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Sue or not, 89 year old injured in Auto Accident not at fault. What is best strategy?


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First off let me say my Dad is NOT your average 89 year old.  He's in probably the top 2-3% of physical health.  I tease him that he needs to go break some 90 and over age group swimming records next year.  Up and down stairs at home, you get the idea.  This wreck happened a few weeks ago.

Anyhow he T-bones a kid older sedan when he pulls out in front of my Dad's new Subaru.  THANKFULLY the new Subaru, because I think he might have been even more severely injured in his several year old van.  The long story short is a 16 year old stops at the entrance to the road, then pulls out right in front of my Dad.  Witness who was admiring the new Subaru at the time saw everything.  The car had like 2200 miles and the better safety features probably saved his life.  In the end cracked sternum, 8 broken ribs on right side, two broken ribs on left.  So excruciating pain, each time you clear your lungs.  He's smart, and knows those deep clearing breathes were necessary and he just took the agony knowing that it was really the only way to avoid Pneumonia.  He's a badass and stopped taking his pain meds asap, and looks to be well on the road to recovery.  However, the sedentary weeks took a toll and him, and he worries about what the potential debilitation might be long term (me as well). The insurance company GEICO sent him a bunch of forms about falls and other medical information requests.  I assume to make a low offer, and simply gather information.  Right now his main concern is whether or not the accident may have changed the Aneurysm in his chest, which luckily did not burst when the airbags deployed.  HE also has atrial fib so while in otherwise great physical health with a wonderful quality of life, he could also drop dead any day.

He is willing to sue, and referenced an incident where he did in the past to recover damages in some of the prior accident information he was providing GEICO.  

This is way out of my realm and do not know if he should retain an attorney.  Or do what he is now doing which is giving GEICO information and seeing what sort of offer they come up with. He is not looking to "cash in" and knows a good deal of the settlement will go to attorney's fees and expenses if he goes that route.  I honestly do not have any good advice for him here as it's not my area of expertise. 

One cheaper option might be a letter from my sister-in-law attorney if they come in low, but by allowing my Dad to work towards as settlement with GEICO? (ultimately not my decision) is he doing the wrong thing?

Thanks in Advance

 

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7 minutes ago, horn4life said:

First off let me say my Dad is NOT your average 89 year old.  He's in probably the top 2-3% of physical health.  I tease him that he needs to go break some 90 and over age group swimming records next year.  Up and down stairs at home, you get the idea.  This wreck happened a few weeks ago.

Anyhow he T-bones a kid older sedan when he pulls out in front of my Dad's new Subaru.  THANKFULLY the new Subaru, because I think he might have been even more severely injured in his several year old van.  The long story short is a 16 year old stops at the entrance to the road, then pulls out right in front of my Dad.  Witness who was admiring the new Subaru at the time saw everything.  The car had like 2200 miles and the better safety features probably saved his life.  In the end cracked sternum, 8 broken ribs on right side, two broken ribs on left.  So excruciating pain, each time you clear your lungs.  He's smart, and knows those deep clearing breathes were necessary and he just took the agony knowing that it was really the only way to avoid Pneumonia.  He's a badass and stopped taking his pain meds asap, and looks to be well on the road to recovery.  However, the sedentary weeks took a toll and him, and he worries about what the potential debilitation might be long term (me as well). The insurance company GEICO sent him a bunch of forms about falls and other medical information requests.  I assume to make a low offer, and simply gather information.  Right now his main concern is whether or not the accident may have changed the Aneurysm in his chest, which luckily did not burst when the airbags deployed.  HE also has atrial fib so while in otherwise great physical health with a wonderful quality of life, he could also drop dead any day.

He is willing to sue, and referenced an incident where he did in the past to recover damages in some of the prior accident information he was providing GEICO.  

