The value of a personal injury claim or lawsuit isn’t set in stone. Ultimately, it comes down to the value placed on the case by a judge or jury using their “enlightened conscience.” That being said, most cases still settle without a trial with a settlement. The value agreed to is typically the result of an insurance company’s evaluation, the demands of the injured person and their attorney, or a combination of both.
Many injured people don’t realize the number is subject to argument, which means they often accept an insurer’s initial offer without demanding the amount they truly deserve because they think it’s the only amount they can get. However, when you work with an experienced lawyer, you’ll have an advocate standing up to the insurance company and fighting back against lowball offers.
Why Going It Alone Rarely Works
Insurance companies rarely take seriously claims made by people representing themselves. This is because, firstly, they know that this type of plaintiff doesn’t know the value of their claim, and more importantly, because this type of plaintiff rarely knows how to put together the right type of documentation needed to support their claim and force insurance companies to comply.
Insurance companies don’t believe people without lawyers will be willing to take them to court, which is often the only threat they pay attention to. But having a lawyer on your side from the very start, even if you want to avoid going to trial and would rather settle out of court for a quicker result, tells them you are very serious about your claim and not going to back down.
To better understand this process and the importance of getting a lawyer who can demand full compensation, let’s look at how insurance companies evaluate claims.
How Insurers Evaluate a Case’s Value
When someone files an injury claim, they may do so with their own insurance company or the at-fault party’s insurance company. Most personal injury claims involve the liable party’s insurance coverage, which means they are “third-party” injury claims.
The “at-fault” party’s insurance company will designate an insurance adjuster to evaluate the claim. That adjuster will speak with their policyholder (the person who caused your injury) to get their account of what happened. The adjuster will also try to contact you, but it’s important for you to have a lawyer on your side so they can be present for the conversation.
Insurance adjusters also review many other documents to determine the value of a claim, including but not limited to:
- A police report
- Medical bills
- Proof of property damage
- Verification of income (to determine how much wages you lost due to your injury)
In many cases, insurance adjusters take the financial information they receive, including financial damages, the length and cost of medical treatment, and other factors, and run them through a computer software to tally a dollar amount that they’ll offer to the injured person. Software programs like Colossus, a famous software used in settlement calculations, use algorithms to determine how much the insurer will offer.
Adjusters generally try to limit what they consider and usually look at only some of the financial aspects of a claim. They’ll also reconsider the claim’s potential value if it’s disputed and taken to court. If the injured person has a high likelihood of success, the insurance company might be more likely to offer a satisfactory amount. However, they’re still likely to offer you less than you and your attorney would demand in compensation. Rarely are insurance adjusters allowed to pay what the claim can be worth without a fight, and if you are dealing with the adjuster assigned to your file at the beginning, that person rarely has much authority to change the offer.
Related reading: What NOT to Say to an Insurance Adjuster
What Factors Impact the Offer I Get from an Insurance Company?
Everyone wants to know how much money they can expect to get when they file a personal injury claim, preferably with a simple, easy, upfront number. Unfortunately, the answer truly is, “it depends!”
There are so many factors that go into determining a settlement, both in terms of how little the insurance company thinks they can get away with offering, and how much your injury is actually worth. But there are three main factors that will determine a settlement offer.
Medical Treatment
Did you decide not to get checked out by a doctor after your car crash? Did you go to a doctor, but skip your follow-up appointment, forgo physical therapy, or not finish taking the prescriptions written for you? If you are ever in a car wreck, slip and fall in a store or restaurant, or are injured in some other way through someone else’s negligence, it’s extremely important to always see a doctor to get evaluated for any potential injuries, even if you don’t think you were seriously injured! Many injuries, especially soft tissue injuries, may not be immediately obvious or may only worsen without treatment rather than get better on their own.
When you do see a doctor, it’s important to always follow all of your doctor’s orders and recommendations until you receive a clean bill of health from them. This is because the insurance adjuster will be going through your medical records and bills with a fine-tooth comb.
A personal injury claim is supposed to help you get compensation for the money your injury cost you, so if you can’t prove that your injury cost you money (because you didn’t receive treatment that you were billed for), your claim may be denied. Likewise, if you skipped follow-up treatment or physical therapy when it was recommended by your doctor, your compensation for pain and suffering could be reduced because the insurance adjuster will claim if you were actually in pain from your injuries, you would have gone.
Pre-Existing Conditions
It’s very common for insurance adjusters to try to deny claims when the victim has a pre-existing condition, because they’ll try to claim your injury and pain is only the pre-existing condition and not the fault of their client. However, with the help of a lawyer, you can fight these denials of coverage.
Pre-existing conditions cannot prevent you from getting compensation in an accident if the pre-existing condition is not the sole cause of your injury. For example, if a car crash made a pre-existing condition worse, you could still be eligible for compensation.
However, the amount of compensation you can get may be smaller when pre-existing conditions exist, because you can only get compensation for the exacerbation of the injury, not the pre-existing condition itself. If you have a pre-existing condition, we recommend hiring a lawyer to make sure you aren’t unfairly denied compensation after an accident caused by someone else.
