How Do Insurance Companies Determine The Worth of An Injury Claim?

The worth of an injury claim represents what damages must be covered by the defendant’s insurance agency, and which damages that same agency feels ready to consider.

The damages that must be covered

• Medical expenses
• Lost wages
• Consequences of any physical disability or disfigurement
• Loss of educational, family or social experiences
• Pain and suffering: Represented by any emotional damage
• Property losses

Formula used for calculating an estimate of the claim’s total worth

Calculate total for all of the medical expenses; Add up the sum that appears on each of the claimant’s medical bills. Personal injury lawyer in Sault Ste. Marie will select a figure to use as a multiplier. This is usually a number that falls between 1.5 and 5. That number must indicate the severity of the reported injuries; an adjuster might use a 6, 7 or more for a case where the victim has sustained catastrophic injuries.

Multiply the total for the medical expenses by the selected multiplier. Take the product from the multiplication operation and add it to the value for the lost wages. The number obtained by using the formula should be used as a possible opening bid, at the start of negotiations

The amount calculated by the formula might not be the case’s true worth.

The formula does not take into account the issue of fact; the evidence might have suggested shared fault. The formula does not take into account the source of the prescribed treatment. Insurance companies favor treatment that was prescribed by a medical doctor.

An adjuster might lower the value/worth of an injury case, if a chiropractor had prescribed the utilized treatment. In cases where there is shared blame, or where the injured victim has been treated by a chiropractor, the adjuster’s opening bid could be lower than the result obtained by using the formula.

A possible alternative to utilization of a formula:

Some insurance companies use computer software, when calculating an estimate for a given injury claim’s worth. That software could have the ability to account for the source of the claimant’s treatment. In other words, the software could make the needed adjustments, when calculating an estimate for a given injury’s worth/value.

The computer software cannot introduce adaptations, in order to account for any potential evidence of shared blame. Adjusters must carry out their own calculations, when attempting to estimate the value of a given client’s injury.

An adjuster’s supervisor might suggest another factor to consider, before presenting the offer that should get the negotiations started. That additional factor could be the presence or absence of any legal supports that might be available to a given client. Adjusters tend to raise the size of the initial offer, if the claimant has chosen to hire a personal injury lawyer.