This is way out of my realm and do not know if he should retain an attorney.  Or do what he is now doing which is giving GEICO information and seeing what sort of offer they come up with. He is not looking to "cash in" and knows a good deal of the settlement will go to attorney's fees and expenses if he goes that route.  I honestly do not have any good advice for him here as it's not my area of expertise. 

One cheaper option might be a letter from my sister-in-law attorney if they come in low, but by allowing my Dad to work towards as settlement with GEICO? (ultimately not my decision) is he doing the wrong thing?

Thanks in Advance

 

My advice, have your dad ask for the policy limits from the kid's insurance. If the insurance company denies that, retain an attorney. This sounds like a case the insurance company should just pay policy limits and be done with it. Not much of a reason to pay 33% to an attorney if the insurance is going to pay without too much fuss other than to be cautious that you don't screw something up (which isn't a terrible reason, but I sometimes I feel other attorneys just process the easy cases without providing a ton of benefit to the client). In no way shape or form should he negotiate for anything less than policy limits. Also, if you dad has UIM coverage, look at making a claim with his insurance as well as I can pretty much guarantee his damages exceed whatever insurance coverage the kid has. 

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You have a two-year statute of limitations in Texas on a negligence/auto accident claim.  So you don't really need to consider suing until that deadline approaches.  Suing a 16-year old and his/her parents sounds like a pain in the ass that isn't worth the candle for the most part.

The property damage aspect should be fairly clear, as they usually are, so you can "settle" that separately from any injury claim.  But make damn sure you are settling only property.

Historically, a decent insurer like Geico will pay for the medicals that are clearly caused by the accident.  Plus a multiplier (1.1 1.2 1.3 etc. depending on the county) for "pain and suffering."  Where it gets hinky is payment for aggravation of "preexisting conditions" and things less easily attributed to the accident.  Limited, of course, by the policy limits.

I would give settlement without an attorney a good try before hiring one.

You can hire an attorney to negotiate long before you sue.  But the value proposition may be sketchier.

Dahobbs advice is good assuming the medicals are in the vicinity of the injury limits.  Note again that property damage and personal injury are "separate" policies with different limits and property claims are usually fairly easily settled.

 

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44 minutes ago, TwiceHorn said:

Dahobbs advice is good assuming the medicals are in the vicinity of the injury limits.  Note again that property damage and personal injury are "separate" policies with different limits and property claims are usually fairly easily settled.

 

Look at the injuries, cracked sternum, 8 broken ribs on right side, two broken ribs on left, on going pain and potential medical complications for an 89 year old man.  Even if it is a fabulous policy with 100k in limits (which is near the max I've seen someone actually carry), the insurer should still pay out policy limits on the injury side and I wouldn't accept a penny less, and I wouldn't care if the medical bills were substantially less than that. 

Edited by Dahobbs
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4 minutes ago, Dahobbs said:

Look at the injuries, cracked sternum, 8 broken ribs on right side, two broken ribs on left, on going pain and potential medical complications for an 89 year old man.  Even if it is a fabulous policy with 100k in limits (which is near the max I've seen someone actually carry), the insurer should still pay out policy limits on the injury side and I wouldn't accept a penny less, and I wouldn't care if the medical bills were substantially less than that. 

Yeah, that's fair.  Some years ago, my roommate did insurance defense and lightly advised my parents on a claim and they made out really well.  In fact, were able to buy a new car off the settlement.  But the multiples were higher then (pre tort reform campaign).  There were no serious injuries, but they were late to a cruise vacation (caught it at a stop) and my Dad was sore for a couple of weeks.  A kind of key factor was "we're retired, and not spring chickens, who knows how many of these vacations we'll get to take."

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13 minutes ago, Dahobbs said:

Look at the injuries, cracked sternum, 8 broken ribs on right side, two broken ribs on left, on going pain and potential medical complications for an 89 year old man.  Even if it is a fabulous policy with 100k in limits (which is near the max I've seen someone actually carry), the insurer should still pay out policy limits on the injury side and I wouldn't accept a penny less, and I wouldn't care if the medical bills were substantially less than that. 