On the flip side, a pre-existing condition can also make it easier to prove you were injured and deserve compensation after an auto wreck. This is because your healthcare provider will likely have clear documentation of that pre-existing condition and how it affected your health and level of pain. Your doctor can act as a witness to the difference in your health and pain levels before and after your crash, and how the crash made them worse.
Lawyer Experience and Reputation
Insurance adjusters make lowball offers because they know that most injury victims don’t know how high their injury costs could actually end up being. They also know victims are often reluctant to turn down a low settlement offer either because they have been told that they won’t get anything if they do (which is UNTRUE) or because they are desperate and need money right away to pay their mounting bills.
However, when victims of negligence hire a lawyer to negotiate for them, insurance companies will be way less likely to try to play tricks, because they know they have less chance of getting away with it. The better your lawyer’s experience and reputation, the greater your chances of resolving your claim quickly, efficiently, and for an amount that matches what you actually need and deserve.
Insurance companies are also usually less willing to try to fight you on the money you are owed when they are dealing with a locally-based lawyer, because they don’t want to go to court against a local firm. They’d rather go up against an out-of-town law firm with limited local connections who are unfamiliar with all the important players who may be involved in a trial. Local lawyers are also more invested in the communities in which they live, which often means they are more motivated to get you the best result possible for you, rather than just wrap up the case with as little travel and engagement as possible for them.
Insurance Company Valuation vs. Trial Lawyer Valuation Methods
Trial lawyers take a different approach when valuing a personal injury case. They consider not only the economic damages but also the non-economic damages, such as pain and suffering, emotional distress, and loss of enjoyment of life. Trial lawyers understand the long-term consequences of the injuries and their impact on the victim’s quality of life. They gather comprehensive evidence, including expert testimonies, to establish the full extent of the damages suffered. This approach ensures that victims are adequately compensated for both their economic and non-economic losses.
Contrasting Insurance Company and Trial Lawyer Methods
While insurance companies focus primarily on economic damages, trial lawyers take a bigger-picture approach. Insurance companies often undervalue pain and suffering, emotional distress, and other non-economic damages. Trial lawyers, on the other hand, understand the profound impact these losses can have on the victim’s life and fight to secure fair compensation. By considering the broader scope of damages, trial lawyers strive to ensure that victims receive the financial support they need to rebuild their lives after an accident.
Why Insurance Companies Often Offer Less Than You Deserve
Most insurance companies are very profitable businesses. If they paid the full and fair amount to people injured by their policyholders, they’d cease to be so profitable.
As mentioned, insurance adjusters will review documents and use computer software to determine what their employer should offer, but that offer rarely reflects all the damages the injured person has and will experience because of the accident and injury. The insurer is hoping that its offer will be accepted without argument or negotiation.
Unfortunately, insurance company’s initial offers often are accepted without question. Many people filing claims either don’t realize that they can dispute an offer or fail to account for the entirety of their damages, especially those injury-related costs they’ll face in the years to come.
The insurance company may even tell injury victims that if they don’t accept the initial offer, they won’t receive any money at all or they will “close the file.” But this isn’t true, and they don’t control whether you file a complaint. When you have a valid claim, it is considered bad faith for the insurance company to refuse to pay. Turning down an initial offer is often the only way to get them to raise their offer to what you actually need.
An Experienced Injury Lawyer Helps Level the Playing Field
Insurance adjusters and their employers know the claim evaluation process well. They also know that many injured people blindly accept their first offers without demanding what they’re entitled to.
Frankly, most claims NEED the threat of a lawsuit or a trial to achieve a just result. Individuals might “threaten,” but insurance companies know when someone is serious. Filing a lawsuit changes who is in charge—and new adjusters are many times brought in to reevaluate at that point.
The best way to protect yourself from getting a raw deal is by having an equally experienced advocate on your side. At the Law Offices of Gary Bruce, we know the insurance company’s tactics. More importantly, we know the steps to take to maximize the compensation our clients receive. We can explain your options and the pros and cons of the process.
If You Need Help, Get Gary Bruce
For Georgia and Alabama residents, it might feel like everyone involved in their claims are outsiders who don’t understand how vital that money is to get their lives back together after a devastating injury. National insurance companies and national law firms might see your situation as little more than a case number, and that will likely be reflected in the way they deal with your claim.
At the Law Offices of Gary Bruce, we’re proud to say that we are local through and through. We file suits in our local courts. The insurance companies know it.
Based in Columbus, GA, we help clients throughout Georgia and across the border into Alabama, and we have ties to communities throughout both states. We care about our communities and the people in them.
If you’re concerned about the offer an insurance company has made or will soon be making to you, then call our team to schedule a free, no-obligation consultation. You’ll receive a no-nonsense assessment of your case. Be certain you call before too much time passes, because evidence can disappear, and cases can be barred by the statute of limitations. We are happy to discuss options you have even if an offer has been made. You don’t have to guess about what is possible. Contact our team today to get started.
