How Your Insurance Company Will Evaluate Your California Injury Claim
If you have been injured in an accident in Orange County, you may be entitled to personal injury compensation. But how will the insurer evaluate your claim?
First, you will need to speak to your own insurance company after the accident, and they will conduct their own investigation. When your insurance company begins the investigation, you can expect the insurance agent to:
- Ask you questions about what happened. Be careful not to admit fault, minimize the extent of your injuries, or lie—simply give the facts that you remember about the accident.
- Ask for documentation from your medical providers regarding your injuries. This might include your family doctor, emergency medical professionals, physical therapists, etc.
- Ask for documentation regarding your time away from work.
- Inspect any physical damage to your bike. If your motorcycle was damaged in the accident, wait on repairs until the damage has been documented.
- Give instructions for seeking repair estimates.
- Review the police report and statements.
- Review witness statements and/or speak with witnesses.
- Talk to the other driver(s) involved about what happened.
- Attempt to determine who was at fault in the accident.
The claims process after an OC accident can be confusing, and many injured victims choose to seek the help of an experienced attorney who can handle communication and negotiation with the insurance companies involved.
If you feel uncomfortable speaking to the insurance adjusters on your own, or if you need help filing an insurance claim after an Orange County wreck, reach out to the OC accident attorneys with Russell & Lazarus today for answers. Please give us a call today to schedule a completely free initial consultation with an experienced personal injury attorney to learn how to get personal injury compensation.
How Insurers Value Cases for Personal Injury Compensation
Like medicine, law is more of an art than a science. Plaintiffs and lawyers who seek a mathematical formula for valuation of cases will be disappointed.
Insurers and their representatives — including claims adjusters, investigators, and attorneys — gather facts and evidence necessary to assess the value of a case. A diligent assessment includes obtaining copies of police and other investigative reports, identifying and interviewing witnesses, and obtaining pertinent evidence including photographs, video recordings, witness statements, EMS records, and hospital records. Insurers also consider details such as the qualifications of the plaintiff’s lawyer, the background of the judge, and the venue where the lawsuit is filed.
Insurers thoroughly review the facts of a plaintiff’s case. Insurers want to know background information on a plaintiff such as the name, age, employment history, prior lawsuits or claims filed, and medical history. Insurers will seek the deposition of a plaintiff and will evaluate the plaintiff’s demeanor, credibility, and presentation. Insurers will scrutinize any inconsistent statements made by the plaintiff and make a conclusion regarding whether the plaintiff is believable and likable. Insurers will gather information on the defendant’s case, and analyze the strengths and weaknesses. If there are any co-defendants, insurers will analyze each co-defendant’s case, witnesses, and possible counter claims. Insurers analyze the expected effectiveness of each witness for the plaintiff and that of each witness for the defense.
Insurers carefully examine liability issues. They determine whether there are liability issues that have been or are likely to be decided against their insured. Insurers will evaluate whether there are undisputed facts or questions of law that can be argued by way of a dispositive motion that will result in the dismissal of the plaintiff’s case without a trial. They will seek information regarding any expert witness testimony on behalf of the plaintiff. And they will consider the defense need for expert witnesses. Insurers hire experts to review the evidence and provide an analysis of technical and contested issues. Insurers seek to understand what the expert witness testimony will be of the plaintiff and the defense, and what the counter-arguments will be for any expert testimony provided.
Insurers consider damage issues including joint and several liability, comparative fault, pre-judgment interest considerations, statutory damages, and possible assessment for payment of the plaintiff’s attorney’s fees and costs. Insurers request details regarding plaintiff’s proof of damages. Medical bills should be itemized.
Medical reports should clearly summarize the facts, the treatment received, the need for future treatment, and the future prognosis of the patient. A plaintiff who claims serious medical injuries but whose consultations and treatment by medical professionals consists of only a few visits to a chiropractor and no visits with a medical doctor or physical therapist may be suspect. Plaintiffs alleging damages for pain and suffering should have objective manifestations of the pain and suffering reflected in the medical records.
Past medical history of a plaintiff may reveal that a plaintiff’s claimed injury is pre-existing, and the question arises whether an incident exacerbated a pre-existing injury. A plaintiff who alleges lost income must present provable evidence such as earnings history, a wage statement, and proof from an employer regarding wage rate and days off due to plaintiff’s injury. Sometimes insurers retain an investigator to conduct a secret surveillance of the plaintiff. Undercover surveillance may uncover discrepancies or untruths in a plaintiff’s story.
