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Top 9 Factors We Consider When Evaluating a Personal Injury Claim

Personal injury lawyer Atlanta, GAOne question we are often asked whenever a potential client calls our firm is: “What is my case worth?”

This is a great question and we certainly understand why clients would want to know the answer. They have had their lives turned upside down because of someone else’s negligence. They want to know whether or not their bills will be paid, or whether they will be reimbursed for their lost wages, or compensated for their pain and emotional suffering.

But the only honest answer that any attorney can give to this question — especially if the wreck was very recent — is: “I do not know.” This is because, in the beginning, there are too many questions that still need to be answered before an honest attorney can put a value on a claim.

Fault, Negligence, and Injuries

Remember, there are three things we have to prove in order for a client to recover:

  1. That someone other than the client was at fault for the wreck;
  2. That the defendant’s negligence (or fault) was the proximate cause of a client’s injuries and damages; and
  3. The extent of the client’s injuries and damages, including:
    • past, present, and future medical bills
    • past, present, and future lost wages
    • the severity of the injuries:
      • are the injuries permanent?
      • are the injuries disabling?
      • will the client be able to continue to work in the same occupation?
      • was the defendant driving while drunk?
      • was the defendant driving while under the influence of drugs?
      • was the defendant texting while driving?
      • did the defendant attempt to flee the scene of the wreck?

For sections (1) and (2), if the attorney had not done a complete investigation about what happened in the wreck, they will not be able to completely understand who is at fault. The defendant and the defendant’s insurance company may try and place fault on someone else or even the client.

If the wreck that injured the client was recent and the client is still treating, there is no way to fully answer section (3). We will not know:

  • the dollar amount of the medical treatment as they are still treating;
  • whether or not the injuries will be permanent;
  • how long the client will be disabled from work;
  • or what future medical treatment, including potential physical therapy, surgery, prescriptions, etc., will be needed, if any.

Settling Too Early

Too many times we receive calls from potential clients who were involved in a wreck but they thought their injuries were minor and would resolve quickly. The person just assumed they were “sore” and would get better. The insurance adjuster may even assure them that they’ll be fine in no time.

And then the adjuster offers them $500 for their trouble and inconvenience. The injured victim takes the check, signs the release, and then tries to move on with their life. But then things start to unravel.

The nagging neck injury becomes more painful. An MRI confirms that the injury is not just a sprain, but the person has a herniated cervical disk that will require surgery. This procedure, the hospitalization, the anesthesia, the physical therapy, the prescription costs, etc., will cost tens of thousands of dollars.

But here’s the problem: the case has been settled for $500. Period. Over. No one forced that caller to settle. The person did it on their own free will and accord. They knew the risks when they took the money — or they should have known the risks. Yet they were “hoodwinked” by the adjuster, and now they are faced with the real consequences.

It’s a difficult conversation to have. We have to tell these potential clients there is nothing that can be done because they settled their claim already. It doesn’t matter how much they will incur in bills, lost wages, or the pain and suffering they will experience.

Dealing With Insurance

There is another important factor that we must investigate before we can arrive at a value range of the personal injury claim. We have to know what insurance policies are available to help pay for the claim. Here is an example case:

The defendant runs a red light and crashes into Claudia’s car on the driver’s side. Witnesses at the scene confirm that the defendant was at fault for the wreck and they get a ticket. Claudia sustains several injuries, including:

  • a fractured left hip;
  • a broken left arm;
  • a broken left leg;
  • several deep gashes, including facial lacerations requiring multiple stitches;
  • there is also a concern about internal injuries.

Claudia’s husband calls Gary Martin Hays & Associates from the hospital. She is currently in surgery as the orthopedic surgeon is attempting to repair her fractured hip. The husband is distraught about his wife and concerned about her recovery. He is also worried about the exorbitant medical bills that will result from the medical treatments. As their attorney, we share his concerns about his wife and their financial situation.

Our firm investigates and finds that the defendant was driving a delivery van for his employer. He was in the course and scope of his employment when he ran the red light and caused the wreck and injuries. This means there will be a company insurance policy available for coverage. These policies often carry much higher limits than regular personal policies.

But what if the defendant was not driving for his employer when he caused the wreck? Under Georgia law, everyone has to carry liability coverage on their vehicle. However, the required limits are only $25,000. Claudia’s medical expenses may greatly exceed that amount just for her hip surgery.

What other options are available?

We would also look at our client’s personal insurance policies, as well as the policies of any other relative that may be living at their home. Our clients may have purchased uninsured/under-insured motorist’s (UM/UIM) coverage on their automobile policies.