250/500/100 liability limits aren’t uncommon at all.

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14 minutes ago, conVINCEd said:

250/500/100 liability limits aren’t uncommon at all.

That's interesting. I've never seen any that high, but granted I don't do a ton of auto accident work. I just handle the occasional case here and there, usually as a favor to someone else. 

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3 minutes ago, Dahobbs said:

That's interesting. I've never seen any that high, but granted I don't do a ton of auto accident work. I just handle the occasional case here and there, usually as a favor to someone else. 

It’s actually pretty standard for anyone who has some assets.  When I was doing personal lines 100/300/100 with a $1M umbrella was normal for your typical family with a $500k home and a couple of nice cars.  The additional cost for that increase in coverage over state minimums was around $10-20 per month assuming no unusual circumstances.  I would assume a teenager insured by GEICO is probably carrying 30/60/25 if he is paying for the insurance himself, but if he’s piggybacking on his parent’s policy there might be some more coverage there.

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2 hours ago, Dahobbs said:

My advice, have your dad ask for the policy limits from the kid's insurance. If the insurance company denies that, retain an attorney. This sounds like a case the insurance company should just pay policy limits and be done with it. Not much of a reason to pay 33% to an attorney if the insurance is going to pay without too much fuss other than to be cautious that you don't screw something up (which isn't a terrible reason, but I sometimes I feel other attorneys just process the easy cases without providing a ton of benefit to the client). In no way shape or form should he negotiate for anything less than policy limits. Also, if you dad has UIM coverage, look at making a claim with his insurance as well as I can pretty much guarantee his damages exceed whatever insurance coverage the kid has. 

Let's say you get $100k from the kid's insurance company for pain and suffering. Let's say you have your own insurance coverage that would cover the same amount. Can your insurer be forced to pay you in addition to his? Or, what if your insurance is up to $500k.

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On 5/11/2021 at 1:15 PM, Irish Wrist Watch said:

Let's say you get $100k from the kid's insurance company for pain and suffering. Let's say you have your own insurance coverage that would cover the same amount. Can your insurer be forced to pay you in addition to his? Or, what if your insurance is up to $500k.

No.  Your own coverage would only kick in if uninsured/underinsured motorist, if you have it.  It would cover any shortfall up to policy limits.

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On 5/11/2021 at 1:15 PM, Irish Wrist Watch said:

Let's say you get $100k from the kid's insurance company for pain and suffering. Let's say you have your own insurance coverage that would cover the same amount. Can your insurer be forced to pay you in addition to his? Or, what if your insurance is up to $500k.

Depends on the type of coverage you have and your state. In Texas, medpay and PIP policies would still have to pay you, i.e., you can be paid twice. Your comprehensive coverage would have a subrogation claim against the third-party, so you couldn't get double paid there. 

also see @TwiceHorn's post above on UIM coverage. 

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11 minutes ago, Dahobbs said:

Depends on the type of coverage you have and your state. In Texas, medpay and PIP policies would still have to pay you, i.e., you can be paid twice. Your comprehensive coverage would have a subrogation claim against the third-party, so you couldn't get double paid there. 

Yeah, my answer assumed Texas where both PIP and UIM/UM are offered but not required.  And I left off PIP.

Also, while both are optional, they have to be waived in writing, so it's likely you were talked into it and have it, the question being how much.  PIP tends to be low and cover minor injuries of the driver/car owner and passengers without any elaborate claims process.

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1 minute ago, Dahobbs said:

I have 50k PIP with USAA and can get up to 100k. I have 100k medpay.

May be a company thing.  My experience with personal lines is with just one company, and it’s been a few years since I took the licensing exam.

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11 minutes ago, Nice Guy Eddie said:

I don't understand the need to sue here. Are they not willing to cover his medical bills?

Suing is premature, for sure.  Things may have changed, but GEICO tends to be pretty reasonable on settlements.

