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How Insurance Companies Value Auto Accident Cases

This entry was posted on Thursday, May 26th, 2016

Posted in News & Articles | Posted by:


car accidentYou’ve been injured in an automobile collision; the other driver’s insurance company contacts you and wants to settle with you. How does the insurance company’s adjuster go about evaluating your claim? As an experienced San Diego auto accident lawyer, I can tell you the likely answer is: not generously.

People who have been in automobile accidents should be aware of the following:  a)  the adjuster will sound very nice and friendly (and probably is), but b) remember that it is in the adjuster’s best interest to pay you the least amount of money possible; c) since she does this for a living, she is probably more skilled at negotiating than you are; d) she likely knows the law better than you do; e) she owes you practically zero legal responsibility: Her loyalty belongs to the other driver and to the insurance company she’s working for—not to you;  f) Most important: You would do much better having a San Diego auto accident lawyer represent you (the more serious the injury, the more crucial this is).

The adjuster will be most interested in two major components of your claim: damages and fault.

DAMAGES.   You have a right to be compensated for losses caused by the accident, which include:

  • Expenses for medical care and related expenses.
  • Pain and suffering.
  • Future pain and suffering likely to occur.
  • Lost income caused by the accident, including time lost to attend doctor visits or therapy.
  • Income reasonably likely to be lost in the future.
  • Damage to property.
  • Physical disability.
  • Some types of emotional injury.
  • Services, such as house-keeping or baby-sitting, necessitated by your injury.

Loss of consortium. Be aware, too, that someone other than you may also have been damaged as a result of your injury, and that person may have a right to compensation as well.  Your spouse, for example, may have a claim for the loss of your companionship and services—called an action for “loss of consortium.”  In California and some other states, this remedy is only available to spouses and registered domestic partners of the injured party; a child, for example, would not have a cause of action for the loss of consortium of a parent in those states.

FAULT. Of course the adjuster will be anxious to determine who was really at fault in the accident.  The adjuster will carefully examine the facts to evaluate comparative fault—that is, the relative fault of both drivers in the collision—and to determine to what degree the accident was your own fault.  This concept, known as comparative negligence, will be used in attempting to assign to you as great a percentage of fault as possible.  Any compensation to you, either by way of settlement or by an award by a court, will be reduced by the percentage that you yourself were at fault.  Among the states there are various approaches to comparative negligence; they fall into three general categories:

Pure Contributory Negligence.  This rule says: if one’s own negligence in any way contributed to the accident, that person cannot recover damages.  Only five jurisdictions still follow the Pure Contributory Negligence rule: Maryland, District of Columbia, North Carolina, Alabama, and Virginia.

Modified Comparative Negligence. Most states follow this rule: One who is 50% or more responsible for the accident cannot recover at all.  (There are some slight variations of this rule.)

Pure Comparative Fault. California, as well as several other states, follows this rule.  It simply says that a person’s compensation for an injury will be reduced by the degree to which that person was at fault, whatever it may be. Thus in theory one could be 99% responsible for the accident and still be entitled to be compensated for 1% of one’s damage.

Whatever rule applies, it is a virtual guarantee that the adjustor will try to attribute as much fault to you as possible.

What should you do?  Get medical treatment as soon as possible. If you do not seek medical treatment, the adjustor will not believe that you have been injured, and will not take your claim seriously.  Keep track of you medical bills, your medical visits, and lost income. And keep notes on your pain, suffering, and disability, and what your doctor tells you.  Be sure you have contact information for any witnesses. As soon as possible, take photographs of the scene, and photographs of damage to your vehicle.

But perhaps the most important thing is: Contact a lawyer as early as possible; the sooner the better. Ideally, do so before having any communication whatsoever with the other party’s insurance company. Then, simply refer them to your lawyer.  You have little to lose–personal injury attorneys are generally compensated by a percentage of whatever is recovered. Thus–no recovery, no fee.  If you try to deal with the insurance company yourself, you may unwittingly make mistakes–mistakes that will be irretrievable, that can have devastating consequences. It is a virtual certainty that a lawyer can resolve the matter more efficiently, and with better results, than you can by yourself.

To speak with an experienced San Diego auto accident lawyer, call George Charles Heppner at (888) 503-6473, today.