The Formula

How much are your injuries worth? And how to determine your claim:

After an accident happens, insurance companies make calls to those involved in an attempt to settle any claims. Their representatives total the medical expenses associated with a person's injuries, and they refer to these expenses as "the medical special damages," which they sometimes refer to simply as "specials." In addition to medical damages, there are other damages, referred to as "general damages," for which the injured party may be compensated. These damages include the victim's suffering, permanent disabilities, and emotional damages. After the "special" and "general" damages have been determined, an adjuster multiplies the amount of the "special damages" by a factor of 1.5 to 3.0 when the injuries are minor. When the injuries are major, i.e., long lasting or extremely painful, the multiplication factor can be 5.0 or higher. Then, the adjuster adds in the amount of any income that was lost due to the injury. Thus, the total compensation for "general damages" can range from 1.5 to more than 5.0 times medical expenses plus lost income. This provides a reasonable number for use in negotiations.

The adjuster's formula is not revealed:

When the adjuster begins her or his negotiations on a claim, the injured party will not be informed about the formula that was used to determine compensation. In fact, the adjuster will even mention that a formula was used, because he or she does not want to reveal the details of how the settlement amount was derived. Thus, it is advisable for the injured party to have her or his own calculations as a starting point from which to arrive at a negotiated settlement amount.

The deciding factor:

There are two simple, but important, points to remember about the damage formula. The first is that the figure arrived at by multiplying the special damages by some factor is just a starting point for negotiation. It is likely that additional factors can be considered as the case progresses. The second point to remember is the adjuster has a wide range of choices for the settlement amount, depending on the factor (ranging from 1.5 to more than 5) used to multiply the medical expenses.

Several considerations contribute to the selection of the multiplication factor, and they should be kept in mind in determining the appropriate factor to be used for a specific person's claim. These considerations include:

  • The more painful, the higher the factor should be.
  • The longer recovery from the injury takes, the higher the factor should be.
  • The more definitive the medical requirements are, the higher the factor should be.
  • The more serious and visible any permanent damage is, the higher the factor should be.