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Do insurance companies pay for pain & suffering for soft tissue car accident injuries?

Los Angeles, CA |

I was in a car accident which exacerbated an existing back problem. If the other driver, who was at fault, admits liability, is their insurer supposed to pay for my car repairs, deductible, medical treatment, plus 3x meds for pain & suffering?

What if they don't admit liability, will I need to sue them?

Attorney Answers 4


  1. Best answer

    This concept of being paid three times the medical expenses for pain and suffering is a concept propagated by the insurance industry. It is not true. It is the insurance industry's attempt to hold down claims payments. Your entitlement to pain and suffering damages depend wholly upon the facts of your particular circumstance. A jury would ultimately determine the value of your pain and suffering claim if you are not able to successfully negotiate a reasonable figure.

    You should obtain needed medical care and treatment immediately and follow your doctor's advice. Do not give any statement to the adverse party or insurance company nor grant them access to your medical records. Photograph your injuries and the damage done to any vehicle or other property. Contact a personal injury attorney in your area as soon as possible so that you can protect your rights. You may also find it helpful to review the Legal Guides I have published on Avvo.com dealing with many of the issues you are now facing.

    Legal Disclaimer:

    Mr. Lundeen is licensed to practice law in Florida and Vermont. The response herein is not legal advice and does not create an attorney/client relationship. The response is in the form of legal education and is intended to provide general information about the matter within the question. Oftentimes the question does not include significant and important facts and timelines that, if known, could significantly change the reply and make it unsuitable. Mr. Lundeen strongly advises the questioner to confer with an attorney in your state in order to insure proper advice is received.


  2. I have heard many ways of calculating personal injury. The truth is, there is no specific way to calculate pain and suffering, and each settlement is different depending on the facts of the case. Further, each insurance company has its own way of calculating its settlement offers.

    Typically, the damages you described above are recoverable, but I would never say that "3x meds for pain and suffering" is a given in any case. Your case might be worth that and it might not. You should consult with an experienced personal injury attorney in your area who can go over the specific facts of your case.

    If the other driver doesn't admit fault, you will likely have to file a lawsuit to resolve the issue. Personal injury lawsuits can be complex and difficult. You should consult with an attorney in your area who handles these cases. Most personal injury attorneys offer free initial consultations and do not get paid until they are successful in recovering on your behalf. I wish you the best of luck on your case.

    Disclaimer: This post is for informational purposes only, and is not intended to provide legal advice or create an attorney/client relationship. To obtain legal advice, you should discuss the specific facts of your case with an attorney licensed to practice in your area.


  3. There are no formulas to calculate pain and suffering. The three times medical bills is a myth. In soft tissue cases, you may be lucky if you can get a fraction of your medical bills as pain and suffering. Certainly, you can for sure short change yourself if you decide to do it alone and not get an attorney to help you deal with the insurance adjuster's shenanigans.

    You should speak with a local personal injury attorney at once. Keep in mind that the value of your case may be greatly impacted by the admissions you may make (some which you may even think it does not matter) to the adjuster either by just talking to them or via a recorded statement-which I hope you have refused to give.

    I hope this helps-
    Nima Taradji

    Disclaimer: I am a lawyer licensed in the State of Illinois only, and I am not your lawyer (unless you have been in my office and signed a contract). This communication is not intended as legal advice, and no attorney client relationship results. Please consult your own attorney for legal advice. This is for informational purposes only.


  4. The other contributors have provided informative answers, so I will not duplicate them. The 3x the medical bills formula is called the "Chicago Formula". The Chicago Formula is no longer in use. In fact, at least in many smaller conservative counties, the insurance companies know that juries often award less than three times the medical bills. In fact, if you think about it, 3x the medical bills does not make any sense. For example, assume you hand is cut off, and the only treatment is to cauterize the wound, and the bills are only $3,000. Is the case only worth $9,000? Of course not. 3x the bills was in vogue in the 70s and 80s on soft tissue only cases as a way to easily evaluate them. Keep in mind that back in the 70s and 80s, insurance companies paid "nuisnace value" on cases. They do not do that anymore. My advice is to get a lawyer, and do it fast. Good luck.

    Adam Sorrells
    Injury Lawyer

    Disclaimer: The above was not legal advice and cannot be relied on. For informational purposes only. Time is of the essence, do not delay seeking legal advice and pursuing your legal rights.

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