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34 minutes ago, Nice Guy Eddie said:

I don't understand the need to sue here. Are they not willing to cover his medical bills?

They haven't offered a settlement yet. Unless the other person has very good coverage in excess of $100,000 per individual for damages, GEICO should offer policy limits. Sometimes it takes a suit to force them to do that. In fact, often times it takes a suit to get the insurance company to even tell you what the policy limits are. Also, you are not limited to recovering only your medical bills. You can recover for pain and suffering, including future pain and suffering. These things are real and have a real value and effect on people. For instance, being unable to hold your grand kids(or great grand kids) during the limited time you have left because of a broken ribs is a huge cost that needs to be accounted for. 

Other thing to keep in mind on medical bills is that you can also recover for future medical. And the bill you recover on isn't merely the amount you paid out of pocket, but rather the full amount paid by you and your health insurer (who will then have the right to get a portion of any settlement). And you have the separate issue in Texas of hospital liens. For whatever reason, hospitals have taken the position that the law allows them to recover the full bill charge regardless of whether they have been fully paid the rate owed under their contract with the health insurer. The full bill charge is usually many times greater than what is ever actually paid for the hospital's services. Hospital liens have to be satisfied before settlement funds can be disbursed to the injured party. 

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3 hours ago, Dahobbs said:

You can recover for pain and suffering, including future pain and suffering. These things are real and have a real value and effect on people. For instance, being unable to hold your grand kids(or great grand kids) during the limited time you have left because of a broken ribs is a huge cost that needs to be accounted for. . 

That’s a good argument made by you for the jury but come on.  If someone said they couldn’t pick up their grand kids for a few weeks, I wouldn’t give them any money if I was on the jury.  And I’ve been on a jury that awarded someone 1m because of an injury. 

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1 hour ago, Nice Guy Eddie said:

That’s a good argument made by you for the jury but come on.  If someone said they couldn’t pick up their grand kids for a few weeks, I wouldn’t give them any money if I was on the jury.  And I’ve been on a jury that awarded someone 1m because of an injury. 

I was giving an example of non economic damages and how they have value. If you aren't willing to put any dollar figure on the non economic costs associated with a lawsuit, then you are unable to follow the law and should be struck from any and every jury

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On 5/11/2021 at 10:54 AM, horn4life said:

First off let me say my Dad is NOT your average 89 year old.  He's in probably the top 2-3% of physical health.  I tease him that he needs to go break some 90 and over age group swimming records next year.  Up and down stairs at home, you get the idea.  This wreck happened a few weeks ago.

Anyhow he T-bones a kid older sedan when he pulls out in front of my Dad's new Subaru.  THANKFULLY the new Subaru, because I think he might have been even more severely injured in his several year old van.  The long story short is a 16 year old stops at the entrance to the road, then pulls out right in front of my Dad.  Witness who was admiring the new Subaru at the time saw everything.  The car had like 2200 miles and the better safety features probably saved his life.  In the end cracked sternum, 8 broken ribs on right side, two broken ribs on left.  So excruciating pain, each time you clear your lungs.  He's smart, and knows those deep clearing breathes were necessary and he just took the agony knowing that it was really the only way to avoid Pneumonia.  He's a badass and stopped taking his pain meds asap, and looks to be well on the road to recovery.  However, the sedentary weeks took a toll and him, and he worries about what the potential debilitation might be long term (me as well). The insurance company GEICO sent him a bunch of forms about falls and other medical information requests.  I assume to make a low offer, and simply gather information.  Right now his main concern is whether or not the accident may have changed the Aneurysm in his chest, which luckily did not burst when the airbags deployed.  HE also has atrial fib so while in otherwise great physical health with a wonderful quality of life, he could also drop dead any day.

He is willing to sue, and referenced an incident where he did in the past to recover damages in some of the prior accident information he was providing GEICO.  

