How Does Insurer Assign Dollar Value To Injury Claim?

The dollar value that an insurer has assigned to an injury shows how much the corresponding injury claim is worth. Certain factors receive the most focused attention, as insurance adjusters, employees of the insurer strive to value a particular injury.

Obligations of insurance company

• Cover the medical expenses of the injured victim
• Reimburse victim for lost income
• Provide coverage for any permanent physical damage to victim’s body: That coverage could include money for any needed adaptations in the home, or money for a caregiver.

Cover any of the following losses:

—Loss of an educational opportunity
—Loss of time with those in family
—Loss of social experiences
—Lost chance to advance in chosen career
—Lost chance to remain in current career, or current position in company

Money for pain and suffering: That could include emotional issues, such as anxiety, stress, phobia, depression, trouble sleeping, or other emotional problems.

Reimbursement for damaged property. The above list would be longer, if the victim were to suffer a fatal injury. In that case, the insurance company would owe the affected family money for funeral and burial expenses. The same family members might seek funds to cover the cost of grief counseling.

Insurer uses damages formula to get an estimate of the claim’s value

Your personal injury lawyer in Mississauga adds up the totals on each of the victim’s medical bills and selects a figure to use as a multiplier. Usually, a number between 1.5 and 5 is selected:

—The greater the number of losses, the higher the multiplier; for a case with a catastrophic injury, the multiplier could be 6 or more.

Calculates product of multiplication operation, one where total for medical expenses is one factor and the chosen multiplier is the other factor. It adds to the calculated product the monetary value for the lost income.

The figure obtained by using the formula represents the point at which negotiations could begin.

That figure would get reduced, if the victim had contributed to some of the factors that caused the accident.

By the same token, it could get reduced, if the victim had contributed to some of the factors that heightened the severity of the reported injury.

After taking into consideration any reasonable deductions, the adjuster shares the final figure with a supervisor.

Using guidelines provided by the insurer, the adjuster’s supervisor suggests what percentage of the calculated figure should be used in the adjuster’s initial bid.

Supervisors also take into consideration what the insurance company has learned, concerning whether or not the injured victim has hired a lawyer. Victims that have failed to retain an attorney receive an especially low bid; those represented by a lawyer get a higher bid. Still, neither of those bids equals figure calculated by formula.

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