Seattle Personal Injury Attorney Chris Thayer
Seattle Personal Injury Attorney Chris Thayer
Handling Personal Injury Claims in the Seattle Area and Throughout Washington Since 1995

My name is Chris Thayer and I am a personal injury attorney practicing in downtown Seattle. I handle personal injury, medical malpractice and wrongful death claims throughout the greater Seattle area, including Issaquah, Mercer Island and Kirkland.

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How do insurance companies calculated personal injury awards?

Posted Monday, July 16, 2012 by Chris Thayer

How do insurance companies come up with their settlement offers for personal injury claims? We don’t always know, exactly, but there are a few factors that are almost always considered. As this blog is public, it is not an appropriate place to discuss certain issues, but I can note break down some key points. For a more in-depth review of your case and specific answers to the valuation of your particular case, you should contact an attorney experienced in handling car accident claims.

Factors which effect an insurance company’s evaluation of your personal injury claim:

  1. severity of impact/collision and damage done to vehicles - Even modest impacts can cause serious injuries, but insurance companies are very reluctant to make any significant settlement offers for low-speed collisions that cause very little damage to the vehicles. The reality is that you are made of flesh and bone, not metal and energy absorbing plastic like a car, but insurance companies frequenlty latch on to low speed collisions and decline to make reasonable settlement offers.
  2. nature and severity of injury - a clear diagnosis is helpful, and vague “sprain/strain” injuries that go unresolved for a long period will not be assigned a significant value by insurance companies. Insurance companies put these in the category of “soft tissue” injuries. Cases involving injuries that require surgical repair or clear objective changes on imaging will be valued higher.
  3. duration of any disability - As noted in prior blog entry, any wage loss or time off of work should be authorized by your physician. If you are unable to work or unable to engage in certain activities, this must be documented with your healthcare providers. If you miss 2-3 days of work and “tough it out” even though you are in pain, the insurance company may view this as an indication that you are not really seriously injured. On the converse, if you miss an extensive amount of work that appears to be disproportionate to your injuries and symptoms, the insurance companies will view this as “malingering”. There is a balance to be reached. In the end, you need to let your healthcare providers and your body be the judge of what activities you can and should engage in. Don’t take more time off to try to bolster the value of your claim; but don’t tough it out when perhaps a few days or weeks of rest might help you recover.
  4. future medical expense - if the need for future medical expense, including possible surgical intervention can be confirmed by your healthcare providers, this affects the value of your claim.
  5. Nature and “appropriateness” of treatment received - as noted in prior blog entries, insurance companies will not be inclined to pay for treatment that appears to be merely “paliative” vs. “curative”. If a course of treatment does not appear to be improving your symptoms after a reasonable period of time, you should consider discussing with your healthcare providers other options.

Insurance companies are all about numbers and statistics. That is all you are to them. The adjuster will punch in data to the insurance company’s proprietry software, which will spit out a settlement range. The insurance company will consider a variety of factors (including all of the above), and assess its risk and th adjuster will push hard to try to get the case resolved in the low range. The insurance company does not care about how much the injuries may have affected your life; they only care about the bottom line - profit; and they make more profit by paying out the least amount of money on claims.