2,000 for their time.
So she will be at least £1,000 out of pocket.
I said she is still in pain.
Not sure how I could have phrased it differently that would have made you more empathetic tbh.
This is the danger in engaging claims management companies really. They want their pound of flesh, they're not pursuing these claims for altruistic reasons. If they think you're going to negatively impact their payday somehow then of course they're going to default to threatening you instead of the other party.
I would agree with the above poster. If they've got a record of her agreeing with a doctor who has described it as a "minor and temporary", whether or not that's a semantics argument about what the word "understand" means, assuming that was explicitly what was said (you didn't hear it), then what she has been offered might reasonably be all she is likely to get.
I would agree with the above poster. If they've got a record of her agreeing with a doctor who has described it as a "minor and temporary", whether or not that's a semantics argument about what the word "understand" means, assuming that was explicitly what was said (you didn't hear it), then what she has been offered might reasonably be all she is likely to get.
Largechris said:
BertBert said:
NDNDNDND said:
Is she claiming through her own insurance or is this the other party's Accident Management Company?
Is that a thing? Never had to do this (fortunately), but I was under the impression that AMCs only came into play from one's own insurance company rather than a third party.Forums | Speed, Plod & the Law | Top of Page | What's New | My Stuff