Dealing with insurance claims if you get hit by a car

[Ben]

I've been meaning to write this for a while but never got around to it. Some comments in the crumpled Speedvagen thread finally gave me the nudge. Hopefully other lawyers or industry folks will chime in and make this wiki-worthy.

In case you get hit and find yourself in the position of having to deal with a driver's insurance company, here are a couple of hopefully-useful tidbits:

In most cases, there are two separate claims: a property claim and an injury claim.

Settlement of the property claim is usually pretty cut and dried -- your bike, helmet, clothes, etc. cost what they cost -- and can be resolved within a few days. Make sure that, in getting the check for your bike, you don't inadvertently settle your injury claim as well.

In general, run-of-the mill injury claims are settled for some multiple of the total cost of your medical bills -- typically 2-4 times your medical bills around here (and that's the full-ticket self-pay cost, not the discounted rate your health insurer negotiated). The amount above your medical bills is there as compensation for damages like pain and suffering. If you are in an accident that hospitalizes you or causes you to miss work for any period of time, call an attorney and don't try to handle the claim yourself. In 90% of cases, you will come out better in the long run.

If you are ever hit by a car, go to the hospital. Period. Beyond just making good sense health-wise, it makes settling your injury claim much easier (and, let's be honest, more remunerative). Don't try to be tough and for God's sake don't try to save the driver's insurance company money. The driver hit you, so he deserves to pay to get you checked out. Even if you're not seriously injured, the driver's insurance company is still on the hook for your ER visit, so go. If nothing is required past the initial ER visit, once you get your bill, then you can call their adjuster and start negotiating. They do this a lot, so the best advice I can give you is pick a reasonable multiplier (2.5-3x medical costs) and be stubborn about it. Don't worry if you don't get it settled on the first call. If further treatment is required, wait until it's completed before you start negotiating, so you have a complete idea of your medical costs. Time is of the essence, though, since personal injury statutes of limitation tend to be short -- one year in many cases. If your medical treatment is extensive, call an attorney.

Once you settle your injury claim, you probably owe some people some money. (It's called a right of subrogation, if anyone cares.) If your health insurer paid for your trip to the ER (or subsequent medical expenses) you'll need to repay them. If the hospital bill is still unpaid, you'll need to pay that. In either situation, it is frequently the case that you can negotiate a reduction in what you actually pay. Most hospitals, in particular, will knock off 30% in the first sixty seconds of your phone call. Make it clear that you've got the cash in hand and will send them a check today, since medical collectors are very much in the "bird in the hand" business. Be aware that a single trip to the ER can generate multiple bills -- one from the hospital itself, one from the treating physician's group, and one from the radiologist's group (assuming you have an x-ray). Make sure you have them all before you total up the numbers.

Other lawyers can feel free to chime in and correct me. And here's the ubiquitous disclaimer on behalf of myself and any other lawyer who might contribute: We're lawyers, but we're not your lawyers, and we're almost certainly not licensed in your jurisdiction. Anything we say is provided as general information, and is not advice for the handling of your particular case. Seek professional counsel.

[cody.wms]

If you are ever hit by a car, go to the hospital. Period.

Nothing to add beyond this. I have at least one friend that walked away from an accident to have it bite him later. If you get hit, you'll have a ton of adrenaline in you, and you won't really know if you'v been injured. If you go later (like days later) it's harder to get insurance to cover (from what I know, but haven't experienced thankfully).

-Cody, who won't know if he is officially a lawyer until 5 November.

[stewie]

O man, I hope very few find this write up useful...getting hit by cars is the last thing that should happen...
but it happens all the time...unfortunately. Thanks for the note...I'll be sure to come back (knock on wood!!) and read this but I hope no one here (or elsewhere!) will ever have to.

[Chad]

Generally all good points. I'm from the other side of the fence, formerly an insurance adjuster. Regarding subrogation, normally the health care provider or whoever may have paid the bills on your behalf (health insurance, auto med-pay) will file a lien with the at fault carrier and that money will be paid directly to them on your behalf. At least that's how it's done around here. Some attorneys will try to get around that and have that part of the settlement go through them as well so that they can get their 1/3 of that as well.

As to going to the doctor or ER if you aren't injured, I always look at this like the RCA dog, head cocked to the side and a little confused. If you aren't injured why go? If something hurts, by all means get checked out. I have talked with thousands of claimants over the years and they would say in one sentence that they were fine, then say "but I went to the Doc just to make sure."