Options for Resolution
After reviewing the pertinent facts, applicable law, and potential for liability, insurers consider options for resolution. Insurers seek information regarding prior settlement negotiations, including any settlement offers or demands that have been made. Insurers inquire whether a case is amenable to resolution by settlement or whether a trial is necessary. Insurers look at alternative dispute resolution options such as mediation or arbitration. The choice of a mediator and/or arbitrator and the cost will be evaluated.
Insurers assess the odds of a defense verdict or directed verdict, and analyze the probable range of damages in the event of a plaintiff’s verdict. Insurers consider the estimated length of the trial and attempt to determine what the costs will be to proceed to trial.
In addition to the facts and legal issues of the underlying case, insurers explore coverage issues such as their insured’s policy limits, subrogation, reservation of rights, and potential conflicts.
Some lawyers believe that the value of a case is determined by calculating special damages, including medical bills and lost income, and then applying a multiplier to determine pain and suffering damages. This valuation theory is too simplistic. Often insurers will not even offer the amount of medical bills to settle a case. On other occasions cases settle for much more than three times the value of special damages.
Insurers have too much to lose by way of runaway jury verdicts or a possible bad faith lawsuit from their insured to treat a case in cookie cutter fashion. Each case turns on its own facts. Plaintiffs should expect that insurers have engaged in due diligence and value cases based on careful research and analysis.
Understanding How Insurance Companies Value Particular Injuries
A Newport accident attorney understands the personal toll an accident injury takes on their clients. Your attorney also understands how insurance adjusters view injury claims in terms of personal injury compensation.
What Adjusters Look for When Placing a Value on an Injury
Permanence is often the key word when it comes to adjuster evaluations of injuries. If a doctor has told you or will testify that the injury you sustained is permanent, this will increase the potential settlement value. Injuries that heal quickly and leave no lasting impact on your life are not valued highly in terms of an adjuster’s settlement potential.
Settlement Impact of Disfigurement Claims
Another factor that will influence the value of settlement is whether your injury caused permanent disfigurement or scarring. Facial scarring, no matter how low your medical bills, will increase the potential value of your claim. Your attorney will also discuss ways to document scarring or injury permanence through photographs and evaluation by medical specialists such as a plastic surgeon.
Although your attorney cannot guarantee settlement, they can discuss factors that impact your personal injury compensation.
A Newport accident attorney at the law firm of Russell & Lazarus APC can help you understand how insurance companies value injury claims and negotiate on your behalf. Call to set up a consultation.
Calculation of Damages
After first discussing your case with a Newport Beach personal injury law firm, you may ask what the value of your case is. While your Newport Beach personal injury attorney may not have an exact answer, he or she can explain the components that are part of a damage claim and how this affects personal injury compensation.
When the Newport Beach personal injury law firm that represents you calculates your damages, it will probably commence with economic damages. These damages are easier to quantify than non-economic damages. One element of these damages is the amount that it will take to repair your property that was damaged in the accident. Another element is the value of the income that you lost while recovering or attending medical appointments. In some cases, loss of credit and loss of insurability may also be available as part of your damage claim. Another piece of damages that your Newport Beach personal injury law firm will take into account is medical expenses, including past medical costs, rehabilitation costs and prospective medical costs. If the case involved death, funeral costs may also be included.
Non-economic damages are those that are not easy to quantify, even if it is clear that they have been suffered. Non-economic damages may include loss of enjoyment of life, loss of companionship, loss of society, mental impairment, physical impairment, physical disfigurement, pain and suffering and mental anguish.
If you would like more information about how to calculate the damages that you suffered, contact Russell & Lazarus APC.
Understanding Non Economic Damages in California
Typically, when a victim incurs damages from another party, the victim is entitled to financial personal injury compensation due to the other party’s negligence. The legal purpose behind recovering damages is not only to reimburse victims for the money they spend rectifying their situation, but to place them in the position they would be if the accident had never occurred. This financial reimbursement includes both economic and non economic damages. Additionally, some victims may also be entitled to additional punitive damages, which are designed to punish the tortfeasor (negligent actor) and deter future wrongdoing. Both these kinds of non economic damages are discussed in detail below.
Establishing Non Economic Damages in Settlement Negotiations
The vast majority of negligence cases (well over 85 percent) settle out of court. Often, that settlement occurs before a lawsuit is even filed. But how do attorneys come up with an accurate settlement amount in the first place? Two factors can be considered: The victim’s economic damages, and their non economic damages.
What Are Economic Damages?
Economic damages are relatively easy to establish with expenses like medical bills, income tax returns, and property damage. Property damage is a little more subjective. This is because the victim/plaintiff is entitled to both the monetary value of the lost property, as well as compensation for the additional emotional value of that incidence.
