Claimants should know the methods that various insurance companies use for calculating the worth of a submitted claim. In that way, any claimant could strive to gain a better understanding of the anticipated value for his or her own personal injury.
Factors affecting a given claim’s worth
• The victim’s medical expenses
• The value for any property damage
• The amount of time that the injured victim had to be absent from his or her workplace
• Any changes in the victim’s earning power
• Any interruptions in the daily activities of the recovered victim
• The emotional or mental effects of the accident
Expectations about future medical problems; such expectations would reflect observations that a doctor has made during the slow recovery process.
Traditionally, most insurance companies have chosen to use a formula when calculating the worth of a submitted claim.
One figure in that formula comes from the process of adding up all of the medical specials.That total for the specials then becomes one figure in a multiplication operation. That other figure would be a number, usually one between 1.5 and 5, and that should represent the severity of the claimed injury. For a case with a catastrophic injury, that second figure might be 6 or more.
Following the multiplication of those 2 figures, the resulting product must be added to a 3rd figure. That would be the value for the injured claimant’s lost salary.
After an adjuster has added the value of the lost salary to the calculated product, then he or she has obtained a number that could serve as the starting point for any negotiations. Still, a supervisor might suggest some modifications to that potential starting figure.
Other possible methods for calculation of a claim’s worth
The per diem method: That calls for selection of an amount of money that could be assigned to each day of an injured patient’s recovery. That monetary figure would be multiplied by the number of days that the injured party has spent in recovery. Once again, the calculated figure would provide the adjuster with a number that could be used, when starting the negotiations.
Today, some companies rely on computer software, when trying to determine the worth of a submitted personal injury claim in Hayward. Software programs take into consideration the type of treatment that has been used on the reported injury. Yet, a computer could not provide an adjuster with any number except the one that could be used at the start of negotiations.
As indicated above, the adjuster’s supervisor might suggest a reduction in the size of that calculated number. The size of the reduction would be greater, if the claimant had chosen to proceed with the claims process in the absence of a lawyer.
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