When you are injured in an auto accident, one of the most commonly asked questions is “what is my claim worth?” And the reason that most lawyers can’t give you a definitive answer to that question is that “it depends.”
It really does.
There are so many different factors at play that it is impossible to say with any accuracy what your claim may be worth in the coming months or even years.
Let’s start with the basics – are you representing yourself or will a lawyer be representing you? Believe it or not, this can have a huge impact on your case. In 2004, a study by the Insurance Research Council – an organization created and funded by the insurance industry – found that claimants who hired a lawyer received three and a half times the amount of money for their settlement as claimants who did not have lawyers.
Let that sink in for a second – especially those of you that are concerned about the cost of hiring a lawyer.
Here’s what most people who are injured in an accident don’t understand. Placing a value on your case is much more involved than simply adding up your medical bills and lost wages and sending a request or demand to the insurance company. The insurance companies spend MILLIONS of dollars each year to try to figure out ways to pay less money on insurance claims, not more. The less they pay out in claims, the more money they get to keep for themselves as corporate profit. So if there is a way they can get by paying out a little less on your claim, they will do it.
Here are some other factors that may have an impact on the value of your claim:
- Whether Liability is Contested;
- Where your accident occurred;
- The necessity of your medical treatment;
- The severity of your injuries;
- Whether future medical treatment is necessary;
- The presence of scarring;
- The amount of time you lost from work or will lose in the future;
- Whether you were contributorily negligent;
- The limits of the insurance policy.
These are just some of the various factors that will have an effect on the value of your claim. There are many other considerations that could play a role in the value of your case. But since these are the most common factors, we will touch on some of these factors a bit more in this article.
Is Liability Contested in Your Case?
Before you can recover any form of financial compensation from the insurance company or a jury, you must prove that someone else (either a person or an entity) was negligent and that their negligence was the cause of your injuries. This is called establishing “liability” for your claim. If you are unable to convince the insurance adjuster that their insured is liable for the accident, then you will be unable to collect any financial damages for your injuries.
If this happens, then you are likely going to need to talk to a lawyer and potentially file a lawsuit. Don’t be discouraged though – many insurance adjusters will deny a claim even if it is clear that their insured was at fault. They do this because they no that there are a certain number of people who won’t pursue the claim any further, so they can get away with it. This frequently happens on smaller claims where they are confident a lawyer will not get involved.
But if you have significant injuries and the insurance adjuster has taken a position that their insured is not liable for the injuries, then your only other option is to file a lawsuit. Proving to the insurance adjuster that their insured was to blame for the accident is the first step towards obtaining a recovery for your injuries.
Where the Accident Occurred
Most claimants don’t understand that where their accident occurred can have a profound impact on the value of their case. This is because some counties and jurisdictions will place a much higher value on a case than the same case would command in another jurisdiction.
When you hire a lawyer to help you with your case, they will (or should) research jury verdicts in the city or towns where your case could be tried. Insurance adjusters have this information available to them and will use it to make appropriate adjustments to their value of your claim. Having this information available will help you negotiate a more favorable settlement.
Whether Your Medical Treatment was “Reasonable and Necessary”
It is important for you to understand that when you present your claim to the insurance adjuster, they may determine that some of your treatments and procedures were not “reasonable or necessary”. As a result, they may refuse to pay those bills.
Here is a quick example. If you were rear-ended and suffered a soft-tissue back injury, you may decide to seek treatment with your chiropractor. The insurance adjuster knows (or is told by their superiors) that on past cases, roughly $2,500 in costs for a chiropractor is reasonable for your injuries. However, you end up spending closer to $5,000 in chiropractic care. It is not uncommon for the adjuster to cut that bill and only agree to pay $2,500 – leaving you on the hook for the balance.
Many claimants who have not been through a car accident claim before will go to the first chiropractor they find, without doing any research or seeking referrals. As a result, they end up in a personal injury “specialist mill” that is only interested in billing up as much as they can to your case. Their business model relies on recovering those fees through either your Med Pay or by using a medical lien to recover their fees from your settlement.
For these reasons it can be helpful to speak with a personal injury attorney that can walk you through your proposed treatments and the costs associated. They can help you to understand whether your treatment was reasonable and necessary medical care that the insurance company should pay for.
Were you Contributorily Negligent?
In North Carolina, if you were even 1% at fault for your injuries, the law of contributory negligence says that you can’t recover for your injuries. The insurance companies know and understand this, and will use this law against you every chance they can.
Because the bar is so low for contributory negligence, the insurance companies will closely scrutinize your behavior leading up to the injury to determine whether they can place any fault on your shoulders and will quickly deny your claim if they smell a whiff of negligence on your part.
This is one of the main reasons it is so important to talk to an attorney before you talk to the adjuster, especially if you think that you have been partially to blame for the accident. The burden is on the insurance company to prove that you were contributorily negligent, and an admission on your part goes a long way to letting them carry that burden.
This is almost like a criminal case – anything you say, can and will be used against you! So be very careful if you decide to speak with the adjuster or sign any of their paperwork without talking to a lawyer!
The Limits of the Insurance Policy
Even though we recommend that you carry as much auto insurance as you possibly can (it is the cheapest form of insurance), many people disregard this advice and buy the minimum insurance required by North Carolina law. In North Carolina, the minimum amount of coverage is $30,000 per person and $60,000 per accident.
Needless to say, if your injuries were anything more than minor, this may not be enough coverage to pay for your injuries, medical expenses, and pain and suffering.
So what do you do if there isn’t enough coverage to make you whole?
You have two main options. The first is to file a claim against your own insurance for what is called underinsured motorist coverage. This is a special policy that you can purchase that will cover you if the at fault party does not have enough insurance coverage. Again, we highly recommend that you buy as much of this coverage as you can – typically $1 million.
The second option, which can be used if there still isn’t enough coverage or if the insurance adjuster denies your claim, is to sue the at fault party directly. By doing this you are permitted to seek “discovery” from the defendant, which will tell you whether they have any other assets that can be used to satisfy a judgment, and whether they have any other insurance coverage (such as an umbrella policy) that may be able to pay the claim.
If you decide to go this second route, you will probably need to sue your own insurance company as well in the event they need to step in and pay under your underinsured motorist policy.
Do You Need a Personal Injury Lawyer to Help You?
You are the only one who can say for sure whether you need a lawyer to help you. But generally speaking, the more severe your injuries and the more complicated the issues in your case, the more likely you are to need an auto accident lawyer to help you.
Return to the Personal Injury Claim Guide
If you have a question for us, you can submit it confidentially online by clicking here. You can also call The Hart Law Firm at (919) 883-4861. We are happy to speak to you and answered any detailed questions you may have.