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How does an insurance company determine a settlement amount for a personal injury (premise liability) claim?

Waldorf, MD |

Is there a "formula" for determining compensation/settlement in a personal injury case (specifically a "premises liability" claim)? How much can reasonably be claimed for "pain and suffering" and/or emotional distress? Is it a percentage or multiple of the amount of lost wages and/or medical expenses?

Attorney Answers 13

Posted

Assuming there is liability, you are entitled to all past and future medical expenses, lost income and pain and suffering. Determination of these amounts are very fact specific, especially pain and suffering which is based on the subective experience (judged objectively) of the person who was hurt. There was a rule of thumb many years ago of "three times the specials" is the total value of the case, and while it may be a starting point in some cases, but both insurance companies and attorneys will tell you there is no real "formula" and each case has to be considered on its unique facts.

Good luck.

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Posted

There is no formula for calculating this number.

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Asker

Posted

Well, is it comprised of medical expenses (inclusive of those covered by an individual's health insurance) and lost wages (even if paid leave had to be used, although not the original intent of the leave usage), and how much does one ask for, for pain and suffering (how is that amount "gauged")?

Posted

There is no computer program that spits out a number. An experienced personal injury attorney, however, can give you a very realistic range on settlement. Sit down and talk to one about the possibilities.

In no way am I offering you legal advice, and in no way has my comment created an attorney-client relationship. You are not to rely upon my note above in any way, but insted need to sit down with counsel and share all relevant facts before receiving fully-informed legal advice. If you want to be completely sure of your rights, you must sit down with an experienced criminal defense attorney to be fully aware of your rights.

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Asker

Posted

While I appreciate your response, and called 2 different attorneys briefly describing my incident over the phone, they would not take my case as, in their opinion, my injuries were not "severe enough". However, there was liability in which I was an "invitee" (customer of this business), and although nothing is broken or I am not dying, am indeed in a lot of pain, went to emergency room, doctor concerned enough to take X-rays due to appearance of injuries, prescribed narcotic medication, and am/will be missing work due to this. There were at least 5 witnesses (2 of which helped to carry me out of the way of vehicles as I could not move at the time). So, the 2 I called today gave me the impression that attorneys have no interest unless it is at least a quarter of a million dollar high profile lawsuit, nevermind the pain and losses I have to suffer due to a pothole in the business' parking lot, just 10 steps between the entrance and the parking lot spaces. I do pay attention to where I am walking, however, my primary attention point was to my right, to see if there were any oncoming vehicles headed for the drive through of the business. So I am going to meet with the property owner on my own, and just need advice as to what to include in my claim i will be filing with the business' insurance company.

Posted

There is no formula for calculating the value of a claim.

Call for a free consultation at 727-937-1400 or visit us on the Web at www.serviceandjustice.com.

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Posted

There is no formula that I'm aware of. You have to prove that the defendant is negligent or violated the law in some. This is a big issue in many premises liability cases. These types of cases are very fact dependent. By that I mean, the outcome can vary substantially, depending upon specific facts and circumstances.

You also have to prove that the defendant's negligence was a cause of harm/injury to you. Then, you have to prove that you were injured. In terms of the value of pain and suffering or emotional distress, that too varies from case to case.

Generally, an experienced lawyer can help maximize the value of a case and will know how to deal with common defenses and issues raised by the insurer. Good luck.

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Asker

Posted

While I appreciate your response, and called 2 different attorneys briefly describing my incident over the phone, they would not take my case as, in their opinion, my injuries were not "severe enough". However, there was liability in which I was an "invitee" (customer of this business), and although nothing is broken or I am not dying, am indeed in a lot of pain, went to emergency room, doctor concerned enough to take X-rays due to appearance of injuries, prescribed narcotic medication, and am/will be missing work due to this. There were at least 5 witnesses (2 of which helped to carry me out of the way of vehicles as I could not move at the time). So, the 2 I called today gave me the impression that attorneys have no interest unless it is at least a quarter of a million dollar high profile lawsuit, nevermind the pain and losses I have to suffer due to a pothole in the business' parking lot, just 10 steps between the entrance and the parking lot spaces. I do pay attention to where I am walking, however, my primary attention point was to my right, to see if there were any oncoming vehicles headed for the drive through of the business. So I am going to meet with the property owner on my own, and just need advice as to what to include in my claim i will be filing with the business' insurance company.

Jason Todd Studinski

Jason Todd Studinski

Posted

I am really sorry that you are having a hard time connecting with a good lawyer. Don't give up yet. Keep searching. In the meantime, I think the points you raised about your harms/losses are very good and valid points. I wish you the best of luck in resolving th is claim to your satisfaction.