What Do Non Economic Damages Include?
Non economic damages, however, are almost completely subjective. This category includes items like:
- Pain and suffering,
- Loss of consortium (companionship),
- Emotional distress, and
- Loss of enjoyment in life.
These damages typically MUST be related to a physical injury. So while a “near miss” auto accident may cause substantial amounts of emotional distress and other such losses, there is no such tort under California law.
The exception is, in some cases, the zone of danger rule expands. For example, assume that two parents are in a car crash with their child. The child is seriously injured, but the parents are uninjured. But because the parents have a strong emotional attachment to the victim (their child), because they saw the injury occur, and because they themselves were in danger, the parents are legally entitled to money for emotional distress and other non economic damages.
How Will Your Attorney Value Non Economic Damages?
To establish a ballpark value, some attorneys use a per diem method and calculate non economic damages based on the number of days that the victim/plaintiff physically suffers. Other lawyers multiply the medical bills, perhaps by four or five, based on the severity of the accident. While both methods have their pros and cons, either is usually sufficient to set a reasonable amount of non economic damages.
Establishing Non Economic Damages at Trial
If the case goes to trial, a jury will probably demand more precision than is provided in one of the rough estimates given above.
To determine the amount of non economic damages, the jury will expect to hear testimony regarding the degree of physical suffering that the victim/plaintiff encountered. That can mean calling treating physicians to the stand, as well as nurses, neighbors, friends, co-workers, and others who can testify about the physical challenges of recovery.
The appropriate strategy varies, but it’s usually best to give the jurors both a per diem (or multiplier) estimate of non economic damages, and considerable leeway to determine the value for themselves.
If the tortfeasor displayed reckless or outrageous conduct, additional punitive damages may be available according to California Civil Jury Instruction 3949. This could include driving with an extremely high Blood Alcohol Content, or leaving the scene of an injury collision. These additional non economic damages are available if the victim/plaintiff presents clear and convincing evidence of their appropriateness.
Punitive damages are only available in rare and certain kinds of personal injury cases. Examples may include those involving outrageous individual conduct, or a defective product. In some cases, a punitive damages cap may apply.
Non Economic Damages and Income Taxes
As a rule of thumb, if tort damages are related to personal injury or property loss, they are income tax free. That designation applies to economic damages like medical bills, as well as non economic damages related to pain and suffering as a result of the accident. Under this analysis, punitive damages may be subject to income tax.
It’s a good idea for you to consult with an income tax professional to determine the tax basis of the non economic damages received in a tort lawsuit, if any.
Reach Out to an Experienced Non Economic Damages Lawyer
At Russell & Lazarus, APC, we fight for the maximum available personal injury compensation and we are not satisfied with anything less than the best result. If you live in the Newport Beach, Long Beach, or Riverside area and have been injured, contact us today for a free consultation.
Long Beach Personal Injury Attorney on Documenting Medical Expenses After an Injury
If you or a loved one has been injured in an accident, then you need an experienced Long Beach personal injury attorney representing you. Depending on the nature of your injuries, you may be entitled to personal injury compensation for the damages. Contact your Long Beach personal injury attorney to schedule your consultation.
Being injured in an accident can be a traumatic event that can leave you confused and not knowing what to do next. Your Long Beach personal injury lawyers will be there to help you through the process. The following information provided by your Long Beach personal injury attorney will discuss how you will need to properly document your medical expenses after sustaining an injury in an accident. If you find that you have further questions, contact your personal injury attorney to schedule a consultation.
How to Obtain the Proper Documentation for Your Medical Expenses
Having the proper medical expense documentation is one of the most important records that you and your attorney need to have. Without having all of the proper documentation, then the amount that you may be able to receive in your settlement will likely be compromised. If your personal injury lawyer fails to include a large medical bill in your settlement then you will not receive that amount from the insurance company. You may want to take it upon yourself to obtain your medical expense records. It will be easier for you to obtain rather than your attorney. You will be able to make copies to give to your attorney to keep for their records. Your attorney should give you a medical expense sheet that is similar to a checklist. With this document, you can help keep track of what you have spent on doctor visits, hospital visits, prescriptions, as well as any other medical expenses. Keeping accurate records is of the utmost importance in your personal injury case. This cannot be overstate enough for your benefit.
Schedule a Consultation with Our Long Beach Personal Injury Lawyers
When you have been injured in an accident, you need an experienced Long Beach personal injury attorney representing you. Call yours today from Russell & Lazarus APC. Russell & Lazarus APC are the Long Beach personal injury lawyers that have the dedication and knowledge to help you get the best possible outcome from your personal injury case. Call today to schedule your consultation with the experts in personal injury law.
