Insurance Claim

[sua yai]

Around midnight, 11 days ago, my wife and I were riding her motorbike back home on the main road. There was very little traffic. A car, driven by a young Thai chap and his friend was heading in the opposite direction into town. They decided to turn right suddenly and , not seeing us, smashed into us broadside.

We were both knocked off the bike. My wife hit her head and the cut required 5 stitches. She also had a nasty knock on her hip. Other than than she was OK.

I got the worst of it. 7 stitches to a cut above the eye and other minor cuts and scrapes. However, it would appear that one of the car's headlights hit my lower right leg. This resulted in the leg being torn open from the knee to the ankle. A real mess. In some areas, the wound was down to the bone. The Thai chap stopped and was fully insured.

Took us to a local hospital where I underwent a 2/3 hour operation to stitch the leg back together again. The next day, I transferred to a private hospital. Underwent a second,minor operation last week to remove dead skin and tissue. A third operation may still be necessary. The doctor makes a decision on Friday. Again minor surgery if it goes ahead. I was discharged yesterday.

Now the Thai chap has been brilliant - other than his driving. All my hospital bills have been paid - around 80,000 Baht. He bought me a new pair of glasses - old ones lost in accident. He's paid for repair to the motorcycle and even lent my wife one of his whilst it was being repaired. All this was on his insurance.

A couple of days ago, on the phone to my wife, HE brought up the subject of damages for us. He bandied a figure around of 50,000 Baht. I said that damages could not be discussed with him, or the insurers, until my leg was fully recovered. The doc had said that I won't be walking properly for another 3-4 weeks. Certainly, I'll be left with large scars.

Does anyone have any experience of this kind of situation? I've been here for 7 years, but never come across anyone who was claiming personal damages off someone else's insurance.

I'm not trying to be money grabbing, but as they've brought the subject up and the Thai chap wouldn't be forking out, how much should we be asking for? Apparantly, his insurance is up to 1 million, third party.

[Thetyim]

I don't understand what damages you mean.

You have been paid for damage to your bike, you have been paid for damage to you and your wife, what are the other damages.

My insurance company is very good at paying up but they do not give money away for inconvenience or shock.

If you have been offered 50k then I would take it.

[toastwars]

He will probably suffer pain and discomfort for the rest of his life, I think a payment in recognition of that is needed. Also the scar itself can cause phycological problems of acceptance. you are right to see what happens to your injury before discussing any figures. See what the full and lasting effects of the injury are.

[sua yai]

Well, I was surprised at the offer, as I'm not sure how things work here.

Sure, hospital bills and repairs to motorcycle have been taken care of, but no damages have been paid to us for personal injury.

I appreciate that it's likely to be different over here, but back in the UK, not only would the insurance company have taken care of bills as they have here, but they would also expect to recieve a claim for personal injury in these circumstances. If I'd lost a leg - and believe me, it wasn't far off - I don't think an insurance company would expect to simply be presented with hospital bills.

It is this "other area" of suffering, injury and potential permanent damage to my leg that I'm asking about.

[toastwars]

Well, I was surprised at the offer, as I'm not sure how things work here.

Sure, hospital bills and repairs to motorcycle have been taken care of, but no damages have been paid to us for personal injury.

I appreciate that it's likely to be different over here, but back in the UK, not only would the insurance company have taken care of bills as they have here, but they would also expect to recieve a claim for personal injury in these circumstances. If I'd lost a leg - and believe me, it wasn't far off - I don't think an insurance company would expect to simply be presented with hospital bills.

It is this "other area" of suffering, injury and potential permanent damage to my leg that I'm asking about.

I would suggest talking to a lawyer, I am sure he will advise you to wait and see what long term effects this may have. Legal advice, the best in this case 50000 does not sound a lot for the size of your injury, and there is none at all for your wife.

[ProThaiExpat]

Your post puzzles me when you speak of the Thai driver doing all the paying of bills, etc. Is that a fact or did you mean an insurance agent?

Since insurance adjusters come to the scene of most accidents in Thailand, why is the driver handling the payment of claims? Is he perhaps, an insurance adjuster.

Definitely wait for six months to see what your residual injuries are.

If it was my leg, I would demand the entire proceeds available under the policy.

Certainly a lawyer specializing in personal injury claims is inorder, agree to the fee as a percentage of the recovery, no recovery no fee or a flat fee in the 20k range.

[sua yai]

That sounds like good advice, Toastwars.

I've got an English friend here who, among other things, brokers Bupa insurance. I'll call him tomorrow for his advice. The chances are that he'll have come across this situation before.

50,000 dosn't sound a great deal to me either, hence not agreeing to anything yet.When the amount was mooted a few days ago, the wife couldn't believe it - thought it was a huge sum of money. I warned her not to agree to anything, either verbally or in writing, until I was better.

PS, the 50,000 was supposed to cover the two of us.

[sua yai]

Pro ThaiExpat.

All the bills so far have been covered by the driver's insurance policy. He hasn't personally spent anything.

Again thanks for the advice. I'll start looking into things tomorrow. Only returned home from hospital yesterday.