Asker

Posted

Thank you, I really do appreciate the encouragement and moral support :)

Posted

The "formula" for maximizing your recovery is to know the marketplace. Your lawyer will know the range of awards for similar injuries in your jurisdiction, and will have access to jury verdict and settlement reporters showing results in other cases. He will know about the tendancy of juries and judges, and he will have experience gleaned from years of practice. He will then consider your injuries, course of treatment, the opinions of your medical and vocational providers, and the impacts on your daily and future life. Lost wages, benefits and other special damages may also factor in to his advice. And then, in consultation with you, he will establish a range of recovery as a target. Your ultimate recovery will depend on the course of negotiations, or the willingness of a judge or jury to make the award.

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Posted

There is no magic formula.

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Posted

I practice law here in Maryland in Prince George's county where you reside. There is no straight formula. The key is whether you can present a credible threat that you will take them to court and win. If not, they will lowball you by a lot

So you probably need to retain an attorney if you want to maximize your settlement.

Larry Holzman
The Holzman Law Firm, LLC. 8955-A, Edmonston Road, Greenbelt, Md 20770, (301) 876-4393. lholzman@theholzmanlawfirm.com

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Asker

Posted

Thank you for your response. I was initially discouraged from seeking legal rep. on this when I called a firm nearby and was turned away over the phone as soon as I answered "no" to their question "Was anything broken?" However, there was liability in which I was an "invitee" (customer of this well-known, chain business), and although nothing is broken or I am not dying, am indeed in a lot of pain, went to emergency room, doctor concerned enough to take X-rays due to appearance of injuries, prescribed narcotic medication, and am/will be missing work due to this. There were at least 5 witnesses (2 of which helped to carry me out of the way of vehicles as I could not move at the time). My lost wages per day are $450, medical estimated at $1100. And I believe there were many inconveniences, and pain and suffering, loss of time otherwise spent, and loss of ability to perform day-to-day normal functions. That being said, before I call, would you have any interest in representing me in this case, or would you consider it "insufficient" or unlikely to win? I am supposed to meet with the property owner tomorrow, he said I can file a claim with his insurance company (after being turned down figured I should just try on my own). Please let me know either way. Thank you.

Asker

Posted

I also have pictures of the pothole and this business, and its lot, as well as pictures of my injuries.

Posted

There are way too many factors involved for there to be any formula. Each case is based on its merits. Credibility of plaintiffs, defendant, venue, injuries, and many other factors play a role in claims.

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Posted

There are many factors that go into a personal injury settlement evaluation. You should immediately contact an experienced personal injury attorney since the insurance adjusters will often not include all the factors they should include. We will advocate for you, the injured client, and get everything included, such as outstanding medical expenses, lost wages, periods of total and partial disability, and values for scarring, disfigurement, permanancy or residual symptoms.

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Posted

Your recovery in any personal injury case, will be determined by the seriousness of the injury, incurred medical expenses, forseeable future medical expenses, lost wages, potential future lost wages and any past, present, or future pain and suffering.

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Andrew Lawrence Weitz

Andrew Lawrence Weitz

Posted

One more factor, at least in New York, for settlement purposes, the percentage calculated for the likelihood of prevailing at trial. Also, the value of an award will be reduced by the anticipated per cent portion of fault that might be attributed to the plaintiff.

Posted

There is no formula only factors to consider. If you are trying to handle this matter on your own I would suggest you get the counsel of a qualified personal injury lawyer in your area. Good luck.

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Posted

The first thing that can be said in answer to your question that that the value of the case will be much more if you are represented by a good attorney. Therefore, one answer to the question of your case and how to evaluate it to obtain the maximum possible is to bet the best personal injury attorney you can find in your area. Next, an insurance company determines a settlement amount for a personal injury case by looking at the extent of the treatment and its costs received by the injured party and also determining who is at fault for causing the injury. There is a formula that they use to evaluate the case in those two respects and determine where to being negotiating with the injured party and /or their attorneys. Some formulas can use a multiplier where they multiply the lost wages and medical expenses to come up with a pain and suffering number but as other attorneys have responded that number is so arbitrary that it is flawed and is considered inaccurate. The real answer to your question it seems is to provide you with a number, however, based on the facts provided here that is impossible to do. There are too many unknowns in this scenario to give you a real accurate number. I’m sure if you contact a well-respected personal attorney in your area, he or she will have questions for you to answer, after which they could give you a pretty accurate range of the cases value.

I am licensed in California only and my answers on Avvo assume California law. Answers provided by me are for general information only. They are not legal advice. The exchange of information through this forum does not establish an attorney-client relationship. That relationship is established only by personal and direct consultation with me followed by the execution of a written attorney-client agreement signed by each of us. The communications on this website are not privileged or confidential and I assume no duty to anyone by my participation on Avvo or because I have answered or commented on a question. Also, see Avvo's terms and conditions of use, specifically item 9, incorporated by this reference

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