Each year in the U.S., more than 24 million people seek medical treatment for unintentional injuries caused by someone else’s negligence. Most injuries resulting from someone else’s negligence can be compensated through the personal injury process, which first involves filing a personal injury claim against a relevant insurance policy held by the at-fault party. Reach out to a personal injury lawyer.
If the insurer fails to fairly compensate the claim by paying it outright or entering into a settlement agreement with the claimant, it can also be filed as a legal complaint (lawsuit) in civil court.
Contrary to popular belief, no standard amount will be awarded through the personal injury claims process, as every accident has unique details. Here is a look at the type of compensation you can seek through a personal injury claim and the factors determining how much an accident injury claim is worth.
The Type of Compensation You Can Seek After an Accident
When someone is injured in an accident, they can incur many types of loss due to the injury, including lost productivity, significant expenses resulting from medically treating the injury, and even negative impacts on the claimant’s quality of life.
Two types of compensation can be sought through the personal injury claims process that is often referred to by the legal term damages:
- Economic damages involve compensation for the expenses the injured party incurred as a result of the accident. Medical expenses—such as ambulance transport, diagnostic imaging, and hospitalization—are one type of economic damage sought through a personal injury claim. Another commonly claimed financial loss is lost wages. If the accident resulted in property damage to the claimant, they could also seek replacement or repair of that property. A common example of this is compensation that someone receives for the damage to their vehicle due to a motor vehicle accident. Finally, claimants who incur permanent injuries can seek compensation for estimated future medical expenses and lost earning capacity that will likely be incurred due to the injury during the claimant’s life.
- Non-economic damages involve compensation for the psychological impacts that the claimant incurred resulting from their injury. According to information provided by the American College of Surgeons, the impacts commonly claimed in personal injury cases include physical and emotional pain and suffering, inconvenience, loss of society and companionship, loss of consortium, and loss of enjoyment of life.
In some cases where the defendant caused the claimant’s injury as a result of conscious disregard or gross negligence, the claimant will have the opportunity to seek punitive damages. The court awards punitive damages to financially punish a particularly reckless defendant and curb them from exhibiting such egregious behavior in the future.
The Amount of Insurance Available to Compensate the Claim
Most personal injury claims are compensated through a relevant liability insurance policy held by the at-fault party, such as an auto liability policy, a homeowner’s policy, or a business or property policy. Each policy carries a limit, which refers to the maximum coverage available for claims.
If the amount of the claim exceeds the limits of the policy it was filed against, the claimant’s attorney will generally look for more available insurance policies held by other sources of liability or by the claimant.
For example, after a motor vehicle accident, multiple insurance policies can compensate the injured party:
- The claimant’s personal injury protection (PIP) or medical payments (MedPay) policy that can cover early medical and wage loss expenses the claimant incurred.
- The at-fault party’s liability insurance policy.
- The claimant’s underinsured motorist coverage that can fill in any gaps between the claim’s value and the limits of the at-fault party’s policy. Additionally, gap insurance policies the claimant holds can also come into play. As explained by insurer Allstate, gap auto insurance provides additional coverage to pay off the claimant’s auto loan if their vehicle is totaled or if they owe more than their vehicle is worth due to damage from the accident.
- A group health insurance plan available through the claimant’s employer can be used to cover the medical treatment needed. Often, a claimant will use their own insurance, and their insurance provider will seek to recoup the amount they paid to the claimant and the claimant’s deductible from the at-fault party’s insurer through subrogation.
One of the important tasks an experienced personal injury lawyer can provide when helping you with your claim is a determination of all of the insurance policies that can be used to provide compensation for your claim.
The Severity of the Injury
As the University of Florida Health explains, a traumatic injury has a sudden onset and severity that requires immediate medical attention. While a hospital emergency room can treat many of these injuries, many require a hospital stay.
Traumatic injuries include brain injuries, spinal cord injuries, spinal fractures, traumatic amputations, facial trauma, crush injuries, broken bones, skull fractures, deep cuts and punctures, a collapsed lung, and injuries sustained as a result of electricity.
