How Does Insurer Determine What Injury Case Is Worth?

Every case is different. Despite that fact, insurers exam certain specific factors, when making a determination on any one case’s worth.

The claimant’s losses have to be covered. It includes the cost of treatment represents the bulk of the medical expenses. Some of the claimants often lose some of their salary, while recovering from their injury. An accident victim might suffer a disability of disfigurement. A scar would count as a disfigurement; so, would introduction of an implanted device.

Some injured victims suffer a loss of time with family; others become deprived of a social, recreational or educational experience. Additionally, damaged property counts as a financial loss. Then there is pain and suffering, plus the associated emotional challenges belong in another group of losses.

The value for each loss determines the figures that the insurer must enter in a formula.

Each loss except for pain and suffering should be represented by an established monetary amount. Those are the special damages. The sum of the specials becomes one figure in the insurer’s formula.

That sum becomes one factor in a multiplication operation. The other factor is a multiplier. Multipliers usually range from 1.5 to 5, depending on the seriousness of the claimant’s injury. Once the multiplication has been carried out, the value for the claimant’s lost wages should go into the formula. The result of the multiplication operation must be added to the value of the lost wages.

Utilization of the amount obtained by using the formula

The result of that final addition represents an estimate for a given case’s worth. The way that insurers make use of that final figure depends on the claimants’ decisions. When claimants have chosen to dispense with a lawyer, the figure obtained by using the formula is more than the insurer wants to use as the initial offer.

Hence, that oversized figure gets reduced to a given percentage of its former value. In other words, the adjuster opens negotiations by using that smaller figure. On the other hand, if the claimant has hired an attorney, then the adjuster chooses the figure that was obtained by using the formula as his or her initial bid.

Adjusters assume that lawyers can appreciate the true worth of a case far better than any unrepresented claimant. That is why so many adjusters try to start negotiations with a low-ball offer. An experience Personal Injury Lawyer in Kitchener would advise a client not to accept such an offer.

Knowledgeable claimants react to introduction of a low-ball bid by demanding a justification for presentation of that low number. An adjuster’s approach to negotiations changes, once it has become clear that a given claimant has learned the true worth of his or her case. Claimants’ demands normally change, following acquisition of such useful knowledge.