Maybe you receive an offer from the insurance company while your injuries are healing or you are out of work. It may seem like a good number. How do you know if it's fair?
You need to first know what you can prove about your injury. Then there are other factors that could play into your injury case. Once you understand your claim's value, you have a stronger starting point for injury settlement negotiation.
Table of Contents
- Proving Your Losses
- What Can Be Contested
- Your Injury May Be Worth More Than Your Bills
- Who Was At Fault and How Much Insurance There Is
- Why Injury Settlement Averages Aren't Helpful
- What Will You Take Home From Your Settlement?
- Negotiating With Your Insurance Company
- Valuing Your Injury Claim
Proving Your Losses
You will want to include your medical bills, but this is only part of the equation. Make sure to differentiate between your past expenses and what you may incur in the future.
Collect your hospital bills, doctor visits, prescriptions, physical therapy and any travel expenses to see your doctors. Document your time away from work as well. If you work for someone, get copies of your wages or if you own a business, keep records of your time away from business.
Will you need future treatment? Are there job limitations? Talk to your doctor about what expenses to expect, length of treatment and what may be unknown at this time. You can have a doctor provide an opinion about future expenses. Don't guess, because you can be questioned on your demand.
Keep in mind you may not be able to recover all of your medical bills depending on the state you live in. In Texas, recovery of medical or health care expenses is limited to amounts actually paid or incurred by or on behalf of the claimant. That means the billed total is not automatically recoverable.
What Can Be Contested
You want to make sure you can back up your demand with facts. The insurance company will look at how the accident occurred, who is at fault, if your injury was caused by the incident and how it affected your day to day life.
Make sure your records match from the date of the accident to any follow up visits. The insurance company can question why there was no treatment during certain periods of time.
If you are fighting over liability in your Dallas injury case, an attorney can help you determine who is at fault and what the insurance company should pay for your claim. Freese & Goss provides information about what to expect when dealing with an insurance company regarding medical expenses, lost wages and future treatment.
Some things to include in your case:
- Accident report, photos, witnesses
- Medical records that tie your injury to the accident
- Documentation of lost wages and opportunity
- Future treatment and limitation
Your Injury May Be Worth More Than Your Bills
You may not have bills for all of the ways your injury affected you. You can experience pain, inability to sleep, difficulty walking and not being able to do activities you once enjoyed. These can be compensated for depending on the law in your area.
Describe how these have affected you, but don't overstate your case. Maybe you were able to work long hours without issue, but now you can't. Explain that and for how long you expect to be unable to do these activities.
There is no formula that says you take your medical bills and multiply it by a number to get your pain and suffering. Everyone recovers differently and can suffer from permanent limitations. Make sure you have documentation to support that.
You want to provide the insurance company with dates that they can research. Write down when you experienced pain that prevented you from sleeping or doing activities you normally would do. You can keep a daily log, but don't rely on that alone.
Who Was At Fault and How Much Insurance There Is
Just because you can prove your injury, doesn't mean the other party will admit they are at fault. They can say that you caused part of the accident or that your injuries were caused by something else.
Every state has different laws on who can recover for their injuries. In Texas, if you are found to be more than 50% responsible for your accident, you can't recover for your injury in most cases. If you are found to be partially responsible, your settlement amount can be reduced.
Suppose proven damages total $80,000 and you are found 25% responsible. Under Texas's proportionate responsibility rule, recoverable damages would be reduced by $20,000 to $60,000, before other limits or adjustments. Determining who is at fault can be difficult.
You also need to know how much insurance there is to cover your claim. Someone can have high amounts of damages, but not enough insurance to pay for it all.
These are both numbers to consider when offered a settlement.
Knowing what you can collect becomes difficult when there are multiple insurance companies and/or people to blame. Make sure you understand what you are waiving by releasing the insurance company and others involved.
Why Injury Settlement Averages Aren't Helpful
Settlement averages can be found on many websites, but may not apply to your case.
The Insurance Information Institute states the average bodily injury liability claim was $28,278 in its 2024 private passenger auto data. This does not include all states and is paid claims that include loss adjustment expenses. This is not the average for a lawsuit or how much you should demand for your claim.
As you can see, there are many factors that go into the value of your injury.
Since everyone's injuries are different, the average will not reflect your case.
While you can use this number as an average, you shouldn't base your demand off of this.
What Will You Take Home From Your Settlement?
Your settlement amount may not be the amount you walk away with.
You may have to pay attorney's fees, costs, medical bills and reimburse other parties that have paid for your medical expenses. You may need to negotiate with some of these parties on what they are owed. Each state and situation is different.
Have the attorney give you an estimate of what you would receive from your settlement amount. This way you can see what your gross settlement is and what you will take home.
If you are reimbursing someone, make sure it's included in your costs. Don't double dip on an expense that will come out of your settlement.
Compare what you will take home to your future expenses.
Negotiating With Your Insurance Company
The initial offer may not be a fair number. Saying no to the insurance company may not get you a higher number.
Tell them why you don't think their number is fair. Are there unknown treatment expenses? Provide them with more information on your lost wages or prove they are wrong about who is at fault.
Compare your settlement to what you could get if you went to trial. You could spend more money going to trial, but if you settle your case, you may not account for all your treatment expenses.
Time is also a factor. In Texas, most personal injury lawsuits must be filed within two years after the claim accrues, although exceptions may apply. Negotiating with an insurer does not automatically pause or extend the deadline to file a lawsuit. Check the applicable deadline before it expires.
Know what you are releasing by settling your case.
Valuing Your Injury Claim
There is no set number that is fair for your injury. Use your knowledge of what you can prove, the impact your injury had on your life, who is at fault and what you can collect.
Make sure you are aware of all your evidence, open medical questions, costs and what you are releasing before you decide to settle your case.