I have two pieces of advice, just as Ben said, know the statute of limitations, if the statute runs you are SOL and do not settle if you are not comfortable doing so. Do not let anyone try to hurry you along.

[Blue Jays]

"...If you get hit, you'll have a ton of adrenaline in you, and you won't really know if you'v been injured..."

Agreed, lots of injuries may not be evident at a quick glance. How many can diagnose concussions at roadside?
If one gets slammed by a vehicle, the next stop should be the hospital for a medical exam and treatment for scrapes, bumps, lacerations, and contusions.
The energy dumped by a car (even moving only 10 m.p.h.) into a human body is absolutely tremendous.

[Tom]

How it worked for me:

Got hit. Driver ran. I woke up, went home. Realized I got hit. Went to police. Police yelled at me for not going to the doc. I went to the doc. I told the doc to send the bills to my auto insurance carrier, NYS no fault. Police caught driver. My auto insurance carrier told their auto insurance carrier to pay up. Their auto insurance carrier called me and groveled. I strung them along just to make them grovel more. It was fun. I never had to cough up a dime and was entertained to boot.

[Ben]

As to going to the doctor or ER if you aren't injured, I always look at this like the RCA dog, head cocked to the side and a little confused. If you aren't injured why go? If something hurts, by all means get checked out. I have talked with thousands of claimants over the years and they would say in one sentence that they were fine, then say "but I went to the Doc just to make sure."

I guess I look at it from the opposite perspective (not surprising given our backgrounds): Why in the world wouldn't I go? As other posters have pointed out, lots of serious injuries, including TBI, aren't immediately self-diagnosable. It's my feeling that, if you hit me with your car and were lucky enough not to have injured me, you're getting off easy by paying for nothing more than my peace of mind. The only significant reason not to go to the hospital is to avoid spending the driver's insurance company's money, and that's not a compelling reason to me in the least.

[roseyscot]

what about those who are hit by a car, but then it turns out to be the cyclist's fault? i see people around boston riding on the wrong side of the street, going through stop signs or lights, and generally disobeying the rules of the road all the time. is there a possibility of this working in the other direction? the cyclist is held accountable for all the costs, including possibly damage to the car?

[airedale]

I once ran a red in Sydney peak hour and t-boned a car. Smart I know. I was held responsible for all damages to the vehicle, as I should have been. I hoped the driver would let it slide as it was a company car, but got the dreaded call the next morning.

I was out of pocket over three grand, after talking it down from four and a half grand. They didn't want to go to court for something so trivial so I tried to use that in my favour. They also claimed I'd miraculously damaged both sides of the car. I've got a big hoop, but not that big.

I don't run the reds anymore and have been left with some nice scars to remind me not to.

[dcpdpayne]

If you get hit, always, always.......ALWAYS.....get a police report made. Many insurance companies in my area will tell you "If there's no police report, it didn't happen." Don't try to be a "nice guy" and save their insurance rates, after all, they hit you. I've also seen where the insurance company of the other driver has attempted to "guess" what happened in lew of a law enforcement investigation.... Just say'en

[WadePatton]

if it is the cyclist's fault for the impact, then the police report might indicate such, and the insurance folks will be sure to pick up on that.

12 months personal injury statue of limitations here. but _you_ are not here ('cept for the 5 or 3 of us that are). find out what yours is. any case _must_ be filed in that window of opportunity. if you can't file a lawsuit, the insurance co's will laugh at you.

the "general rule" multiplier given to you by ben is not fluff and "profit", but true compensation for difficult to measure things such as: pain and suffering, missed work/opportunities, loss of consortium, permanent impairment/reduction in function/reduced earning capacity, disfigurement, etc.

now, if the motorists intentionally mowed you over _and there is some proof of that_ then there should be punitive damages, and criminal charges brought-but that's for the prosecutor.

in any case, NEVER sign the checks they push at you for the "medical bills" without consulting a real live attorney. i had them, the insurance company, assure me that signing those checks would not affect my claim--with clear language to the contrary _right on the check_. eff that. i mailed the checks back and got 2x payment w/o hiring an attorney (but i had some experience)

get paid for your suffering whenever possible. if you feel guilty about doing so, simply donate some of that money to some of the riders or families of riders who didn't have that opportunity. there are too many of those.

[gkk]

Anyone have advice on what to do in the (not so unlikely, at least around here) event that the driver who hit you is uninsured (e.g. no insurance co. to deal with other than your own.)

