How Does the Insurance Company Value My Personal Injury Case?

When you’re injured in an accident and dealing with the insurance company, it’s helpful to know what they’re reviewing when evaluating your case. As usual, it’s important to remember that every case is different. Generally, the insurance adjuster will consider the property damage sustained by both vehicles, the narrative in the police report - or whether there was a police report at all – the severity of your injuries, what kind of treatment you received, how long you treated for, and the prognosis of your injuries.

Many attorneys will wait until your treatment has finished before presenting your demand to an insurance company. This gives them a complete picture of your injuries, necessary treatment, and future care. For example, it’s easier to argue that you’re entitled to pain and suffering for a shoulder injury if you can provide proof that you were diagnosed with that injury, treated for the injury, and recovered from that injury. Of course, this isn’t always possible. Some injuries take years to recover from. In that case, the insurance company will often consider a partial demand while you’re still treating for your injuries as long as you have some idea of what treatment you’ll need in the future.

What Kind of Offer Can I Expect?

We get this question all the time! Unfortunately, there isn’t an exact answer. There are so many factors that are involved in your case. Was there a police report? Was liability accepted at 100%? Was the defendant under the influence when they hit you? Did you go to the hospital right away or wait a few days? Have you completely healed from your injuries? Did you miss time from work? Was your life impacted in other ways that you can document?

These questions only scratch the surface of what an insurance adjuster will consider. A significant factor - one that you cannot control – is which insurance company is reviewing your claim. All companies analyze and review cases differently. Some are more willing to pay more for lost wages than others and few are willing to consider future treatment without medical records to support the prognosis. Some require estimates of what the future care will cost while others will take an average of anticipated costs based on your injuries.

All that to say, the offer that you can expect depends on the facts of your case. While your attorney may be able to give you some more insight into what they believe your case could be valued at by the adjuster, it’s nearly impossible to know for sure until that initial offer comes in.

Why isn’t the Driver Paying Personally?

In Texas, the law requires all drivers to carry liability insurance. This liability insurance is to pay for any injuries that drivers may cause another party through negligent or careless actions.

Every insurance policy has a specific plan that outlines the details of that particular policy. The plan outlines the requirements that need to be met in order for the policy to pay out on a particular crash. The plan will also explain circumstances in which the policy will not kick in and the driver is responsible for those damages personally. It’s important to be familiar with your own policy and plan language, as well as to make sure you get the policy information from the order driver.

Keep in mind that this very law helps protect you if you were to accidentally hurt someone in a wreck by stepping in and helping whoever you hit in an accident. That doesn’t mean that the at-fault driver is completely off the hook though. In fact, an injured party is free to go after the driver personally if they do not settle with the insurance company or if they get a verdict that is larger than the policy limits after a trial. If you have questions and want to pursue this route, it’s important to talk to your attorney about it before you sign any documents from the insurance company. Settlement paperwork with the defendant’s insurance company will often bar you from making any further claims from the individual specifically.

What if I Think My Case is Worth More?

Again, every case is different. Nobody is more frustrated about what happened to you than you are but it’s your attorney’s job to fight for what you deserve. Insurance adjusters try to review your case in its entirety. Be forewarned - they will most likely make an offer that you don’t think is fair. It happens all the time. Keep in mind that insurance companies think a “fair” offer is quite low, whereas most plaintiffs think a “fair” offer is very high.

Your attorney will negotiate with the insurance company to get a higher offer. They will also likely be able to negotiate some of your medical bills to get them reduced in order to increase how much money you will actually recover. Ultimately, your accident and your case belong to you. You will only ever settle your case if you decide that it’s the right thing for you to do. Your attorney will be able to advise you, but it’s up to you whether or not to take that advice.

What is the Timeline?

Personal injury cases can take anywhere from 2 months to a year or longer depending on the severity of your injuries to resolve. Generally, your attorney will wait until your treatment has wrapped up before sending a demand packet to the insurance company. There are times when this may not be the best course of action, but typically an adjuster will want to see your complete treatment. Plan with associated prognosis in order to make an offer This demand will include things like the police report, photos of your injuries, bills and medical records and lost wage information.

When the insurance adjuster receives the demand, they will take a few weeks to review the information. After the adjuster skims the demand presented, they will either present an offer to your attorney, ask for an extension, or ask for more information. All three responses are common. Therefore, you shouldn’t expect negotiations to begin exactly 3 weeks after a demand is mailed by your attorney. In larger cases, the adjuster will often send the packet to a third party to evaluate the medical bills and records. That company will provide a range of what the claim is “worth” based on the facts presented. Similarly, for larger cases, the adjuster’s manager will often need to review the demand before making an offer. All of these things can slow down the process.

Patience is Key!

A lot of injured parties are eager to hear the first offer and hope that it’s high enough to close their case asap. That makes perfect sense! You've been through a terrible ordeal and your recovery hasn’t been easy. Wrapping up your case is something that you want to do quickly. However, it may benefit you to be patient. The adjuster might ask for a simple letter from a doctor and even though it may seem like they're procrastinating making you a fair offer, that single letter could be the difference between tens of thousands of dollars for you.

You’ve communicated what the wreck did to your life. Now let your attorney fight for you to be successfully compensated!