What type of letter do I need to send to a third party claims manager?

UPDATED: Dec 28, 2011

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What type of letter do I need to send to a third party claims manager?

My sister fell in a store from water on the floor and broke her wrist during the summer. The amount the claims adjuster is offering is only $8000 and her expenses from the injury are $8619.90. Someone had told us in these cases it is usually 3X the amount of the expenses that is to be asked for due to pain and suffering. What should we do?

Asked on December 28, 2011 under Personal Injury, Alabama


S.L,. Member, California Bar / FreeAdvice Contributing Attorney

Answered 11 years ago | Contributor

Your sister can tell the adjuster that the settlement is rejected. 

Your sister can either continue negotiations by making a counteroffer or can just file a lawsuit for negligence against the store.

There isn't any mathematical formula for determining compensation for pain and suffering.  I would ask for quadruple the medical bills to compensate for pain and suffering, but NOT expecting to get that.  This would just be a starting point in negotiations with the insurance carrier.  However, in your sister's case the amount being offered by the insurance carrier is too low since it doesn't even cover the medical bills assuming that figure you mentioned is for the medical bills.

Your sister's claim filed with the insurance company should have included compensation for the medical bills, compensation for pain and suffering and if applicable, compensation for wage loss.  Compensation for the medical bills is straight reimbursement.  Compensation for wage loss is straight reimbursement.  The medical reports document the nature and extent of your sister's injury and are used to determine compensation for pain and suffering, an amount in addition to the medical bills.

If your sister is dissatisfied with settlement offers from the insurance company, she should reject the settlement offers and file a lawsuit for negligence against the store.  If the case is settled with the insurance company, NO lawsuit is filed.  If the case is NOT settled with the insurance company, your sister will need to file her lawsuit against the store prior to the expiration of the applicable statute of limitations or she will lose her rights forever in the matter.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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