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How Does Insurance Decide How Much My Claim is Worth?

You’re driving down the street in Portland, paying attention to the traffic all
around you, and you proceed through a clear intersection because you have the
green light.

Bang!

Someone who wasn’t paying attention ran a red light, smashed up your car, and
worse, injured you. The other party says they’re sure their light was green, so
it’s time to call a good car collision attorney. Your car’s a mess, and you’ve had
medical expenses, you’ll probably need physical therapy, and you missed three
days at work, for which you weren’t paid. Taking all that into account, exactly
how does an insurance company decide what your claim is worth?

An experienced Portland car injury attorney will tell you that insurance
company’s generally work from a specific damages formula. They start with
what are called the total medical expenses incurred by the injured party. These
are referred to as “medical special damages,” or in some cases, just “specials.”
This becomes the base figure for the formula.

The insurance company then must determine how much to add on for pain,
suffering, and any other nonmonetary damages. These are what are known as
“general damages.” If the injuries suffered were relatively minor, the insurance
adjuster will generally multiply the base figure by 1.5 or 2. So, if medical
expenses came to $2,000, the new figure will be between $3,000 and $4,000.
More serious or painful injuries are allocated a multiplier of up to 5, and in
extreme cases can be as high as 10.

An experienced car collision attorney can give you a good indication of the kind
of number you can expect. Once the insurance company has determined the
total of the specials and the multiplier to be used for the general damages, they
then add on any income lost as a result of the injuries sustained.

That’s basically it. The formula is simple and straightforward, but it’s also only
the beginning, and the number arrived at is only the point at which negotiations
between the insurance company and the car injury attorney begin. A far more
difficult determination to make is the percentage of fault. In other words, how
much was the insured person to blame for the accident. This is not an exact
science, and it’s where having a good car collision attorney can really pay off.
In many cases, both drivers could be partially to blame.
If you were a little at fault, maybe 10 or 15 percent of blame may be attached to
you. If you were the major contributor to the accident, then as much as 75 to 90
percent of the blame could be placed against you. In the hypothetical case at the
beginning of this article, if it could be proven (by witnesses, CCTV or other
means an experienced car collision attorney would investigate) that you had a
green light, weren’t speeding or driving recklessly in any way, and the other
party ran the red light, giving you no chance to avoid the collision, then you
should be awarded 100 percent of the final figure reached in the formula. If,
however, someone is deemed to be slightly at fault, then 10 to 15 percent of the
figure reached in the formula will be deducted from that number, and this is
what the insurance company will offer.

In most cases, both you and the insurance adjuster will know from the
beginning how much of the accident was your fault. An experienced car
collision attorney, however, will ensure that your best interests are looked after,
and that you receive the compensation you deserve.

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What's the Worth of My Auto Insurance Claim?

  • 1. How Does Insurance Decide How Much My Claim is Worth? You’re driving down the street in Portland, paying attention to the traffic all around you, and you proceed through a clear intersection because you have the green light. Bang! Someone who wasn’t paying attention ran a red light, smashed up your car, and worse, injured you. The other party says they’re sure their light was green, so it’s time to call a good car collision attorney. Your car’s a mess, and you’ve had medical expenses, you’ll probably need physical therapy, and you missed three days at work, for which you weren’t paid. Taking all that into account, exactly how does an insurance company decide what your claim is worth? An experienced Portland car injury attorney will tell you that insurance company’s generally work from a specific damages formula. They start with what are called the total medical expenses incurred by the injured party. These are referred to as “medical special damages,” or in some cases, just “specials.” This becomes the base figure for the formula. The insurance company then must determine how much to add on for pain, suffering, and any other nonmonetary damages. These are what are known as “general damages.” If the injuries suffered were relatively minor, the insurance adjuster will generally multiply the base figure by 1.5 or 2. So, if medical expenses came to $2,000, the new figure will be between $3,000 and $4,000. More serious or painful injuries are allocated a multiplier of up to 5, and in extreme cases can be as high as 10. An experienced car collision attorney can give you a good indication of the kind of number you can expect. Once the insurance company has determined the total of the specials and the multiplier to be used for the general damages, they then add on any income lost as a result of the injuries sustained. That’s basically it. The formula is simple and straightforward, but it’s also only the beginning, and the number arrived at is only the point at which negotiations between the insurance company and the car injury attorney begin. A far more difficult determination to make is the percentage of fault. In other words, how much was the insured person to blame for the accident. This is not an exact science, and it’s where having a good car collision attorney can really pay off. In many cases, both drivers could be partially to blame.
  • 2. If you were a little at fault, maybe 10 or 15 percent of blame may be attached to you. If you were the major contributor to the accident, then as much as 75 to 90 percent of the blame could be placed against you. In the hypothetical case at the beginning of this article, if it could be proven (by witnesses, CCTV or other means an experienced car collision attorney would investigate) that you had a green light, weren’t speeding or driving recklessly in any way, and the other party ran the red light, giving you no chance to avoid the collision, then you should be awarded 100 percent of the final figure reached in the formula. If, however, someone is deemed to be slightly at fault, then 10 to 15 percent of the figure reached in the formula will be deducted from that number, and this is what the insurance company will offer. In most cases, both you and the insurance adjuster will know from the beginning how much of the accident was your fault. An experienced car collision attorney, however, will ensure that your best interests are looked after, and that you receive the compensation you deserve.