How does an Insurance Company Evaluate Personal Injury Claims?
Insurance companies play a crucial role in the settlement of personal injury claims. Determining the fairest amount of claim is the most challenging issue because each side may view things from their own perspective. The claims usually vary from one case to another because no two cases will have identical circumstances.
Types of Damages Insurer Must Pay
Fort Lauderdale personal injury lawyers maintain that a person who is held liable for causing an accident and his or her insurance company is required to compensate for certain damages in most cases. These include the cost of medical treatment and related expenses incurred by the victim to recover from the personal injuries. Secondly, the defendant or the insurer must compensate the victim for the wages lost due to absence from work while undergoing medical treatment for the personal injuries.
Compensation may also be claimed for loss of social, education, and family experiences such as missed training, family events, recreation, or vacation. Emotional costs suffered such as loss of confidence, depression, stress, or strained personal relationships may also be a part of the legitimate claim. Lastly, any loss or damage to the victim’s property must be compensated for by the defendants or their insurers.
Damages Computation by Insurers
Medical expenses and loss of income are computable more easily than subjective losses such as emotional loss or pain and suffering experienced by the victim. In such cases, the insurance adjusters usually add up the actual medical costs known as “medical special damages”. This amount is treated as a base figure to arrive at an amount for the non-monetary costs, which is known as “general damages”.
If the personal injuries suffered are minor in nature, the insurance adjuster may compute the general damages by multiplying the special damages amount by 1.5 or 2. If the personal injuries are serious in nature, the general damages may go up to five times the special damages, or even up to 10 times in extreme cases. However, this is just a broad formula used by insurance adjusters, but the actual figures may vary from one case to another. Furthermore, this is not a final figure, but only an amount from where the insurer may initiate negotiations for compensation with the victim.
Extent of Fault
In some personal injury cases, both the victim and the defendant may be partially at fault for having caused the accident, resulting in personal injuries to one of them. In such cases, the insurance company will try to determine the percentage of fault of each party. The insurer may reduce the amount of compensation by the same percentage for which it holds the victim responsible for the accident. This is an issue of comparative liability, and a fair distribution of liability must be determined based on the facts and circumstances of the accident.
