How Insurance Companies Evaluate the Value of a Claim

Factors Considered by Insurance Companies

In most cases, insurance companies will consider the following factors when evaluating a personal injury claim: 

1. The Severity of Your Injury 

The insurance company will consider the nature and severity of your injuries. They will look at the type of injury sustained, the length of treatment, and the extent of your recovery. Serious injuries such as broken bones, traumatic brain injuries, spinal cord injuries, and loss of limb are typically considered more valuable than minor injuries like bruises or sprains. 

2. The Injury’s Impact on Your Life 

Insurance companies will also consider how your injury has affected your daily life. This involves looking into how your injury has impacted your relationships and your ability to enjoy your hobbies. If your injury impaired your ability to engage in your favorite activities, the insurance company must take that into account when evaluating your claim. 

3. Your Medical Bills and Other Economic Damage

Medical expenses are often the most significant economic damages in a personal injury case. The insurance company will review your medical bills, prescriptions, and any other costs related to your medical care. Other economic damages that may be considered include lost wages, loss of earning capacity, and property damage. 

4. Whether or Not You Are Expected to Make a Full Recovery 

The insurance company will also evaluate your prospects for a full recovery. If you are not expected to recover fully or need ongoing treatment, your claim may be worth more. The future costs of medical care and treatment must be considered, along with any future effects on your ability to earn a living. 

5. The Impact of the Injury on Your Earning Capacity 

The insurance company will examine how your injury has impacted your ability to earn an income. If your injury has resulted in the inability to earn money in the future, your claim will be worth more. The insurance company will look at how long you have been out of work and whether your ability to earn a living has been permanently impacted. 

6. The Availability of Evidence 

Evidence is critical when evaluating a personal injury claim. The insurance company will evaluate the strength, quality, and amount of available evidence to support your claim. This includes medical records, witnesses’ statements, police reports, and other related documentation. 

7. Whether or Not Your Fault Contributed to Your Injury 

Finally, fault plays an important role in the evaluation of a claim. If the insurance company finds that you were partially responsible for the accident that led to your injury, your claim may be worth less. 

Comparative Fault in New Jersey

Comparative fault means that if you were partially responsible for the accident that caused your injury, your compensation amount can be reduced accordingly. For example, if you were 10% responsible for the accident, your compensation amount will be reduced by 10%. However, if you were more than 50% responsible, you will not be able to recover any compensation. 

Failure to Mitigate Damages

Another factor that can reduce the value of your claim is your failure to mitigate damages. It means that if you have not taken reasonable steps to treat your injury and prevent further damage, your compensation amount can be reduced. For example, if you did not follow your doctor’s prescribed treatments or engaged in activities that worsened your injury, the insurance company or defendant’s attorney may argue that you are responsible for the extent of your damages. 

Your Actions After Sustaining the Injury

Your actions after the injury can significantly impact your claim's value. For example, if you post a picture on social media that contradicts your injury claims, such as engaging in physical activities or traveling, the insurance company or the defendant’s attorney may use them to undermine your credibility. 

Knowledgeable Legal Advocacy

Understanding how insurance companies evaluate personal injury claims can help you maximize your compensation. Reach out to my law firm – Maran & Maran PC – to get the assistance you need when filing a personal injury claim. I can help you ensure that your settlement is appropriately evaluated by the insurance company. Set up a free consultation today.