[taxexile]

you will need a full medical report detailing the extent of the injuries and the surgery necessary to repair them , make sure the surgeon names the ligaments , bones , nerves and muscles that were damaged and needed repair.

get the doctor to give a prognosis re. residual scarring and any loss of movement , function or sensation on the affected leg.

get a second opinion as to the prognosis.

as toastwars said , there may be long term affects...... in 20 years time you might have arthritis problems as a result of this accident.

dont agree to a compensation payment until you have taken proper advice , and whilst nobody suggests you exaggerate your claim , dont sell yourself short either , you or your misses could have been killed or put in comas for a year.

the thai guy who hit you may of been nice about it , but he was probably thankful he hadnt killed you , he needs to be taught a lesson too.

i , personally , would sue him for a lot , and let the insurance companies fight it out. but i dont know how these things work here in thailand.

good luck and get well soon !

[Merlin]

amazing Thailand!

You've found a Thai with "jai dee". I bet he doesn't have any baht bus drivers in his family - or he would have backed up and finished you off...

If it was me, I'd take his offer, thank him deeply, and then go and make Tambon at the nearest Wat.

Think positive and follow the Doctor's advice, your leg will heal if you let it.

[mraloha]

i was happy to hear that you and your wife will survive.

any effort on the part of the thai perpatrater was only to pay you off and end the thing as soon as possible, actually i think you were lucky to get what you got. because you don't want to get tied up in the court system here.

my other thought is anybody who rides a motorbike in this country has big odds of getting hurt or killed. if you can't afford a car, take a songtow.

i rode a harley here for three years went down once and hit a poor thai man on a motorbike( who i paid off right away, fixed the bike, paid the hospital bill, gave him about three month rages).

i will never ride a motorbike in this country again!

[ProThaiExpat]

taxexiles advice is the best so far, in my view, and that includes mine.

The settlement of an insurance claim is a matter for professionals, usually their cost is paid out of the amount greater than you can get without representation.

The human mind tends to blot out painful and threatening events, so as you recover, what you went through will fade from your memory. Insurance companies know this.

Many lawyers experienced in peronal injury claims litigation will have thier clients keep diaries of their day to day experience from the day you were hurt onward. Your hospital experience is recent enough so you can start the diary NOW from day one and use recent memory to document everything so far including your feelings, pains, surgeries, etc. You will need this information when you negotiate your settlement.

It is often said that insurance companies really want to pay what is "fair". But it is always their definition of what is "fair". You are at a disadvantage from the beginig as they are professionals at this and your not. Thus hiring a lawyer is western countries is a must, in Thailand, who knows how good they are?

The advice that you hear in this thread to take what your offered and be happy reminds me of "Painless Parker" the famous dentist, its painless to him.

Assuming you fully recover without any residuals at all, doubtful but possible, you still have residual scarring to consider in discussing compensation.

Are the scars disfiguring, ugly to look at, discolored, etc? Will they be subject to comment when you wear shorts? They must be considered as well.

Keep in mind, scar tissue is in-elastic, so the scars below the surface of the skin will not stretch, expand, flex or otherwise be pliant as you engage in activity.

Hopefully your wife's scars are not visibile, a very important compensation factor with women. Hopefully, your facial scar won't be visible in a year, but if so, what about revision surgery by a plastic surgeon? You are entitled to live the rest of your life without a visible reminder, every time you shave or brush you teeth, of this unforntunate event.

The foregoing is provided to expand your thinking on how compensation in insurance claims are viewed by experienced insurance companies, who's primary function, in that arena, is to settle the claim for as litttle as possible.

Edited February 28, 2005 by ProThaiExpat

[sua yai]

Thanks to everyone who's offered advice on this topic. It all seems very sensible.

I'll be getting on to the hospitals today - the first, major operation was performed at the public hospital in town before I was transferred to a private one.

Obviously, it's difficult to say at this early stage how bad the scarring will be. What is definite is that there will be some. There are around 40 stitches in the leg and three open areas where the skin and tissue were torn out to the bone in the accident. The surgeons had no option but to leave these open and over time the tissue and skin will grow back - the process has already started.

I'll keep a diary. Memories do fade as has been pointed out.

I'll contact a freind here who deals in insurance for his advice and try to get the name of a reliable personal injury lawyer. The sooner done the better.

I'm not too bad. I can hobble around the house with the aid of crutches and as each day goes by, the pain decreases. I'm lucky that my wife can take care of me - she went back to work at a restaurant in town yesterday - but she has time in the morning to take me to the hospital to get the wound cleaned and dressed and then to the market for shopping.

I'll keep everyone advised of how how things are progressing.

[madmitch]

Taxexile and Prothai expat are absolutely right.

I was an insurance professional in the UK and at one point in my career handled third party claims of this nature.

THB50,000 is a large amount of cash for the average Thai but the insurers will know that this is not necessarily the case for a farang. All insurers take status into account when assessing potential third party payments.

I would highly recommend employing a lawyer as soon as possible and you must find one with personal injury experience and a lawyer who is "farang friendly". I don't believe you will get "no-win-no-fee" with many Thai lawyers but I'm not sure. Sadly, not being in the industry any more, I can't recommend anyone personally.

The likelihood of this case going to the courts is minimal. Very few personal injury cases get that far anywhere in the world; it's too costly for all involved parties.

If 50k is an initial offer then the insurance company will certainly have reserved an amount substantially more than this but leave negotiations to the legal people and experts.