The dollar amount of claims per vehicle per year, known in the insurance industry as the loss cost, has been rising in recent years – with an increase of 13 percent in the two years ending March 2016. If you have suffered a car accident injury in NJ, you certainly want to secure the full amount of compensation you are owed. Insurance claims adjusters are often secretive about the specific formula they use to determine claim value in an injury case. However, the manner in which these adjusters determine settlement offers is largely understood, and having an understanding of the factors they consider can help you and your attorney negotiate a more advantageous result.
Beyond the damages associated with medical treatment, physical therapy, and other medical care costs, individuals injured in a car accident caused by the negligence of another party may be entitled to compensation for:
Wages or earnings due to the inability to work
Long-term physical disability, impairment, or disfigurement
Loss of the ability to participate in family, social, educational, or recreational activities, resulting in loss of enjoyment of life
Physical pain and suffering
Emotional or psychological damage stemming from the results of the accident
Calculating some of these damages is straightforward and simple. Medical care damages, for instance, are tallied by summing the total bills from hospitals, doctors, physical therapists, and other healthcare providers, plus the costs of medical devices or pharmaceuticals they prescribed. However, other damages involving loss of enjoyment of life and pain and suffering are not determined in such a clear-cut fashion. For this reason, insurance adjusters employ damage formulas to arrive at the total value of a proposed insurance payout.
All of the medical expenses resulting from your New Jersey car accident injury are referred to as medical special damages. Other damages that are less concrete in nature, such as long-term impairment, emotional trauma, and physical pain are all referred to as general damages.
An insurance adjuster will not attempt to assign a specific dollar value to each item of general damages. Rather he or she will assign them a number which serves as a multiplier. Less severe injuries and those that are likely to heal completely without complications or undue hardship may be assigned a multiplier between 1.5 and 3.
Other more severe injuries that require long recovery times, are acutely painful, require extensive treatment, or that leave scarring on the victim’s body may be assigned a multiplier as high as 5, and even higher in some cases. This multiplier is used with the previously calculated dollar value for medical special damages. Any lost income is added to the total after the multiplier is applied. The insurance company often uses this total as its initial offer in settlement negotiations.
The value of the multiplier representing your general damages may be higher if medical tests or scans clearly indicate the nature of the injury, as opposed to depending exclusively on the patient’s word regarding pain and symptoms.
Higher multipliers are also generally assigned to injuries that have longer recovery times, require invasive treatment to repair or are generally recognized as acutely painful. Bone fractures, head injuries, and paralysis tend to receive higher multipliers.
