Calculate an Auto Insurance Settlement

After all repairs are made and medical treatment is finished, you must negotiate with an insurance adjuster before you can put an auto accident completely behind you. The adjuster has two jobs: to assess the damage from an accident and to negotiate as small a settlement to you as possible. Although most adjusters will assess an auto insurance settlement fairly and in good faith, understanding how those settlements are calculated can help you get the best payment possible. After the typical hassle and pain involved with an accident, you deserve a fair settlement.

Steps

Calculating Monetary Damages

  1. Understand the basic factors involved. Due to wide variations in policy and coverage details, it is difficult to determine ahead of time exactly how an insurance company will calculate your settlement. The circumstances of each car accident differ greatly, so there are not precise mathematical formulae involved.[1] However, there are factors that are generally used to calculate a settlement for most accidents. These include:
    • The type and nature of property damage
    • Whether or not a party is injured
    • The policy limits of the involved insurance policies
  2. Assess vehicular property damage. Most car accidents involve property damage to one or both cars involved. The insurance company will likely offer to cover the cost of repairs to your vehicle.
    • For example, if the back bumper of your car is dented in the accident, the company will likely pay for the cost of repair to the bumper, including labor costs. The company may wish for you to use one of their “approved” mechanics, and they may remit payment directly to the mechanic. Alternately, they may remit the payment directly to you and allow you to choose your own mechanic and pay him yourself.
  3. Be aware that your car might be “totaled.” If repairing the damage to your vehicle would cost more than paying you for the value of your vehicle, the insurance company may consider the accident a “total loss” and pay you for the value of your car.
    • The value of your car is the depreciated value, which includes age and mileage of the vehicle. The depreciated value is unlikely to be close to the price of a brand new car, and it is possible that it could be less than you owe on the vehicle if you have a car loan.
  4. Understand personal injury negotiations. First, be aware that personal injury compensation is usually calculated separately from the settlement for damage to your car.[1] The insurance company will consider:
    • Medical reports
    • Documented loss of wages due to injury
    • The nature and extent of your injuries
  5. Be sure to request compensation for pain and suffering if applicable. The best course of action is to consult a personal injury attorney who can ensure that you are claiming all applicable medical expenses. It can be particularly difficult to quantify pain and suffering, which is a request for compensation for past and future discomfort that the individual has suffered and will continue to suffer as a result of the car accident.[2]
    • To receive “pain and suffering” compensation, you should have completed medical treatments or be able to provide an estimate from a physician about ongoing medical costs that will be incurred in the future.
      • For example, if a person was diagnosed with chronic pain as a result of the car accident, the settlement should include extra compensation for any medical expenses associated with the treatments as well as compensation for the permanent condition.
  6. Do not accept an offer for a settlement too soon. You will receive one settlement for all personal injury expenses, so if you accept an offer before you have completed treatments, you will not be able to file additional expense claims. It is best to hire a personal injury attorney if possible to advise you about claim settlement.
  7. Ask about policy limits. Though the amount the policy will play is determined by the extent of personal injury and property damage, there are also limits that control the maximum amount that the policy pays out.[1] This is negotiated between the insurance company and the insured, and the insurance company will not pay more than the maximum amount.
    • For example, if you were in a major accident that amassed $40,000 in property damages and personal injuries, but the insurance plan has a policy limit of $30,000, then the insurance company will only pay $30,000. If you wish to get the remaining $10,000 covered, you would have to hire a private attorney and sue the driver of the car.
  8. Determine whether you live in a “no fault” state. Some state laws are such that the driver of the car is not responsible for your personal injury costs, even if the other driver was responsible for the incident. If you live in a “no fault” state, your own car insurance will pay up to your policy limit for personal injury and medical bills.[3]
    • Even in a “no fault” state, he damage to property is covered by the insurance company of the driver who caused the accident. If your car is totaled by someone who ran a red light, for example, that driver’s insurance will most likely cover the cost of repairs or replacement for your vehicle.
  9. Talk to your insurance company if you are in a wreck with an uninsured motorist. Though all drivers are supposed to have car insurance, some drive without it. If you are in an accident in which an uninsured driver is at fault, you will either have to sue the driver personally for the cost of repairs and medical expenses or you will have to file a claim with your own insurance company.
    • Some insurance companies offer additional “uninsured motorist” coverage. Consider purchasing this additional coverage to safeguard yourself against uninsured drivers.

