Claims Advice

[Claimadvice]

Good morning, I am hoping some wise Mumsnetters can help me in relation to an offer I have received.

I was in a road traffic accident 10 months ago. I received a pre medical offer of circa 2k which I declined.

The crash was relatively minor however I had pre-existing conditions which have been aggravated. My arthritis has flared considerably leading to a large increase in pain, diminished function and increase in medication. I have had side effects from the meds. This has not yet stabilised.

My Rheumatologist suspects I may now have Fibromyalgia and will keep this under review. Whether this is linked I do not know.

I have attended several sessions of physiotherapy and still have pain and restricted movement in my neck. My back is much better however the medical examiner has recommended a referral to an orthopedic surgeon.

I had existing anxiety and depression and this rapidly deteriorated. I have developed travel anxiety and social phobia and required a re-referral to a psychiatrist and a large increase in medication. The medical examiner has suggested a referral to a psychologist.

I have received a global offer of 10k to settle, prior to seeing a surgeon or psychologist. My claims handler has changed numerous times and the one I have just spoken too said they could not give me any advice yet as they don’t know my case. They need time to get acquainted.

I asked what they meant by global - they said they would need to check but suspect this means the treatment costs would need to be deducted and would include all other expenses. I’m not sure I have any confidence in the insurance company I am using (referred by my legal cover).

They said I have 21 days to accept the offer and this may be withdrawn or reduced if I choose to have further medical reports.

My gut feeling is that I should wait and see what the specialists say. What would you advise? Does this seem a fair offer?

Many thanks in advance.

Anyone?

Claims handler has advised me that the 21 days ends tomorrow - even though they only told me this morning! I have requested extra time to consider the offer but not sure if this will be granted.

It’s a lot for you to ask, which is why I suspect those who do this for a living wouldn’t be comfortable giving you advice it seems you’ll rely on based on the small amount of information contained in your post. Ask for an extension of time to respond so that you can take proper legal advice.

Thanks for your response Collaborate.

I have requested an extension of time. The claims handler said they do not know what to suggest as no prognosis has been made for full recovery and it is my decision.

Where would I take legal advice? Could I call a personal injury solicitor and ask them to take a look for a fee?

Someone will always take a look for a fee but isn't that what the claims handler is there for? Presumably they're telling you that it's a risk to accept the offer because it's been made too early and the prognosis is uncertain.

Hi Collaborate. No they haven’t said anything - that is exactly what I asked. The lady said she is unsure what she would do in my situation.

I am using the company my insurance recommended. I don’t actually think they are solicitors and I seem to speak to someone new every time who does not know my file.

My gut feeling is to wait and see the specialists.

Ask them to seek advice from a barrister. Complain if you feel that they are not advising you. It might well be that they will not advise you until the long term prognosis is reported on, and if they've said that, there might be nowhere for you to go. However you do not seem to be receiving advice from anyone with sufficient qualifications.

Have you had an independent medical report draw up that specifically details the injuries, impact and prognosis?

It should give a recommendation on whether they can accurately predict long term impact and recovery time or if they need to redo the report in a set time period such as 12 months after treatment has taken place.

You may need to wait on a final settlement until you have a firm prognosis and the settlement should factor in future treatment as per the report.

I had an independent report completed in December. That outlined my injuries and stated it was beyond the expertise of the doctor to give a prognosis and recommended Physio plus a referral to a Clinical Psychologist and Orthopaedic Surgeon.

There were some minor amendments, such as changes to medication, dates of time off work that I advised them about in Jan after receiving the report. It then took months to get the revised report back.

I have been chasing the referrals however they said they needed to disclose the medical report first to the other side. Not sure what the hold up was.

After being fobbed off for another couple of weeks that someone would call I got the voicemail yesterday advising of the offer and saying I had 21 days. When I got through to someone I was told the deadline was today and they don’t know why I was not informed sooner.

It was me who requested an extension to the deadline to give me time to consider the offer however they have not confirmed this.

They would not tell me whether to settle or go ahead with the referrals. I will ask about a barrister.

Is it possible for me to tell my car insurance company that I am not happy with their recommended claims handlers and ask to choose a solicitor myself? Just worried that I will incur all costs accrued to date.

Having anxiety, this stress is making me worse.

I appreciate all responses, thank you.

Hi again.

I have made attempts to speak to a barrister or even a solicitor. Discovered the call centre/claims handlers are based in a different country. My allocated claims handler actually called me today to say he is unsure what day a solicitor will be able to contact me as they are busy.

I asked again why I had only received 1 days notice of the offer before the 21 day expiration date. He replied it’s not his fault as the company had received it but it was somewhere in the internal postal system and only materialised on his desk the day before I was notified.

He was unable to confirm if an extension had been agreed and said as far as he is aware the offer is still on the table but they could withdraw it at any time and offer less.

He said I have seemingly received a good offer as he’s never known an offer to be multiplied by 5 before seeing any specialists that have been recommended by the initial medical advisor.

I explained this is why I need legal advice and outlined I remain concerned I have no prognosis especially as my own doctor has just referred me for acupuncture and further physiotherapy - I am literally trying everything to speed up full recovery.

I plan to submit a written complaint - would I have grounds to ask them to stop acting on my behalf so I can nstruct my own solicitor?

I would really prefer to see someone face to face however I am worried I be liable for costs already incurred.

Thanks in advance for any responses.

Hopeful bump. Anyone?