While any injury that results in medical and other expenses can be compensated through a personal injury claim, severe injuries generally result in:
- Hospitalization. The U.S. Centers for Medicare & Medicaid Services reports an average three-day hospital stay of around $30,000.
- Additional medical services and supplies, such as the need for a short-term or long-term skilled nursing facility placement or the provision of a wheelchair, prosthetic limbs, or modifications to the claimant’s home or car to accommodate disabilities incurred from the accident.
- Extensive time away from work. Each nonfatal work injury causes an average of 11 days off, with an average value of lost time of $1,560 per person. Obviously, some injuries will mean even longer work absences or the permanent loss of the injured party’s ability to perform the tasks of the job they had before the accident.
- More injury-related doctor’s appointments, surgery to repair the injury, and the loss of the ability to participate in activities that the claimant formerly enjoyed due to the severity of their injury.
How Much the Injured Party was Making Before the Accident
As noted above, the time missed from work—and the associated loss of income—is one of several types of compensation that an injured person can seek through a personal injury claim. It stands to reason that the more money the person made when the accident occurred, the higher the amount of wage loss compensation they can seek through their claim.
The Clarity of Liability
When a claim is filed against the at-fault party’s insurance policy, it is assigned to a claims adjuster. The claims adjuster’s job is to protect the insurance company’s bottom line by keeping claim payouts as low as possible.
They evaluate the claim to ensure that the policy it was filed against offers coverage for the type of accident the claimant incurred and that the insured was liable for the accident. In some cases, liability is disputed, as the claims adjuster—upon looking at the case details—finds reason to believe that liability was shared or that the claimant was at fault.
When the claims adjuster makes these determinations, the adjuster commonly reduces the settlement amount they plan to offer. The claimant’s attorney will then be tasked with offering further evidence to prove the insured’s liability and negotiating with the adjuster to garner a higher settlement offer. The claimant and their attorney can also file a lawsuit to allow a judge or jury to view the evidence and determine fault and compensation.
The Presence of Permanent Injuries
Permanent injuries commonly result in permanent losses, such as losing the ability to work or live independently. Unfortunately, they also result in additional medical treatment throughout the claimant’s life to deal with the medical complications and monitoring that is frequently needed for traumatic injuries to the brain or spinal cord and other types of permanent injuries.
The personal injury claims process allows claimants to seek compensation not only for the expenses and impact they have already incurred but also for expenses and impacts they are highly likely to experience due to their injury.
The Claimant’s Patience With the Process
The personal injury claims process can take far longer than many claimants wish. The claim is not generally valued until the injuries have been fully treated. The claimant’s attorney can find themselves in lengthy negotiations with the claims adjuster.
The claims adjuster can wait until the eve of the trial to offer a fair settlement or even after the trial has begun. While the personal injury statute of limitations for filing the claim in court can occur within a few years after the accident, depending on the state where the accident occurred, this refers to the time the claimant has to file the claim in court, not the time it takes to resolve the claim.
While most personal injury claims will be resolved within a year or two of the accident, many claimants are impatient with the length of the process. This is understandable, as they likely continue to face expenses and impacts and need compensation to move forward.
While you can get a settlement offer for a legitimate claim, getting a settlement offer that fairly compensates the claim is another story. Claimants who do not jump at an initial offer that is a fraction of the value of their claim but instead wait for their attorney to negotiate a fair offer will generally receive more compensation for their claim.
How an Attorney Can Help You Get the Most from Your Accident Injury Claim
An experienced personal injury lawyer is crucial to receiving the compensation you need for your accident injury claim. Considering the many factors listed above, your attorney can properly value the claim. They can also help their client to understand how the claim is valued so that the claimant can make important decisions about their claim, such as whether to accept an offered settlement.
An attorney has experience in the process, a legal team to help gather the evidence needed to prove the claim, and an understanding of the court process that will be necessary if the adjuster is willing to make a fair offer.
If you have been injured in an accident caused by another party’s carelessness and recklessness and you want to know more about the personal injury claims process, attend a free case evaluation with a personal injury lawyer who can answer your questions.