Sadly both pain and suffering are a part of everyone’s life. But I hope that Pain and Suffering isn’t a part of your life. The phrase “pain and suffering” has a particular meaning in the insurance world. Pain and suffering is a legal term to describe physical and emotional injury that usually results from some kind of accident.
On January 30, 2018, I was driving home from physical therapy. It was a typical slushy, snowy evening in North East Ohio. On my way up the hill to my house people in front of me haphazardly merged and changed lanes. I had to stop at one point to accommodate the person cutting off the person in front of me. The person behind me hadn’t left enough space between us as we climbed the hill and she rear ended me.
It was a mild car accident all things considered, but she hit me just right. I wasn’t feeling the greatest. The ambulance drove me a mile down the road to the Clinic where I was diagnosed with a concussion. Later at the concussion clinic I was diagnosed with whiplash and sent to physical therapy. I had no desire to drag out physical therapy for my neck since I was already in physical therapy for my hip surgery. I got my one session of physical therapy and was ready to move on with my life.
But when it comes to matters of insurance, you can’t move on with your life so quickly. It took a few weeks before my car could be repaired. Since my car was still drivable with its damage, it wasn’t the body shop’s first priority. And getting someone else’s insurance to pay your medical bills is just a mess.
Having the other party’s car insurance pay for fixes to my car was pretty straight forward. The dealership has a fairly streamlined process for getting the payments and that was closed out in February.
The very next day after the accident, the claims representative had already started to talk money with me. He told me an amount “they’d be able to get me.” I said “OK” as if I understood but I had to ask my friends what he was talking about. I was clueless. One of my other friends had been hit by a drunk driver while we were in college and she knew all about Pain and Suffering. She explained that when someone hits you and injures you they aren’t just responsible for paying for your medical bills. They are also responsible for the huge inconvenience they have caused you by having to deal with doctors and missing work and of course the actual physical pain you experience. So they will pay for everything that has an explicit expense but also pay you for your pain and your suffering.
After a lot of confusion and mixed messages from various people, it turned out most of my medical bills had been automatically processed and sent off to my health insurance. Only the emergency room visit had been processed on something called Med Pay, so it automatically was sent to the car insurance instead of my health insurance. For weeks, I was on the phone with different billing people at the Clinic trying to figure out how to get the other bills to the car insurance. After a month, a patient advocate helped me sort out the situation: essentially there was no point in me attempting to do any calling or coordinating because my health insurance had already been billed. So they paid without question (remember I have great health insurance with a $0 deductible and just have to pay very affordable copays). The other party’s car insurance now needed to pay my health insurance back for the medical care I received.
Once my health insurance was alerted to the fact that someone else was responsible for paying those bills, it was actually on me to ensure they got paid back from any settlement I might get. The company representing my health insurance in this process was pretty slow to send out details. They told me to make sure there would be enough in my settlement to cover what they are owed. They questioned whether I had a personal injury lawyer. I had not gotten one nor had I any intention of doing so.
I was very lucky to be working with a good insurance company. The woman who hit me and I both have Progressive car insurance so we were mutually represented. Having been hit by someone else with Progressive Insurance while in college, they never seem to argue or to try to make things difficult. It was beneficial that the claim was handled by one person and from a business perspective Progressive wanted to make sure I am taken care of so I stay with them. They wanted me to get a fair deal.
In order to complete a Pain and Suffering claim, you have to send in all of your discharge paper work from each doctor’s appointment to establish diagnoses and necessary medical care. Because I only took off one day of work, I didn’t have to actually submit evidence of missed days or my daily pay rate. I was able to just tell the claims representative over the phone, but he did tell me that if it had been a week or more I would have had to submit proof of absence. Eventually, I also sent in my billing statements from the Clinic in order to prove the payments I had personally made toward the medical care required as a result of the car accident.
I had two doctor’s appointments in February and a follow up with the neurologist in the beginning of June. So the process was doomed to last into the summer. The company representing my health insurance was in no rush to send out the bills to the car insurance. I had to call them to help facilitate the process. Eventually Progressive was able to pay back the health insurance for my three doctor’s appointments. In mid-August I got an email that my pain and suffering check would be sent out and so would a separate check to reimburse me for the copays I had paid. I was thankful the process was finally closed out.
The money that comes with Pain and Suffering
Pain and suffering payments are not taxable if you do not take an itemized deduction for the medical expenses related to the injury. Since I definitely don’t itemize my taxes, the pain and suffering check is tax free.
So I took that tax free money and put it into my Roth IRA, where it will grow tax free and will be withdrawn tax free. This money was obviously an unexpected windfall and I want it to help me in the future since, all in all, I am fine after the accident. Certainly, I didn’t feel great in the couple weeks after the accident but I was fortunate. Things could have been so much worse. I was mostly grateful I remembered to take my foot off the brake right before I got hit so that the impact would be lessened. There was no impact against my leg or hip, so my road to recovery there was not hampered.
Before this car accident I didn’t know very much about Pain and Suffering damages. I had seen some media references to it: TV shows depicting people trying to get an insurance adjuster to believe they are injured worse than they actually were. But I never expected to get a payment for getting hurt in a car accident. It has been a strange experience.
If you find yourself injured…
For anyone who might go through this or is currently going through this, don’t be afraid to advocate for yourself. If you need a personal injury lawyer to ensure you are fairly compensated, look in to it. There may be affordable ways to retain a lawyer such as through your union or another professional organization. And it may really just pay off to get an expert on your side. I was really lucky not to need one. My injuries were not life threatening or crippling. So I would have been OK not getting as much, but some people really need the money to make up for lost wages and to pay for continued medical care.
Keep track of every appointment on a calendar or in a notebook of some kind. Keep track of missed days of work and know how much you get paid for a day’s work. Keep track of how much you have paid for appointments and medications. You will need to submit bills and/or receipts for these things. Keep the paperwork the doctor gives you when you leave your appointment (the Clinic always prints out about 4 pages of information for me). And you don’t have to be afraid to accept follow up appointments for your care. This demonstrates the extent of your injury and the appointment will ultimately be paid for. If the doctor says you need it, then you need it.
If you do not need your settlement check for any continued medical care, you should consider putting it away in some investment vehicle. Since my payment was small in terms of pain and suffering, it made perfect sense to just stick it in my Roth IRA. But for larger payments a taxable account may be the best and only option. Build your wealth with the settlement and secure your future however you can.