How Do Insurers Value an Injury Claim?

July 29, 2022

Most personal injury victims are going to have to deal with insurance carriers. When another individual or entity caused the injury, then that person or entity’s insurance carrier will usually be responsible for paying compensation to you. However, you need to know how insurance carriers value injury claims so that you have an understanding of what to expect when it comes to compensation amounts.

Examining the Medical Expenses

Perhaps the costliest part of an injury settlement that insurance carriers will deal with includes medical bills. This extends beyond just the emergency medical expenses related to the initial incident. Insurance carriers should pay for all medical costs related to an injury caused by their policyholder. This includes:

  • All hospital expenses
  • Surgical expenses
  • Physical therapy and rehabilitation
  • Medical equipment
  • Prescription medications
  • Out-of-pocket expenses
  • Travel expenses

It is imperative that personal injury victims not settle their claim until they have fully recovered, which could take some time. Settling a claim before finishing medical care could result in an incomplete settlement. After signing the settlement offer, there will be no way to go back and obtain more compensation at a later date.

Looking at Property Damage Estimates

If any property was damaged as a result of the incident, the insurance carrier will need estimates about property damage repair or replacement expenses. Most commonly, we will see this become a major expense after a vehicle accident occurs. However, there are other types of property that can be damaged in an injury incident, including cell phones, jewelry, computers, and more.

The insurance carrier may require multiple estimates related to how much repairing or replacing certain property will cost, and you can also get your own estimate to submit to the insurance carrier.

Totaling Lost Wages

If an injury prevents an individual from working at all or results in them having to work at a diminished capacity for less income, it will be crucial to ensure lost wages are calculated in the insurance settlement. Properly calculating lost wages includes gathering pay stubs, tax returns, bank statements, letters from an employer, and any other type of documentation that shows the wages that a person is no longer able to earn as a result of the injury.

Other Factors to Consider

There are various other factors that can affect how an insurance carrier values a claim. The insurance carrier will need to look at the overall recovery timeline when determining an adequate settlement offer. If the carrier wants to settle the claim, but a person has not recovered, the insurance carrier could offer more compensation than has already currently been paid out, but this can get challenging. In general, no claim should be settled before medical treatment has ended.

The insurance carrier will also examine whether or not the injury victim shared any liability for the incident. Typically, shared liability will result in the person receiving less compensation, but this will not necessarily mean they receive no compensation at all.

It is crucial for injury victims in West Virginia to work with a skilled personal injury attorney who has experience handling negotiations with insurance carriers. A lawyer will understand the tactics and insurance carriers used to lower settlements and will push back vigorously to obtain maximum compensation for their client.


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