Thursday, January 24, 2008
So What Is a Full and Final Settlement?
Many times people come to see me and they say the insurance company wants to settle with me for a sum of money. I ask for more information and they show me a Final Admission of Liability which has a money figure on it. I then have to say what I have said many times before...a Final Admission is not a settlement at all. It is the Respondents (insurance, employer) saying they owe you some money but they also seek to close your case after 30 days. A Final Admission requires a swift response and usually we object and do much more to protect the claimants rights. A Final Admission is a very detailed document so never assume it is a settlement at all. It is what the insurer believes it owes you but it is often too low and leaves out benefits so once closed you are left only with limited rights, if any. A settlement is a contract which is agreed upon by both sides. It is also very negotiable or almost always negotiable. But do not drop the ball if a Final Admission is filed and you receive it. Do not think you can keep negotiating and pay no attention to the Final Admission. That is BIG MISTAKE. Closure of your case occurs if you think you can just keep negotiating after you receive a Final Admission. If you fail to properly act within 30 days of the date of the Final Admission your case will almost always be closed. Once closed trying to reopen is not easy although sometimes some benefits are left open by the language in the Final Admission. The point is act fast or you are at risk. A settlement is usually an agreed upon figure which can include many things. It can be much higher then any figure in the Final Admission and it can also address your future medical benefits and a host of other things. It is a complicated document but the two biggest points are the dollar figure you are to get and the medical situation. If represented by an attorney a claimant can rely on him to review all of the terms and negotiate a fair figure authorized by you. If you are doing this yourself historically it has required that you appear before a Judge so he can warn you it totally ends your case. There are no do overs and no way unless documented in the settlement to return for any more benefits. So if you think you can take the money and then reopen the case if your condition worsens or if you forgot to get all your meds before you settled...sorry you are out of luck. Full and Final means you are bound by all the terms of the settlement and so are they. If you get better you still keep all the money. If you get worse you still keep all the money but can't say I want more. If at all possible you should try to review your case with an attorney when either a settlement is possible or you receive a Final Admission. The fact is there are possible increases in the figures which are seldom mentioned to you by the insurer but which can dramatically increase the numbers or which can even lead to more benefits and treatment! In my last few cases the figures nearly doubled from what the insurer felt was due the client. NEVER accept at face value the insurers computations or analysis of your claim. We've even settled cases for large sums when the insurer never admitted to pay a dime! I always assume the insurer is minimizing as much as it can the benefits or amounts due. Frankly that is their job but you can often increase it. If it is a Full and Final Settlement or a Final Admission get help if at all possible. Your injury may last with you forever...make it count.