A look at the numbers and reasoning supporting the insurance adjuster’s assessment of your personal injury claim.
You might have heard that insurance adjusters utilize a secretive mathematical method in figuring out how much compensation needs to be paid through a personal injury settlement. The method part is true, but it surely isn’t a secret. And the formula doesn’t actually establish how much compensation an individual is going to receive. It’s only a tool the adjusters use to start the process of determining how much a personal injury claim is valued at. Final determinations concerning compensation are not made until multiple other aspects are considered.
This post details how insurance adjusters use their formula and the way they integrate it with other facts to come to a number they are willing to pay for a claim. After you comprehend how the compensation formula works, you are going to be able to negotiate with conviction for a fair personal injury claim settlement.
Why the Requirement for a Damages Formula?
Typically, an individual liable for an accident—and usually that individual’s liability insurance company—is required to pay an injured individual for:
- medical bills and associated expenses
- missed work time or other loss of income
- pain and other physical suffering
- constant physical disability or deformity
- loss of family, social, and educational accounts, and
- emotional damages as the result from any of the above.
Whereas it is usually somewhat simple to add up the money spent, and money lost, there is no specific way to put a dollar amount for pain and suffering, and on wasted experiences and lost chances. That is why the damages formula comes into play.
The Way that the Damages Formula Works
At the start of negotiations on a personal injury claim, the insurance adjuster is going to add up the total medical expenses associated to the injury. These costs are called “the medical special damages” or just “specials.” As a way to start discovering how much to compensate the injured individual for their pain and suffering, continual disability, and emotional damages—combined known as “general damages”—the insurance adjuster is going to multiply the number of special damages by around 1.5 to 3 times when the injuries are somewhat minor, and up to 5 (and occasionally more) times when the injuries are significantly painful, severe, or enduring. After that amount is come to, the adjuster is then going to add on any income you may have lost because of the injuries.
That calculation—medical specials multiplied by 1.5 to 5 (and sometimes higher), then added to loss of income—becomes the number by which settlement negotiations start.
Illustrative Damages Formula:
Steve, injured in an auto accident, had $600 in medical specials. Applying the formula, the initial claim ranges from $900 to $3,000 (1.5 to 5 times $600). Adding his $400 income loss, negotiations start from this figure for Steve’s compensation. Further considerations determine the total compensation the insurance company is willing to pay for his injuries.
Insurance Adjusters Don’t Disclose Their Formula
When negotiating for a personal injury settlement, the insurance adjuster won’t usually let you know what formula they used to assess your claim, or even say they are utilizing any formula at all. They’re following a primary rule of negotiations: Don’t let the other side know how or what you are thinking. Because the insurance adjusters aren’t going to let you know what formula they are using, it’s most likely wise not to let them know what you are thinking, either. Instead, you are going to simply negotiate total settlement figures.
The Formula and the Deciding Factors
Two crucial points about the damages formula: First, multiplying special damages is just the starting point for settlement. After reaching this point, other details about your accident and injuries factor in. The initial formula, ranging from 1.5 to 5 times specials (and sometimes more with an increased multiplier), produces varied results based on your claim’s chosen range. Several factors decide this in your special damages claim.
- The more severe your injury, the higher the formula’s end result will be.
- The more aggressive and longer-lasting your medical treatments, the higher the formula.
- The clearer the medical evidence of your injury, increases the formula.
- The longer recovery time from your injuries, the higher the formula.
- The more serious and visible any permanent impact of your injury, increases the formula.
Source:
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David Goguen, J. D. (2019, July 22). The damages and compensation formula in an injury case. www.alllaw.com. Retrieved April 28, 2022, from https://www.alllaw.com/articles/nolo/personal-injury/damages-compensation-formula.html