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How Do Insurance Companies Evaluate Claims And Injuries?


When you have an injury case, your attorney will try to negotiate your case to see if it will settle before having to file a lawsuit, or before having to go to a full trial in front of a jury. During that time, it is likely that the defendant or its insurance company will make an offer to try to resolve your case.

When that offer is made, you will have to decide whether to take the offer, and thus, settle your case, or whether to reject that offer and continue the case.

But how do defendants and insurance companies evaluate cases? What goes into calculating the offers that Defendants and insurance companies make to settle cases?

Looking at a Prospective Jury

Insurance companies don’t just pull numbers out of the air. And while your injury, your condition, and your accident matter, there’s one thing that matters more to insurance companies when it comes to what to offer to you to settle: What will a jury do with your case?

The insurance company will come up with an idea of what a jury may award you. They will look at the best case scenario and worst case scenario for both you and them. They do this based on their own experience with hundreds if not thousands of cases prior to yours, as well as commercial services, which publish jury verdicts.

The insurance company will look at these two numbers–the high and potential low–and then calculate your particular case. This is where things like your medical expenses, your pain and suffering and the facts of your case will come in.

Negative Aspects to Your Case

The insurance company will see where on the spectrum of “best case/worst case scenario” they feel your case is. After that, the insurance company will ask whether you are responsible for your own injuries, or whether there are things in your case that the insurance company feels is negative to your case.

Examples may be things like whether you contributed to your own injuries, or whether you failed to get medical treatment that doctors wanted you to get, or whether you are likable or unlikeable (as in exact of a science as that may be). Another example may be laws that may exist, which may limit your ability to recover damages from a jury. They may even consider what lawyer you have; insurance companies often know who the more skilled, experienced and trustworthy personal injuries are, and that factors into their evaluation of your case as well.

Making Offers

After the insurance company comes to a general figure of what a jury may do when presented with your case, it then will make a lower offer to you–the insurance company needs room to negotiate, and thus, usually will not start with the maximum dollar figure that they are willing to pay. The negotiation will then go back and forth, to see if the case can settle without the need for more litigation.

Call the Clinton personal injury lawyers at Fox Farley Willis & Burnette, PLLC, today if you were injured in any kind of accident.

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