How Do Insurance Companies Determine Settlement Prices?

When you are dealing with your personal injury claim, you are more than likely working with an insurance claim adjuster. Even though everything regarding your settlement is their job, it is helpful to know just how they determine where to go with it. You should surely know how they handle your personal injury claim before you write you demand letter, and you should definitely know before you decide to accept or decline the settlement offer. In order for the claim adjuster to provide you with a fair and just settlement offer, they need to do proper investigating to gather all of the facts.

This article is going to go over what they look for when determining your settlement offer.

Insurance Investigation

Listening to the Insured Persons Side of the Story

You are making a “third party” claim if you are making a claim with the insurance company against the person you believe is responsible for the accident. We recommend not speaking to the insurance company about the facts of the case and sending the police report. However, if no police report is available then a short statement of what happened can help move the claim forward. We never recommend clients describe their injuries to the adjuster especially while treatment is ongoing. This can lead to a person not accurately stating an injury that is documented. You are not a medical professional. While you may describe your pain as shoulder pain it is actually a localized neck injury causing pain. This can get your case put in pickle quickly.

Investigating the Claimant

Claim databases allow for insurers to determine if the claimant has ever filed a personal injury case before. The insurance companies have more money than bill gates and therefore access to more information. If you have ever filed any insurance claim, they will absolutely know about it. Lying about it will destroy your case because it destroys your credibility. Always tell the truth about past wrecks and injuries.

Requesting Documentation of the Claim

The insurance adjuster will contact the claimant for documents such as medical bills, tax returns, proof of property damage, and proof of earnings. They are only entitled to certain documents. Not all of them. Having a lawyer help with this can lead to a better and less stressful outcome.

Determining Settlement Value

The two important questions the adjuster will have to ask are 1) what are the claimant’s chances of winning at trial if a personal injury lawsuit is filed and 2) how much might a jury award the plaintiff in damages? The medical bills and lost wages will be included in this calculation. That’s the easy part. The hard part is determining what was taken away from the injured person’s life. The value of pain and suffering is the hardest part for people to articulate to an adjuster.

Determining the Value of a Pain and Suffering Claim

Many adjusters will use specialized software to set a value to pain and suffering claims. These computer systems set the value of being paralyzed at $250,000. I would not trade $250,000 for being paralyzed. This is where having a skilled personal injury lawyer can help the most. The computer can be overridden by people higher up in the insurance company, but you have to get your case in front of those people. The low-level insurance adjuster will never have the authority to offer you anywhere near what your case is worth. The only way to get past the low level adjuster is to have the ability to sue the person who caused the wreck.

The Final Settlement Offer Is a Percentage of Full Value

It is important to remember that adjuster have leeway to adjust the first offer made depending on who they are dealing with. The adjuster will always have more money after their first offer. They want to pretend that they are negotiating with you, so you feel like you did something good for yourself. They had the case priced at whatever they offer you at the very beginning. Don’t be fooled.

We have had several clients try to negotiate their own case and then come to us. We took on their case and received a substantially larger offer than the individual. We have also evaluated cases and told folks that the insurance company was giving them an offer that was fair and adding the expense of a lawyer wasn’t necessary. We are honest with potential clients because we want you to keep come back to us again when you need us.

Schedule a Free Consultation With a Dixie Attorney

If you have questions about your claim, the Dixie Law Group has attorneys experienced in handling personal injury claims. We are happy to evaluate your case for free and let you know if you need a lawyer for your claim or not. Call us at 502-290-2397 for a 100% free consultation today!

Reach Out To Us For Help

We work closely with our clients and offer vigorous representation both in and out of the courtroom. If you would like to learn more about our services, please reach out to our office today.

You can contact our lawyers in Louisville at 502-806-8711 or contact us online. Initial consultations are always free.


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If you would like to speak with an attorney, reach out to us. You can call our firm at 502-273-5178 or contact us online.

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