Orange County Accident Attorneys on Mitigating Damages
If you have been injured because of someone else’s negligence, you cannot just sit back and wait for your claim to be paid. Orange County accident attorneys are here to help you understand your obligation to “mitigate your damages.”
What Does Mitigating Your Damages Mean?
As the injured person, you should act reasonably in dealing with the consequences of your injuries. If you do nothing to help yourself, the defendant will argue that he/she should not have to pay all of your damages.
If your case goes before a court or jury, they legally have to consider whether you could have avoided some of your damages by acting in a more reasonable way. If your Orange County accident attorneys are negotiating on your behalf with an insurance company, their job is a lot harder if they cannot show that you are trying to help yourself recover, physically and financially.
Just How Much Do You Have To Do To Reduce Your Damages?
As the injured person, you have an obligation to act in a way that most people would act in a similar situation. This could mean seeking medical treatment, or it could mean looking for a new job. It could even mean looking for a job that is totally different from your previous job, especially if your injuries prevent you from doing your old job.
Our Orange County accident attorneys can give you more personalized examples of what would be considered “reasonable” during your initial consultation.
When Can You Choose Not To Seek Treatment?
For many people, even if their doctor has recommended surgery as the best way to treat an injury, they may refuse surgery. Sometimes this decision is faith-based, and sometimes it is just a personal preference not to take on that risk.
Depending on your circumstances, the decision not to seek certain treatments such as surgery may result in you being unable to recover damages for the aspects of your injury that could have potentially been significantly lessened or avoided al ltogether by surgery or other treatment.
If the risk of death or further injury is too great and a reasonable person would choose to live with the injury, you could make that choice and still be compensated for your damages.
Get Help from Top Orange County Accident Attorneys
If you or a loved one has been injured in an accident, call Russell & Lazarus APC, Orange County accident attorneys.
Are You Self-Employed? Proving Lost Wages after an OC Accident Injury
While it can be difficult for any Orange County car accident attorney victim to recover lost wages after an injury, self-employed victims can face an especially challenging road. While any accident victim claiming lost wages must prove that they missed work due to their accident injuries, self-employed victims face additional complications because:
- Work is often seasonal or on an irregular schedule. If the nature of your work means you have busy seasons and dry seasons, or if you simply work when there’s work, it can be difficult to prove that you actually lost income as a result of your injuries.
- It’s more difficult to provide documentation of your time away from work. Because you are your own boss, it can be difficult to provide something as simple as a letter from your employer or your pay stubs when you’re negotiating a personal injury lawsuit settlement.
- It may be impossible to estimate the income that was lost. Depending on the nature of your self-employment, it may be difficult to estimate exactly how much you would have made in the time you were away from work and recovering.
- It’s hard to avoid your own business, even when you’re hurt. Even if you aren’t feeling up to it and your doctor has advised against it, it’s hard to avoid the temptation to tend to your business and clients—especially if you work from home. Unfortunately, the insurance company could use that as evidence that you’re not as badly hurt as you claim.
Contact Orange County Accident Attorney
If you have been hurt in an Orange County wreck and have questions about recovering personal injury compensation for your time away from work, please reach out to an experienced Anaheim accident attorney today.
Issues With Proving the Value of Pain and Suffering in an Accident Claim
An important component of any personal injury claim is the amount of pain and suffering a victim may have endured. A Newport Beach personal injury lawyer can help explain issues that may arise in proving the value of pain and suffering to an insurance adjuster.
The Subjective Nature of Pain and Suffering Claims
When accident victims file claims for compensation with an insurance company, the adjuster must inevitably put a dollar value on an individual’s suffering. This is no easy task since pain is often subjective. A Newport Beach personal injury attorney can help clients understand and organize the documentation needed to present a pain and suffering claim.
Documenting Pain and Suffering
Successful injury claimants are those who can fully document their damages. The ability to provide solid medical records, receipts, bills, statements from employers and other types of documentation is crucial. To verify pain and suffering, adjusters look for evidence that’s consistent with a victim’s claims such as the use of pain medication, types of treatment and verification that a claimed injury impacted the victim’s ability to work or enjoy other aspects of their lives.
While no attorney can guarantee an individual claim will settle for a certain dollar amount or at all, a good lawyer knows how to help his/her client build a case for personal injury compensation through proper documentation.
To discuss this matter with a skilled Newport Beach personal injury lawyer, contact Russell & Lazarus APC.