Calculating Your Accident Settlement Compensation

  1. Understand how insurance companies calculate a payout. After you provide the insurance company with documentation of your expenses related to the accident and a claims adjuster has assessed your vehicle, the insurance company will determine how much money they will pay.
    • This amount is determined by the strength of your liability claim and the extent of your damages.
  2. Determine the strength of your liability claim. Your claim is dependent upon convincing the insurance company that their client was liable for the accident.[4] Generally, you must prove that the other driver was negligent or careless. Your case will be helped if you have a police report that identifies the other party as responsible for the accident. Some examples of driver negligence include:
    • not seeing another vehicle that should have been seen
    • following too closely
    • driving too fast for the circumstances
    • making an unsafe turn
    • disobeying traffic signals or signs
    • talking on the phone or texting while driving
  3. Recognize your own negligence. If you and the driver of the other vehicle both contributed to the accident, your claim may be reduced or dismissed.
    • Some states have “contributory negligence laws” that state that you cannot win a claim if you were at all negligent, even if the other party was far more negligent.[5] States with this law include Alabama, Maryland, North Carolina, Virginia, and the District of Columbia.
    • Some states have “comparative negligence laws” that reduce claims based on the proportion of the fault. This means that if it is determined that you are 30% responsible and the other party is 70% responsible, your claim will be reduced by 30%.
    • You can find out the laws in your state here.
  4. Know how insurance companies calculate the extent of your damages. Most insurance companies use a software program called “Colossus” to determine the amount of damages a claimant is entitled to.
    • Insurance companies that use Colossus include Aetna, Allstate, CNA, Erie, Farmers, Metropolitan, Ohio Casualty, The Hartford, MetLife, Travelers, USAA and Zurich.
  5. Estimate your damages. While you likely do not have access to Colossus, you can consider some of the areas that the software takes into account. The program considers and assigns values based on the data that is entered (usually from medical records). The next steps explain how determine whether your claim will be assigned higher values.
  6. Submit thorough medical records. The program assigns “severity points” to injuries, rewarding higher points to injuries that are easy to verify, like broken bones, and lower values to soft tissue damage, like strains. Some injuries that tend to increase the Colossus value include:[6]
    • muscle spasms
    • dizziness
    • radiating pain
    • headaches
    • restriction of movement
    • nausea
    • vision impairment
    • neurosis
    • depression or anxiety
  7. Understand medical treatments that will be assigned higher values. Hospitalization: claims that involve a documented trip to the hospital are assigned a higher value. Additionally, treatment by specialists is given a higher value.[6]
    • Physical therapy: physical therapy is assessed by duration. 1-90 days is considered 1-3 months, and 91+ days is 3-6 months (or longer). Longer periods of physical therapy are assigned higher values.[6]
  8. Avoid delays or gaps in treatment. Delays or gaps that are not explained by a doctor in the medical records drastically diminish the value of the settlement assigned by Colossus.[6]
  9. Hire a proven attorney. The Colossus system will take the lawyer’s success rate against insurance companies into account, assigning a higher settlement amount to clients of successful attorneys.[6]

Tips

  • Keep in mind that the final settlement for your auto insurance will be an approximation and a negotiated number.

Related Articles

Sources and Citations

  1. ↑ 1.0 1.1 1.2 http://accident-law.freeadvice.com/accident-law/auto/how-insurance-companies-calculate-settlements.htm
  2. ↑ http://accident-law.freeadvice.com/accident-law/auto/how-insurance-companies-calculate-settlements.htm
  3. ↑ http://www.avvo.com/legal-guides/ugc/car-accident-liability-no-fault-vs-fault-states
  4. ↑ http://www.all-about-car-accidents.com/accident-settlement-value.html
  5. ↑ The Law of Torts: Examples & Explanations, Joseph Glannon (pgs. 489-509).
  6. ↑ 6.0 6.1 6.2 6.3 6.4 http://www.all-about-car-accidents.com/colossus.html
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