(As an attorney perhaps I should know this, but it's not my field ... and I know enough not to guess.)

[Rico]

I have a quiick question.
Does anyone know if your insurance covers you on a bicycle since it is considered a vehicle?
This could be really important if involved with an under insured or non insured motorist. Also if you as the rider are at fault.

While unrelated to my question I've tried to explain to other riders the reason I don't run reds or stop signs is to avoid any contributary negligence.
My wife is an experienced paralegal ihere in NC who works for a firm that speciializes in subrogation. In this sate if there is any contributary negligence on your part it is game over. There's no attempt to pro rate based on your amount contributray negligence. So ride so that you are always in the right.

[Rico]

I have a quiick question.
Does anyone know if your insurance covers you on a bicycle since it is considered a vehicle?
This could be really important if involved with an under insured or non insured motorist. Also if you as the rider are at fault.

While unrelated to my question I've tried to explain to other riders the reason I don't run reds or stop signs is to avoid any contributary negligence.
My wife is an experienced paralegal ihere in NC who works for a firm that speciializes in subrogation. In this sate if there is any contributary negligence on your part it is game over. There's no attempt to pro rate based on your amount contributray negligence. So ride so that you are always in the right.

[stackie]

Chad,

In answer to your question, "If you aren't injured why go?"

Because that cervical spine fracture that doesn't hurt now, will still cause you to be a quadriplegic surfing the TV channels with your tongue later when you turn your head just so. But, if the thought of your loved ones wiping your butt for the rest of your life sounds great, don't bother going to the ER. Of course, you can take comfort in the fact that you saved the insurance company a whole bunch of money since you never went to the ER after that accident.

Me? I think I'll just head off to the ER and have one of my surgical colleagues run his hands over my neck just to be sure. Heck, I might even go for the CT scan.

Sorry to be so full of vitriol, but that one just got me.

That's from the doctor side of the fence.

Jon

[Erik B]

Anyone have advice on what to do in the (not so unlikely, at least around here) event that the driver who hit you is uninsured (e.g. no insurance co. to deal with other than your own.)

(As an attorney perhaps I should know this, but it's not my field ... and I know enough not to guess.)

The answer around here at least is to have lots and lots of uninsured/underinsured coverage on your own vehicles. If there is a car involved so is that coverage (here, YMMV)

[Tom]

In New York State I believe it's called 'no fault'. At first, we didn't know who got me and then at first we thought they were uninsured. (They got hit for 3rd degree aggravated unlicensed operation because their license was suspended for no insurance but then they had State Farm, so I am unclear on how that all worked.) My auto policy was covering everything under no fault.

Now, if I hit them I am not sure how it work. I suspect I would be signing a lot of checks.

One of the things I realize was really really really stupid was not calling the cops at the scene. I carry a phone. My excuse is that I bumped my head and wasn't myself. I absolutely should have gone to the doc. The vindictive side of me regrets it very much because we could have got the driver for leaving the scene of a personal injury accident. They couldn't make a good prosecution on that when I didn't see the doc for 48 hours. Also, you'd be amazed how much stuff gets banged up pretty good and you simply don't feel it. I had rib cartilage abused to the point where ribs are displaced and I never felt it at the time.

[a-game]

Talented and good-looking moderators, this thread or something like it should be a sticky.

Thank you. (Knocking on wood.)

[cody.wms]

what about those who are hit by a car, but then it turns out to be the cyclist's fault? i see people around boston riding on the wrong side of the street, going through stop signs or lights, and generally disobeying the rules of the road all the time. is there a possibility of this working in the other direction? the cyclist is held accountable for all the costs, including possibly damage to the car?

real quick: There are three possibilities that I _know_ of, and there are likely more. Some of these have been addressed:

1. You pay out of pocket.
2. Their insurance pays through the un/underinsured component.
3. Your homeowners insurance may pay. Homeowners covers a wide range of stuff. The wildest case I've seen involves a passsenger getting shot while off-roading in a dune buggy (the gun was between the front seats and went off), and homeowners covered. What homeowners will cover varies widely from state to state and judge to judge, obviously.

[boots2000]

Lots of good info here- mostly everything is covered. I might add.
1.) If anything still hurts after the ER- go to a specialist. ER's miss stuff and mis-read x-rays all the time.
2.) If the insured's insurance company contacts you by phone- do not make a statement to them over the phone. Only do so in writing. They may use the phone statement against you in the final settlement.