- Jurisdiction
- South Carolina
The driver of the car was found at fault by the police report. Injuries were shoulder blade fracture and rotator cuff tear. No surgery required, just PT. Per Driver's insurer (major carrier) request, all medical bill copies were submitted. Carrier has sent an Agreement and Release:
For and in consideration of the payment of the sum of ____ [this is for pain & suffering] dollars, the receipt and sufficiency of which is hereby acknowledged, and the promise of payment to the undersigned of benefits in accordance with the Schedule of Benefits set forth below, by the Company accepting this Agreement
Schedule of Benefits
(1) To pay all reasonable and necessary expenses, not previously paid by the Company not to exceed _____ [roughly three times what the medical bills amounted to] incurred for medical, dental or surgical treatment, ambulance, hospital, professional nursing services, and prosthetic devices, furnished to the named beneficary as a result of the accident described herein and not previously considered or included in the above paid consideration, from the date of the accident described herein for 180 days following the date of this agreement.
I am confused with this A&R. I called a friend who is a labor law attorney. He read the A&R and was also confused and mentioned that he'd never seen such 'wording'. The pain & suffering benefit seems clear-cut but I do not understand why the Schedule of Benefits reads 3x what the actual bills amounted to nor what their exact settlement would be for the 'benefits' portion. So I'm torn whether to engage an attorney or to assume that the pain & suffering + actual bills would be the benefit. I understand that the safe bet is to hire an attorney however I would naturally prefer that the attorney better the offer... but I also know that there are no guarantees.Schedule of Benefits
(1) To pay all reasonable and necessary expenses, not previously paid by the Company not to exceed _____ [roughly three times what the medical bills amounted to] incurred for medical, dental or surgical treatment, ambulance, hospital, professional nursing services, and prosthetic devices, furnished to the named beneficary as a result of the accident described herein and not previously considered or included in the above paid consideration, from the date of the accident described herein for 180 days following the date of this agreement.
