The last thing accident victims want to worry about after being involved in a personal injury accident is dealing with the claims process.
However, 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, an insurance company representative will collect as many facts as possible before settling your claim and they 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 making sure you do not receive a fair settlement for your losses.
If an adjuster cannot collect all necessary facts relating to the claim during the negotiation process, they will either not make an offer or will offer you a very low settlement agreement.
After the case goes to suit, the claims adjuster can still not obtain all important facts, they will still make the lowest settlement offer or let the case go to trial. The reason for this is that if facts cannot be collected, the insurance adjuster will have reason to believe that the injured person is hiding something.
Questions the insurance company will ask
Before coming to a settlement agreement, the claims adjuster will want to collect the following essential details:
- What the accident victim said about how the accident happened, including a tape-recorded statement if possible.
- What the injured party says about how the accident happened.
- Accident reports prepared by the police.
- All other written reports related to the accident.
- All the medical records and bills of the injury victim.
- All of the injured party's medical records going back as far as 20 years regarding all previous bodily injury and any pre-existing conditions.
- The injured person's proof of earnings and loss of income records.
- Property damage records.
- All out-of-pocket expenses related to the accident.
- Emotional trauma.
- Information about any prior accident 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 missing, you bet they will ask your personal injury attorney to provide the missing page.
Adjusters believe missing facts could be damaging to the plaintiff.
The value of insurance claims are 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 is Compensation for Damages Calculated?
The insurance carrier typically calculates compensation for damages when trying to determine pain and suffering, loss of enjoyment of life, poor quality of life, 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 current injuries that were sustained in the accident.
These medical costs are referred to 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 severity of injuries is painful and long-lasting, or if permanent impairment occurred, 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.
This 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 are the plaintiff’s chances of winning the trial?
- Also, how badly was the plaintiff injured, and what damages will the jury likely 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 an unlikeable person
- Whether the plaintiff has a criminal record
- Whether the plaintiff has received medical treatment from high-quality healthcare 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, they 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 the intricacies of a situation.
Nice plaintiffs do 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 during the personal injury claim process; these are just a few examples.
Hire a Personal Injury Lawyer
If you were involved in an accident and believe that someone else was at fault, it's crucial to hire an experienced personal injury lawyer to assist with all aspects of your claim.
Insurance policies, along with insurance companies, can be extremely difficult to handle without an accident attorney who has experience handling these types of claims.
The only way for you to receive maximum compensation for your losses is to have an attorney take legal action against the party at fault as soon as possible.
When a personal injury attorney is working on your case, the insurance company may think twice before sending lowball offers.
It is not worth the mental anguish to fight the at-fault party's insurance company on your own.
What's important is for you to receive the medical care you need while an experienced lawyer handles the common tactics and tricks of the insurance provider.
When you contact our law firm, we assign an expert legal professional to your case. They will fight for your legal rights and prepare to take your case to trial if optimal financial recovery cannot be achieved outside of the courtroom.
You will never pay any out-of-pocket costs when you hire an attorney from one of our personal injury law firms. All of our lawyers work on a contingency fee basis, which means they only get paid when you receive fair compensation from the at-fault party.
Personal injury lawsuits take time, and to avoid taking a quick settlement, you'll need all the help you can get.
To get help with the personal injury claims process, click the link below to schedule a free initial consultation with an expert personal injury attorney near you.
