How Do Insurers Value a Personal Injury Claim in California? (2024)

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One of the main concerns claimants have during personal injury cases in California is how much their cases are worth. The value of your claim can determine your future. The answer depends on several factors unique to your specific case. Learning how an insurance company typically evaluates a personal injury claim can allow you to fight for a settlement that is fair and reasonable based on the facts of your case.

Medical Damages

The main aspect of your personal injury claim will be the value of your injuries. Injury evaluation requires an analysis of factors such as medical bills, surgeries, treatments, medications, medical devices, live-in care, disability costs, the nature and extent of your injuries, physical pain, your medical history, your age, and your occupation. An insurance company could look at dozens of factors in determining how much your medical damages are worth.

One of the main measures an insurer will use in evaluating medical damages is medical bills. As a claimant, you will submit your medical bills and other documents demonstrating the health care costs of your injury along with your insurance claim. The insurance claims adjuster will add up your bills and use it as part of the larger picture. The adjuster will also look at noneconomic damages associated with your injuries, including disfigurement, physical disabilities, scarring, loss of experiences, lost quality of life, and pain and suffering.

Foreseeable Future Damages

In examining the value of a personal injury claim, an insurance company in California will assess the potential future losses and damages the claimant will suffer. This will mainly apply to claims involving serious, long-term and permanent injuries. If a car accident gave you a spinal cord injury, for example, your insurance claim should account for your future lost wages, lost enjoyment of life, medical care and more. You may need a doctor or medical expert to write a letter explaining how long your injury will impact you.

Property Damages

Another category of damages an insurance company may reimburse is property damage. Property damage is a monetary loss that stems from having to repair damaged property or replace destroyed property. An insurance company may offer an amount that is reasonable and appropriate to restore your lost or damaged property based on repair estimates, appraisals, in-person evaluations and the prior value of your property. Property damage repairs can be part of your economic recovery during an insurance claim.

Apportionment of Fault

Comparative fault can also play a role in an insurance claim in California. California uses a pure comparative fault law, meaning you could still recover compensation if you contributed to your accident. An insurance company, however, will have the right to reduce your compensatory award by a percentage equivalent to your fault. If the insurer’s investigation finds you 20% responsible for causing the accident, for example, it could reduce your benefits by 20%. Determining fault for an injury is not an exact science. A lawyer may be able to negotiate your degree of fault on your behalf.

Insurance Coverage

Finally, the insurance company will compare the amount it believes your claim is worth with the amount of coverage available. A policy limit can reduce how much you receive from an insurance provider. The insurer could estimate your claim to be $75,000 in value, for example, but you may only be able to recover up to $50,000 based on the limits of the policy. Your claim may then go to a second insurance company, such as your own insurer, to cover the remaining damages.

A Sacramento personal injury attorney could help you explore all your potential outlets for recovery after an accident in California. A lawyer could help you fight for maximum benefits from an insurance corporation. An attorney can negotiate with claims adjusters for you, protecting your rights and demanding an award that matches your injuries and losses. You can rest assured in the fair and full value of your settlement when you hire an attorney to represent you during an injury claim. If a settlement is not possible, your lawyer can take your case to trial instead.

How Do Insurers Value a Personal Injury Claim in California? (2024)
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