One of the most common questions I get as a personal injury lawyer in Florida is a client calling in who has been injured in some type of an accident, like an auto accident, pedestrian injury or fall for instance, and wanting to know what are the things that will affect or go into understanding the value of their case. What is the insurance adjuster going to need to know in order to evaluate their case?
I can tell you that in general, there are eleven things that I'll point out to you today that a claims adjuster is going to consider in one form or the other.
- Is there evidence that the driver or the person who injured you was at fault? This could be the driver of the car or the owner of a piece of property.
- In an auto accident case, claims adjusters want to know how much damage was done to the car of the person who was injured. Was this an accident that had $50 worth of damage, which is basically a paint transfer or is there $15,000 worth of damage and the car was totaled? Another factor with the property damage would be how much damage was done to the car that ran into them. Many times there won't be great damage done to the injured person's car but the other person's car might have had tremendous damage to it.
- Is there evidence that the injured person may also be somewhat at fault in the accident? That's because Florida is a comparative fault state and the fault of the person involved in the accident can be a factor affecting the value of any case. It doesn't mean that they are partially at fault but in some cases they may be.
- Was there a delay in seeking medical treatment?
- Was the medical treatment reasonable and necessary? They are looking at the overall reasonableness of the care. Did they get into the hands of a provider who unreasonably ran up the medical bills beyond what should have been reasonably necessary for their recovery?
- Was the injury new to them or was it an aggravation to a pre-existing condition?
- How serious is the injury? This takes into the account the extent of the medical bills, the nature of the rehabilitation of treatment, as well as the recovery.
- Are there unpaid medical bills and how much is owed?
- What are the future medical needs of the injured person? Is the doctor saying that the person is more likely to need medical care in the future?
- Has the injured person recovered fully? Have they returned to their normal pre-accident level of activity and feeling? Or do they have restrictions, pain, limitations in their activity and the loss of the ability to enjoy the things that they took for granted in the past?
- Has the injured person lost wages or have they lost the ability to earn wages in the future?
Any claims adjuster is going to take the sum of all of these factors and there might be other factors and they all aren't weighted equally. Every case has issues that make or break a big difference in the case. But, these are general factors that a claims adjuster will consider for these types of cases.
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