Claiming Compensation
Personal injury claims are usually filed against the insurance company of whoever is responsible for the injury. Even though each personal injury claim is unique, there are a number of guidelines that insurance companies follow to assess each claim. Individual circumstances play a large role in the worth of the claim.
In general, liability insurance will pay for:
- Medical care and other expenses related to the medical care
- Damage to property
- Loss of income due to the personal injury
- Permanent physical disfigurement or disability
- Loss of educational, family or social experiences (for example, missed training, school or vacation)
- Pain and suffering such as stress, anxiety, post-traumatic stress disorder, embarrassment, depression or marital relations
Although it is relatively easy to determine the amount of money spent and lost due to medical bills, rehabilitation, missed and so on, pain and suffering is much harder to fix a price tag on.
In general, the adjuster often adds up all of the medical expenses in order to produce a base figure. This base figure is then multiplied by a figure that usually ranges from 1.5 to 5 depending upon the severity of the injury and its long-term implications. This multiplier can go as high as 10 in extreme cases. When deciding on the multiplying figure, the claims adjuster usually takes these points into consideration:
- How painful was the injury?
- How serious is the permanent effect of the injury?
- How obvious is the medical evidence of injury?
- How long is the recovery period?
- How invasive and long-term will medical treatment be?
- How much treatment was received from a physician or at a hospital (rather than physical therapy or other non-physician treatment)?
The multiplier figure increases in relation to the severity of the answers to each of these questions.
Another multiplier (or actually a reverse multiplier) is applied to the figure to take into account the extent of the claimant's fault in the matter. For example, a person may be deemed 75% at fault, which will reduce the total amount by 75%.
Finally, the adjuster adds any income lost due to the personal injury.
In many cases, claims can be settled out-of-court.
