How Does Insurer Determine Worth of Injury Claim?

The insurer and the adjuster follow a standard approach to evaluate the claim’s worth and the adjuster creates a listing of the victim’s losses. This includes:

• The total for all the medical expenses
• The extent to which the injury caused a permanent physical change in the victim
• The victim’s loss of family, social or educational opportunities
• The value of lost property
• The size of the lost income
• The amount of pain and suffering endured by the victim
* Effect of depression
* Effect of anxiety
* Symptoms caused by stress
* Problems caused by inability to get a good night’s sleep.
* Neuroses, such as fear
* Actual physical pain

The adjuster calculates a given claim’s worth using a special formula.

The formula focuses on the nature and extent of the victim’s injuries. The adjuster must add up the total from each of the claimant’s medical bills. Then that total should be multiplied by a figure called a multiplier.

* The multiplier is normally a figure between 1.5 and 5.
* It represents the degree to which the injury has disrupted the victim’s life.
* For victims of a catastrophic injury, the multiplier could be 6 or more.

After the multiplication operation has been completed, the adjuster must add to the product the amount of the claimant’s lost income. The result of that addition operation is the figure that the adjuster can use at the start of negotiations.

Changes introduced by using a computer

Before creation of computers, adjuster did all the calculations by hand, or by using a calculator. That approach ruled out the chance for taking into consideration the type of doctor consulted by the injured victim. The creation of computer software made it possible to estimate the effect of the victim’s choice.

Some victims elect to have their injuries treated by a chiropractor. Insurance companies prefer to give a pay-out to someone that was treated by a medical doctor. For that reason, the computer software reduces the worth of any claim that has come from a victim that did not see a medical doctor.

The adjuster’s supervisor might add to the items used for revising a claim’s worth. The supervisor might tell the adjuster to use a lower offer, if the claimant has failed to hire a personal injury lawyer in Cambridge. The supervisor would realize that in the absence of a lawyer, a claimant’s readiness to fight any offer would be low.

Still, the biggest factor contributing to any claim’s worth would be the nature and extent of the victim’s injuries. That fact has not changed with the introduction of computers. Neither has the influential nature of multipliers. Those multipliers cause the resulting figure to do a good job of reflecting the nature and extent of the victim’s injuries.