For most people, the last thing they want to do is hash out their injuries with an insurance company.
Learning how insurance companies handle personal injury claims is vital to the value of your case.
After you file an injury claim, negotiating your settlement with an insurance adjuster may be a sticky process, but here are some tips to make things run smoother.
Insurance Companies Collect As Many Facts As Possible
After a claim is filed, the insurance adjuster will collect as many facts as possible before settling your claim, and will want to resolve your claim the cheapest way possible.
That’s how insurance companies make money, and their employees are well trained and experienced at achieving small settlements.
If an adjuster is unable to collect all necessary facts relating to your claim he/she will either not make an offer or will make a low offer.
After the case goes to suit, and he/she can still not obtain all important facts, the adjuster will still make a cheap offer or let the case go to trial. The reason for this is if facts cannot be collected, the insurance adjuster will have reason to believe the injured person is usually hiding something.
Questions the insurance company will ask
Before making a settlement offer, the adjuster will want to collect the following information:
- What the injured people say about how the accident happened, including a tape-recorded statement if the injured will submit one
- What the insured says about how the accident happened
- The police report prepared in connection with the accident
- All other written reports related to the accident
- All the injured persons medical records and bills related to the accident
- All of the injured person’s medical records going back as far as 20 years to all injuries to the same part of the body at issue to the current claim
- The injured person proof of earnings, if he/she is making a lost earnings claim
- Information about any prior personal injury claims made by the injured person
Missing Facts May Hurt Your Claim
Once all information is collected the insurer will analyze every piece thoroughly, and even if one page is noticed missing you bet he/she will ask your lawyer to provide the missing page.
Adjusters believe missing facts could be damaging to the plaintiff.
The value of a claim is based on liability and damages. Your injuries and financial loss (damages), and a connection of fault for your losses to the defendant (liability) are used to calculate a settlement amount.
How are Damages Calculated?
The insurance companies typically calculate damages when trying to determine pain and suffering, missed experiences, and lost opportunities. Although it is tricky to put a dollar amount on these losses adjusters, implement a “damages formula,” to reach a compensation value.
In the initial stage of negotiation, an insurance adjuster adds up the total medical expenses related to the injury. These expenses are referred as “medical special damages” or simply “specials.” This is the base figure used to calculate pain and suffering, and other non-monetary losses, which are called “general” damages.
If the damages are relatively minor, the adjustor multiplies that amount of special damages by 1.5 or 2. However if the injuries are painful, long-lasting, or severe, the special damages amount can be multiplied by up to 5. (the multiple can be as great as 10 in extreme cases). Next, any income lost is added as a result of injuries. That completes the formula, however, this figure is not the final compensation but only the number from which negotiations begin.
Considerations made by the insurance company
Along with calculating a settlement the adjustor will take into account two important pieces when evaluating the facts.
- Can the plaintiff prove the defendant was negligent, and what the plaintiff’s chances are of winning the trial?
- Also, how badly was the plaintiff injured, and what damages are the jury likely to award at the trial.
The insurance company also examines the intangibles-meaning facts and circumstances that are likely to sway a jury in one direction or another.
Significant Intangibles include:
- Whether potential witnesses have lied
- Whether the plaintiff appears to be a likable person or unlikable person
- Whether the plaintiff has a criminal record
- Whether the plaintiff has been treating with high-quality health care providers.
Being truthful throughout your claim
Lying about your personal injury claim will have an immense impact on the outcome. If a plaintiff lies and the lie is exposed, he/she will lose the claim. If the defendant, or one of the defendant’s witnesses, lies, typically this will be substantial on the verdict at trial. Adjusters are trained for this, and they will factor in lying or potential lying into the valuation of the claim.
Likewise, the demeanor of the plaintiff is an important aspect of valuing a claim. It’s human nature to react a certain way depending on your intricacies to a situation. Nice plaintiffs to better with juries. Nasty plaintiffs turn juries off. That is the natural moral of humankind and adjustors will consider a plaintiff’s quality when valuing a claim.
Other complications can arise when filing a personal injury claim; these are just a few examples.
If you have any questions relating to your personal injury claim or are experiencing issues settling your claim with an insurance company, contact our Georgia Personal Injury Lawyers today.