How Insurance Companies Determine The Value Of Your Accident Injury Claim
Compensation claims are only payable where one party is proven to be liable for your injuries. This could be: An individual – e.g., a criminal who attacked you during a mugging, or a driver who caused a road traffic accident you were caught up in A group or organisation – e.g., the local council who failed to maintain their public toilets, leading to an injury caused by a basin falling off the wall A company – e.g., the business responsible for the upkeep of a building in which you slipped as a result of their negligence.
Whoever is responsible for your injuries, it’s their insurance company who will have to pay your medical expenses and a sum of compensation for your injuries if your claim is successful. They may also be liable for other expenses related to the incident, such as:
- Loss of income as a result of not being able to work while you recover
- Childcare expenses
- Emotional or psychological damages
- Travel expenses relating to your treatment
- Any other expenses directly relating to your accident.
When you pursue a personal injury claim with a qualified claims solicitor, they’ll explore your situation and help you to understand which expenses you could feasibly claim back. Even seemingly innocuous details could help – for example, in some circumstances you might be able to claim for a missed event such as a holiday or wedding if you couldn’t attend because of your injuries.
In many cases, medical expenses will make up the largest proportion of your claim’s value. Insurance companies will use comprehensive damages formulae to calculate what they deem to be a reasonable amount of remuneration based on your injuries. No two personal injury cases are the same, so you can expect there to be some variation on any estimates you’re given.
However, knowing the rough amount of damages you could receive will help you to know if what you’re being offered is in the right ballpark for what you’re entitled to. As a general guide, insurance companies will typically use your medical records and similar evidence to total up your medical expenses – i.e., how much your treatment cost, even if you were treated somewhere like the NHS where you don’t pay the price at the point of access.
Then they’ll add a sum onto that total to account for your pain and suffering caused by the injury. For minor injuries, this could mean your medical expenses are doubled. For more serious, impactful cases, however, you could receive much more. Afterwards, other expenses like lost income or childcare costs would be added to the rolling total.
The at-fault party is also responsible for paying your legal fees, so this would be included in your compensation, although it’s likely that these fees would be paid before the money actually reaches you. In all personal injury cases, one of the most important factors in determining the amount of compensation is the distribution of blame.
Based on the facts surrounding the incident, the insurance adjustor will decide whether you were entirely, partially or not at all your fault. This will then impact the amount of compensation you receive. If the incident was wholly your fault, then you won’t receive any compensation. If it was all the other party’s fault, you’ll get the full amount. But if you’re partially to blame, the amount can vary:
- If the incident was mostly the other party’s fault, you might receive most of the compensation amount – e.g., 75%
- If the blame lies equally upon you both, then you might receive 50% of the compensation calculated
- If the accident was mostly your own fault, then you may receive only a small proportion of the compensation amount, such as 25%.
Bear in mind that, if your solicitor operates on a no win, no fee basis, which most do, up to 25% of your final compensation amount will be payable to them for their services. For members of the general public, all these factors can be hard to get your head around – particularly in the aftermath of a traumatic event.