This is way out of my realm and do not know if he should retain an attorney.  Or do what he is now doing which is giving GEICO information and seeing what sort of offer they come up with. He is not looking to "cash in" and knows a good deal of the settlement will go to attorney's fees and expenses if he goes that route.  I honestly do not have any good advice for him here as it's not my area of expertise. 

One cheaper option might be a letter from my sister-in-law attorney if they come in low, but by allowing my Dad to work towards as settlement with GEICO? (ultimately not my decision) is he doing the wrong thing?

Thanks in Advance

 

No PI experience,  but it sounds like you are aware GEICO will not "play nice" during this litigation.   There is a stigma (right or wrong) associated with elderly drivers about their qualifications to drive.    So it may be a point of contention.

Has your Dad's insurance company commented  ?      Best of luck to you and your great Dad !

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3 hours ago, Nice Guy Eddie said:

That’s a good argument made by you for the jury but come on.  If someone said they couldn’t pick up their grand kids for a few weeks, I wouldn’t give them any money if I was on the jury.  And I’ve been on a jury that awarded someone 1m because of an injury. 

Just so there is no confusion, in my prior post I really meant the royal you as opposed to your personally. I also wasn't trying to imply that a case where the damages were limited to not being able to pick up grand kids for a couple of weeks would be high value. In this case, the medical cost of hospitalization and treatment of an 89 year old man for multiple broken ribs would exceed minimum policy limits by itself. And, where the grandfather had been active before the incident, the impact that kind of injury can have on quality of life is pretty dramatic and even can even start a precipitous decline. Further, the problem with arranging early settlement is that often time the injured doesn't know the full scope of required future treatment. I feel comfortable in saying that the case described would warrant a policy limit offer for any policy with 100k or less coverage. More than that and it becomes questionable. 

54 minutes ago, T’Boo Ted Marshall said:

You can’t subrogate PIP but I thought you could on MPC. That was the case when using UM/UIM.
 

Medpay policies only cover out of pocket costs, so you can't subrogate at all as a health insurer. It isn't subrogation if the same policy provides both UIM coverage and PIP/Medpay. Subrogation refers to efforts to collect against a third-party for insurance proceeds paid. Intrapolicy issues like that are driven by the terms of the policy. Typically UIM coverage has a provision that allows the insurer to offset its UIM coverage for amounts paid under PIP coverage under the same policy. I don't believe Texas law allows an offset for payments made under Medpay coverage. And, at least in Texas, offsets are pretty limited since you can't offset at all if the damages exceed the total of the UIM and PIP coverage.    

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On 5/12/2021 at 1:32 PM, Dahobbs said:

Depends on the type of coverage you have and your state. In Texas, medpay and PIP policies would still have to pay you, i.e., you can be paid twice. Your comprehensive coverage would have a subrogation claim against the third-party, so you couldn't get double paid there. 

also see @TwiceHorn's post above on UIM coverage. 

You can only double dip with PIP. MedPay gets to subrogate against the liability coverage and any agent who sells it instead of PIP should be summarily executed for crookedness or incompetence.

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8 hours ago, TwiceHorn said:

Suing is premature, for sure.  Things may have changed, but GEICO tends to be pretty reasonable on settlements.

I mean, they're not Allstate, but I'm going to go ahead and strongly disagree about GEICO being reasonable. Although, unlike Allstate, they do tend to get reasonable once you sue.

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28 minutes ago, DanRydell said:

You can only double dip with PIP. MedPay gets to subrogate against the liability coverage and any agent who sells it instead of PIP should be summarily executed for crookedness or incompetence.

Good catch. 

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Medpay policies only cover out of pocket costs, so you can't subrogate at all as a health insurer. It isn't subrogation if the same policy provides both UIM coverage and PIP/Medpay. Subrogation refers to efforts to collect against a third-party for insurance proceeds paid. Intrapolicy issues like that are driven by the terms of the policy. Typically UIM coverage has a provision that allows the insurer to offset its UIM coverage for amounts paid under PIP coverage under the same policy. I don't believe Texas law allows an offset for payments made under Medpay coverage. And, at least in Texas, offsets are pretty limited since you can't offset at all if the damages exceed the total of the UIM and PIP coverage.    

