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How Insurance Companies Evaluate the Value of a Claim

The Haslam Firm Aug. 23, 2023

In Texas, personal injury and accident victims may be eligible to pursue compensation for their injuries and damages through an insurance claim. Upon filing a claim, the insurance provider will investigate your case and determine the value of your claims using different factors. For this reason, understanding how insurance companies evaluate your claim's value is crucial to recover the maximum available compensation. 

Our experienced Texas personal injury attorneys can evaluate all of the facts of your unique situation, estimate claims value, and help you pursue your rightful financial compensation. We're proud to serve clients across Fort Worth, Dallas, Houston, and areas of Texas. We have many friends across the State and Country that will help us as local counsel. 

Not All Claims Are Equal

Filing a personal injury claim is a crucial step when seeking damages for your injuries. However, it is important to understand that not all claims are equal. Essentially, the insurance provider will evaluate your claim based on your prospect of getting a favorable judgment if you file a personal injury lawsuit. In addition, the insurer will consider the amount of financial compensation that the judge or jury may likely award. 

For instance, if you delay getting medical treatments or fail to visit a qualified doctor after the accident, the insurance carrier may use this as an excuse to reduce your claims. Similarly, if you have an underlying health issue, the insurer may value your injury claims lower than someone without a pre-existing medical condition. The insurance company might argue that the underlying health issue caused your injury and not only the accident. 

Your life will be examined under a microscope. We are here to guide you through the process and try the lawsuit if necessary. If you prepare a case to settle you will either recover little or lose. If you prepare the case for trial, you may

Factors That May Be Considered

Here are some factors that the insurance carrier may consider to determine the value of an injury claim: 

  • The total costs of medical treatments, including medication, surgery, rehabilitation, therapy, and other out-of-pocket expenses due to the injury or accident. 

  • The cost of replacing or repairing your damaged property or vehicle. 

  • The impact of the injury on your ability to work or earn a living. 

  • How much has the injury disrupted your daily life? 

  • The number of days or weeks you're unable to work due to your injuries. 

  • Whether you suffered mental anguish or emotional distress as a result of the accident. 

  • The timeline of your recovery. 

  • Whether you're expected to recover fully. 

  • The available evidence used to support your insurance claims. 

  • The strength of your legal arguments. 

If you or someone you know was involved in an accident, you need to reach out to a seasoned personal injury lawyer immediately. Your legal counsel can investigate your case details, gather substantial evidence, and help pursue your rightful financial compensation. 

Your Actions Factor In

However, the events that led to the accident and what you do – or fail to do – after the incident can have a significant impact on the outcome of your injury claims. 

Comparative Fault

Your contributions to the accident or injury can affect the amount of financial compensation you will likely receive. Texas operates using the comparative negligence system, with a 51% bar. According to the rule, you may be able to pursue damages if the other party was mostly (50% or more) responsible for the occurrence or injury. However, the amount of compensation available to you will be reduced by your fault percentage. 

For example, if the jury finds $70,000 in total damages against the at-fault party but finds you to be 20% liable for the accident or your injuries, your compensation will be reduced by $14,000. You will only receive 80% of $70,000 ($56,000). Under Texas's comparative negligence rule, you will be completely barred from pursuing compensation if you were found to be mostly (51% or more) at fault for the occurrence. 

Failure to Mitigate Damages

Additionally, your failure to take necessary steps to mitigate damages may affect your settlement or judgment. For example, the insurance provider may reduce or deny your claims if you fail to seek medical help and document your injuries. A jury will ook critically at why you waited or delayed medical care. Likewise, if you fail to follow through with your doctor's recommended treatment plan, the insurer and jury may undervalue or deny your claims by arguing that you're not really injured or your condition worsened as a result of your conduct. 

Steps You Can Take to Maximize Compensation

Here are some insightful tips to help maximize your financial compensation after an accident: 

  • Hire a skilled lawyer to help file you negotiate a settlement with the insurer or prosecute the case to verdict and Judgment.

  • Seek immediate medical help from a qualified doctor and properly document your injuries and treatments. 

  • Do not be eager to accept the insurance company's first settlement offer. It is often low and may not cover all your damages. Insurance companies have duties to shareholders to pay as little on claims as possible.

  • Gather relevant information and document everything, including police reports, accident scene pictures, medical reports, and witness statements.  The lawyer can help orhandle this for you.

  • Follow your medical doctors advice and get well as soon as possible. 

  • Consider the cost of future medical treatments and damages. 

  • Avoid posting on social media. What you say can and will be used against you.

  • File your injury claims as soon as possible and before the filing deadline

An experienced personal injury attorney preferably board certified can guide you through the claims process and attempt to recover the maximum possible financial compensation for your damages.  Many attorneys advertise large dollar amounts but treat this simply as a business and they will not challenge the sophisticated insurance defense attorneys in Court.

At The Haslam Firm, we have the experience, history, and diligence to advise you through the process. Getting proper guidance and advocacy when navigating the claims process is crucial for a successful outcome. Contact us at The Haslam Firm today to schedule a case assessment with practiced personal injury attorneys. We're proud to serve clients across Fort Worth, Dallas, and Houston, Texas.