Whenever a potential client calls us for their free initial consultation regarding their wreck, we will ask a lot of questions about insurance, about the defendant driver, as well as questions about our client’s own policies and those of any resident relatives. Often, we may not have the answers to these questions for some time. This is yet another factor that must be reviewed when trying to assign a value range to a claim.

Sadly, we have seen a lot of situations where the client has extremely high medical bills coupled with significant, disabling injuries. However, the defendant may only have a minimum liability policy of $25,000. If the injured victim has no UM/UIM or MPC policies available to them, the most that can be realistically recovered from insurance is limited to only $25,000.

The defendant is probably not a person with a lot of assets if they only have the minimum coverage, so any chance of getting money out of them personally is remote. Hopefully, this information will allow you to see the importance of carrying UM/UIM and MPC coverage on your insurance policy.

Top 9 Factors We Consider When Valuing a Claim

It is difficult to list all of the items we consider when we put a “value on a claim.” Our evaluations are not just based on the facts and the law but upon jury verdict research, as well as our experience handling over 45,000 claims for injured victims and their families here in Georgia.

    1. The impact of the crash.
      • How much property damage was done to the vehicles?
      • Are there photos of the crash scene?
      • Did the airbags deploy?
      • Was the vehicle towed from the scene?
      • Are there any witnesses to the crash?
      • What was the size of the vehicles involved?
      • What time did the crash happen?
    2. The severity of the injuries.
      • Were the injuries visible at the scene?
      • Was the injured victim treated at the scene?
      • Was the injured victim transported by ambulance?
      • Are there any witness statements regarding visible injuries at the scene?
      • Were there any broken bones or scarring?
      • Was surgery performed or recommended
      • Are the injuries permanent?
      • Are the injuries disabling?
      • Are there photographs of the injuries?
    3. The amount of special damages.
      • How much in medical bills?
      • Estimate of future medical treatment?
      • How much in lost wages?
      • Estimate of future lost wages?
      • Can the lost wages be credibly documented?
      • Is there any permanent impairment from the injuries?
      • What type of medical treatment was sought for the injuries?
    4. The parties involved.
      • How likable is the plaintiff?
      • How likable is the defendant?
      • Age of the parties?
      • Occupation of parties?
      • Can a jury identify with either party?
      • How credible are the parties?
      • Can the injured victim be painted as a malingerer, or will a jury believe the need for the treatment?
      • Have there ever been any prior accidents and injuries?
      • Were any of the parties on the job when the wreck occurred?
    5. If punitive damages are needed.
      • How did each person conduct themselves at the scene of the wreck?
      • Were drugs and/or alcohol involved?
      • Are there any witness statements regarding the parties at the scene of the wreck?
      • What is the driving history of the defendant?
      • Did the defendant attempt to flee or actually flee the scene of the wreck?
    6. If a tractor-trailer or large truck was involved.
      • Is commercial insurance coverage available?
      • Did the truck driver or trucking company violate any of the Federal Motor Carrier Safety Regulations?
      • Was driver fatigue involved?
      • Did the driver have a valid CDL (commercial driver’s license)?
      • Are there potential claims against the trucking company for negligent hiring, retention or supervision?
      • Was the trailer properly loaded?
      • Was the tractor/trailer in proper working condition?
      • Was the equipment inspected before the truck driver started operating it?
    7. The defendant’s insurance company.
      • What insurance company provides coverage for the defendant?
      • What does the defendant have in liability coverage?
      • Has the insurance company accepted responsibility for the wreck?
      • Has the insurance company paid for the property damage to the plaintiff’s vehicle?
    8. The plaintiff’s insurance company.
      • What insurance company provides UM/UIM coverage for the plaintiff, if any?
      • What are the UM/UIM limits?
      • Do they have MPC (med pay coverage)?
    9. The location of the lawsuit.
      • Is it an urban or rural area?
      • What verdicts have been rendered in this county under similar circumstances?
      • How often are civil jury trials held in this county?
      • Will the plaintiff present well in this venue?
      • Will the defendant present well in this venue?
      • Are either party well known in this county?

In all personal injury claims, I highly recommend you have your case investigated and evaluated by an experienced personal injury attorney.

It is never a good idea to try and settle your claim with an insurance adjuster on your own, especially if you do not have any idea about the full nature and severity of your injuries. They are not in business to try and give you all the cash and benefits you are entitled to receive.

You have absolutely nothing to lose by speaking with an attorney for your free consultation on a claim. But just think of all you could lose if you don’t!

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Further Reading

Handling a Personal Injury Case Yourself vs. Hiring a Lawyer

What to Do About Neck Pain After a Wreck

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