I’ve been out of claims Mgmt for a while but MPC was always offset under UM/UIM. I do seem to recall some lawsuits about how it was calculated though. Meaning, you couldn’t evaluate as a policy limits case then offset the MPC so you would end up paying less then policy limits.
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Been out of town last week and wanted to pop back in and simply say thank you for the advice.  I shot my Dad a link before we went to Pensacola and he also says thank you! 

From my brief conversation yesterday. Looks like he will get policy limit of $30K less whatever medical costs his insurance covered.  He was going to request a copy of the policy, to confirm the limits before signing anything.  Since it was a lease for only a few months, he did get reimbursed for his deposit, and Subaru North America was made whole as well. So now I guess it's just confirming the guy on the phone was telling the truth on the policy limits.  Great thing is my Dad has everything on tape should there have been any misrepresentations by GEICO.  

So I guess really, really fucking lucky he was not severely injured as $30K isn't much cash in the big scheme of things.  Luckily he is doing better every day!

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3 hours ago, horn4life said:

Been out of town last week and wanted to pop back in and simply say thank you for the advice.  I shot my Dad a link before we went to Pensacola and he also says thank you! 

From my brief conversation yesterday. Looks like he will get policy limit of $30K less whatever medical costs his insurance covered.  He was going to request a copy of the policy, to confirm the limits before signing anything.  Since it was a lease for only a few months, he did get reimbursed for his deposit, and Subaru North America was made whole as well. So now I guess it's just confirming the guy on the phone was telling the truth on the policy limits.  Great thing is my Dad has everything on tape should there have been any misrepresentations by GEICO.  

So I guess really, really fucking lucky he was not severely injured as $30K isn't much cash in the big scheme of things.  Luckily he is doing better every day!

There shouldn't be any deduction for what his health insurance paid. Do not let that happen. The money that his insurance paid is part of the other driver's liability. And your grandfather's health insurer will have a claim against your grand father to recover the money it paid out of any settlement. He needs the full policy limits and then he needs to negotiate with his health insurer and get them to take a reduced amount to satisfy their claim. 

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9 minutes ago, Dahobbs said:

There shouldn't be any deduction for what his health insurance paid. Do not let that happen. The money that his insurance paid is part of the other driver's liability. And your grandfather's health insurer will have a claim against your grand father to recover the money it paid out of any settlement. He needs the full policy limits and then he needs to negotiate with his health insurer and get them to take a reduced amount to satisfy their claim. 

Thank you!!! I was unclear on the double dip and the acronyms...  Maybe he was referring to medicare?  Which I assume would not be negotiable?

 

 

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59 minutes ago, horn4life said:

Thank you!!! I was unclear on the double dip and the acronyms...  Maybe he was referring to medicare?  Which I assume would not be negotiable?

 

 

 If Medicare paid for his care, he absolutely 100% needs to recover the full amount from insurance company. There should be no deduction at all. Medicare has a lien on the insurance proceeds. In fact, the other driver's insurance company will require your grandfather sign a release saying there is no Medicare lien or that he alone is responsible for paying the lien. Medicare actually allows you to submit your information online to Medicare about the injury, the settlement value, and Medicare will provide information about the amount it paid and how much it is willing to accept to clear the lien. But, for now, please just make sure he doesn't allow the other driver's insurer to claim a reduction of any sort for other insurance proceeds paid. Deductions like that only come into play when you're dealing with your contracted insurer. They are completely irrelevant when dealing with a third-party's liability insurer. As to medical costs, what is recoverable under the law (in Texas and pretty much everywhere else that I can think of) is everything "paid or incurred" by the injured party. That includes amounts paid by injured party or on behalf of the injury party (e.g., payments by the injured party's insurer).  

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