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How Do Insurance Companies Determine The Worth of A Personal Injury Case?

Before an insurance adjuster poses an initial offer to a claimant, that member of the insurer’ staff has to ascertain the value of the claimant’s case. A case’s value represents its worth and the circumstances surrounding the reported incident affect that case’s worth. Still, insurance companies look most-closely at certain key factors, when trying to assess the value of a claim.

What money is owed to the victim by the responsible party?

Money used to cover the medical expenses: Insurance companies refer to this as the medical special. Frequently, insurers simply use a shorter term, i.e. specials:

• Income lost during recovery.
• Costs created by a permanent physical disability
• Damaged property
• General damages: Loss of family; loss of a social or education experience; pain and suffering

Pain and suffering include emotional damage which translates as stress, depression, embarrassment and strain on family relations.

The adjuster’s calculations

In order to take the claimant’s pain and suffering into account, the adjuster multiplies the specials by a figure between 1.5 and 5. The more severe the claimant’s injury, the larger the figure that gets used to determine the product in the equation that includes the figure for the specials.

If the adjuster must calculate the worth of a catastrophic accident, the specials might get multiplied by a figure that is greater than 5. It might even be one as high as 8 or 9. The product obtained from that calculation gets added to the amount of income lost by the claimant during his or her recovery. That sum provides the adjuster with the figure that he or she must start with.

How adjusters make use of their calculations?

Personal Injury Lawyer in Waterloo know that adjusters use their calculations to work towards pleasing the insurer. Insurers want to pay as little as possible to each claimant, without inviting a charge of bad faith from an unhappy policy holder. The calculated amount suggests a minimum figure. That is the lowest amount that might be offered, without risking the chances that the insurance company might become the target of a bad faith claim.

For that reason, adjusters use that calculated figure when making their first offer. That does not mean that the adjuster expects the claimant to accept that offer. The adjuster’s offer should, however, be within the ballpark. In other words, it should reflect the knowledge gained by making a list of the money that is owed to the victim/claimant.

If that initial offer does qualify as a ballpark figure, then it should provide the claimant with room for introducing a new offer, without proposing one that far exceeds the adjuster’s offer. Adjusters that have mastered the art of using their calculations wisely manage to please the insurer without frustrating or annoying their offer’s recipient (the claimant).