How Insurers Determine the Value of Your Claim and Ways to Push Back

In a personal injury claim, insurers apply set formulas and use software to set a number for your personal injury claim value. You can challenge their number if you know their process, however, and a Hartford, CT injury lawyer knows how insurers make these determinations and what evidence is needed to push back.

Maximizing Personal Injury Claim Value

The Basics

Insurers begin by adding up the economic losses that you can document with paper. Medical bills form the base of the claim, and you’ll also include any lost wages, damaged personal property, and out-of-pocket costs. You must have receipts for all of this.

Non-economic damages are then added on to compensate you for pain or lost enjoyment of daily life. To reach this number, most carriers multiply the total of your economic losses by a number between 1 and 5, depending on how severe the injuries were. However, insurers are notorious for minimizing these numbers.

The Algorithms

Large carriers often feed the same numbers into evaluation software such as Colossus. This program converts the diagnosis codes, procedure codes, treatment length, and imaging results into severity points drawn from thousands of earlier claims in the same region. The software then produces a settlement range that the adjuster may still adjust for other factors.

Liability

Here in Connecticut, we use a modified comparative negligence rule. With this rule, you can only bring a claim if you’re 50% at fault or less for the accident that injured you, and the amount of your award is reduced by the same percentage as your fault. Once again, insurers often overstate a victim’s degree of fault in order to reduce their own payout.

How Your Lawyer Can Help

You can help to raise your final number by building a complete record from the first day. First, get prompt treatment and consistent follow-up so there’s no room to argue that your injuries aren’t related to the accident or that you’ve made them worse by failing to follow the doctor’s orders. Then, keep a simple daily log that notes your pain levels, the limitations on your activities that injuries have caused you, and important events you had to miss. Give your lawyer all this so they can use it to start building a strong case.

It’s also important to work with your lawyer by listening to their advice about how to respond to the insurer. For example, a good lawyer will often advise you to refuse a first offer because those first offers are almost always at the very bottom of the potential range. That’s because the adjuster is testing whether you’re willing to accept less than what you’re owed, either because you don’t know better or because you’re desperate.

Your lawyer will also counter lowball offers with written demands that list every cost you’ve suffered and contain clear and convincing evidence to prove it. When the demand package from your lawyer is well-supported and well-argued, the adjuster is left with a lot less room to wiggle out of their obligations.

Contact Us for Help In Hartford, CT 

Our attorneys handle both plaintiff claims and insurance-defense work, so we know both sides and the tactics carriers use. Reach out to the Adler Law Group, LLC in Hartford, CT to set up a consultation

Posted in Uncategorized | No Comments »