How Insurance Companies Adjust Personal Injury Claims

How Insurance Companies Adjust Personal Injury Claims

Insurance companies can play a critical role in personal injury claims. From car accident cases to product liability claims, insurance companies representing the liable party will:

·         Conduct their own investigations

·         Make their own assessments regarding the validity of a claim

·         Devise settlement offers.

If they determine a claim is valid, they’ll use their own procedures and formulas to come up with an amount for the settlement offer. Here’s how insurers typically determine settlement offers and the factors that can impact them.

While the following information is essential to know whenever you’re pursuing a personal injury case, don’t hesitate to contact the Amaro Law Firm for more answers and advice related to your potential claim.

Call (713) 352-7975 or Email the Amaro Law Firm

for a Free, Confidential, No Obligation Case Evaluation

How Insurance Companies Come Up With Settlement Offers

Different insurers can use different methods for determining the amount of settlement offers. However, they generally use a formula based on the amount of the medical treatment costs or the “medical specials.”  This formula usually involves:

·         Adding up the total cost of the medical specials

·         Applying a multiplier to the total.

The multiplier can start as low as 1.5 and go up from there, depending on the nature and severity of the injuries. The product of the formula then becomes the base, at which point:

·         Additional damages may be added for factors like lost wages and property damage

·         The amount may be decreased if insurers find a basis for doing so.

How Insurers Try to Limit the Amount of Settlement Offers

While rules and formulas dictate how insurers come up with settlement offers, it’s crucial to understand that there’s more at play in these compensation determinations. That’s because insurance companies are usually focused on minimizing settlements, maximizing their profits, and protecting their bottom line.

To that end, insurance companies often take extra measures to reduce settlements with lowball offers. They may do this by trying to allege that:

·      The injuries are not as severe as the injured person has claimed: For instance, insurers may argue that the injured person didn’t follow through with medical treatment (ie., gap in treatment) or didn’t comply with doctor’s orders.  That may give them room to allege that the injuries are not as serious as they’ve been purported to be.

·    The injured person contributed to his own injuries: For example, insurers may try to blame the victim for causing the accident, at least in part, or for playing a role in making their own injuries more serious. This can happen when there’s limited or conflicting evidence associated with a claim or when there are gaps in medical treatment. 

These are just a couple of ways insurers can try to undercut the value of claims. There are, of course, many other tactics insurance companies can use to undervalue claims, and having an experienced lawyer on your side can be the key to combatting these tactics and fighting for the full compensation you deserve.

Protect Your Claim & Your Rights to Recovery: Contact a Houston Personal Injury Lawyer at the Amaro Law Firm

If you or a loved one has been hurt in an accident, a Houston personal injury lawyer at the Amaro Law Firm is ready to partner with you in the pursuit of recovery and justice.

Call (713) 352-7975 or Email Us for Your FREE Consultation

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At the Amaro Law Firm, our attorneys have past experience in insurance defense—that means:

·         We have deep knowledge of how insurance companies work and the various tactics they use to try to avoid paying valid claims.

·         We have the skills and insight to effectively stand up to insurers and help our clients secure the recoveries to which they are entitled.

We understand that nothing can reverse permanent losses and catastrophic injuries. However, we also know that the recoveries from personal injury claims can be pivotal to helping people rebuild their lives.

The Amaro Law Firm’s record of excellence and success in personal injury cases has earned us a 5-star rating on Google and Facebook, glowing testimonials from former clients, and a 10 rating on Avvo.