A Medical Authorization Form is essentially a form asking for permission to obtain your medical records and bills directly from your healthcare providers following a car accident. Whether your claim is a Med Pay claim with your own insurance company or a Bodily Injury claim with the other driver’s insurance company, you will likely be asked to sign one. An authorization letter which accompanies the form (presented below from the other driver’s insurer) may look something like this:
Dear Mr. Jones,
Enclosed you will find an authorization form which you must sign and return to us as quickly as possible. This will allow us to obtain medical records from your treating health care providers and medical bills incurred as a result of your accident with our insured so we may evaluate your claim in a timely fashion. A return envelope is enclosed.
Thank you very much.
Sincerely,
Tom Stine, Adjuster
The adjuster needs to obtain copies of your doctor’s notes, the hospital records, prescriptions you may have been given, bills for treatment, and any other documentation related to your injuries in order to investigate your claim and to determine how much to offer you to settle it. In addition to medical documents, the insurance company may also ask you to sign an authorization allowing them to request your work records from your employer if you are claiming lost wages.
While an authorization saves you from having to collect this documentation from your healthcare providers yourself, keep in mind that insurance companies don’t do this to be helpful; they do it to get information about you!
CAUTION: Watch the wording of the authorization. If, by signing it, you are providing them with the ability to obtain any and all of your medical records, whether related to the accident or not, some of the information may be used against you in negotiating a settlement of your claim. If you are not sure what the authorization is requesting, you should certainly consult an auto accident attorney before signing it.
Note that if you are unable to reach a settlement of your claim with the insurance company and you eventually file suit against the responsible driver, the other driver’s attorney is likely to subpoena (make a legal demand for) all of your medical records and all of your employment records if there is any reason for them to believe they might be relevant to the evaluation of your case.
Monday, August 15, 2011
When Your Car Insurance Claim Is Denied
There are many reasons a car accident claim can be denied, valid or not. If your car insurance claim was denied, take note of the reason(s) given in the insurance company’s denial letter. Then take out your insurance policy and begin reading. The denial could be an error based on a lack of complete information or misinformation. But it could also be a correct determination by the insurance company.
Some common reasons for denial are:
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No car insurance coverage was purchased for the claim presented. For example, if you drive an older vehicle, you may carry only liability insurance and have no collision coverage because it is expensive. A claim under your policy for damage to your own vehicle will rightfully be denied.
You made an Uninsured Motorist Claim under your policy and it turns out the other party to the accident was insured.
You do not qualify as a named insured under the policy. For example, you are a teenager and you are specifically excluded under your parents’ policy because your parents do not expect you to drive their vehicle.
Your coverage has lapsed because you failed to pay your premium before the end of the grace period.
The amount of damage claimed exceeds your policy limits and the insurance company will not cover the excess.
You bought a new car and failed to notify the insurance company to add it to the policy within the specified time given in the policy.
If, after reading the insurance company’s reasons and reviewing your policy, you still believe coverage has been wrongfully denied, there are some steps you may take to try to remedy the situation. You have certain rights under your policy and under state law. Your insurance company has a duty to fairly and promptly settle your car accident insurance claim in good faith.
Steps you can take if coverage has been wrongfully denied:
Write back to the insurance company to tell them where their mistake is and provide them with documentation to support your response.
Appeal the company’s decision to the State Insurance Commissioner.
Hire an insurance bad faith attorney to discuss the error with the insurance company.
Sue the insurance company for bad faith, breach of contract, and/or violations of your state’s insurance code.
If the insurance company realizes its mistake, or you are correct in that the adjuster made an error, they will reopen your claim and move forward with their investigation. Where you don’t understand their reason for denial, ask for clarification. It would be wise to consult an attorney to make sure they are not erroneously denying your claim.
CAUTION: Your insurance company is required to act in good faith when handling your car accident claim. If the insurance company unnecessarily denies your claim or fails to promptly settle it, you can sue them for bad faith, breach of contract, and violations of your state’s insurance code. It is crucial that you seek out an auto accident attorney who is experienced in insurance coverage litigation if you believe your insurance company is not handling your claim fairly.
car insurance rates
Note that if your car accident claim is with the insurance company for the other driver involved in the car accident, a failure to settle promptly or fairly is not a denial of the claim. You should contact an attorney to either negotiate a settlement for you or to file suit against the responsible driver. Under some circumstances and in some states, you may also file a complaint with the State’s Department of Insurance for Third Party Bad Faith. Seek advice from an attorney to see if yours is one of those states.
car insurance rates
Some common reasons for denial are:
car insurance rates
No car insurance coverage was purchased for the claim presented. For example, if you drive an older vehicle, you may carry only liability insurance and have no collision coverage because it is expensive. A claim under your policy for damage to your own vehicle will rightfully be denied.
You made an Uninsured Motorist Claim under your policy and it turns out the other party to the accident was insured.
You do not qualify as a named insured under the policy. For example, you are a teenager and you are specifically excluded under your parents’ policy because your parents do not expect you to drive their vehicle.
Your coverage has lapsed because you failed to pay your premium before the end of the grace period.
The amount of damage claimed exceeds your policy limits and the insurance company will not cover the excess.
You bought a new car and failed to notify the insurance company to add it to the policy within the specified time given in the policy.
If, after reading the insurance company’s reasons and reviewing your policy, you still believe coverage has been wrongfully denied, there are some steps you may take to try to remedy the situation. You have certain rights under your policy and under state law. Your insurance company has a duty to fairly and promptly settle your car accident insurance claim in good faith.
Steps you can take if coverage has been wrongfully denied:
Write back to the insurance company to tell them where their mistake is and provide them with documentation to support your response.
Appeal the company’s decision to the State Insurance Commissioner.
Hire an insurance bad faith attorney to discuss the error with the insurance company.
Sue the insurance company for bad faith, breach of contract, and/or violations of your state’s insurance code.
If the insurance company realizes its mistake, or you are correct in that the adjuster made an error, they will reopen your claim and move forward with their investigation. Where you don’t understand their reason for denial, ask for clarification. It would be wise to consult an attorney to make sure they are not erroneously denying your claim.
CAUTION: Your insurance company is required to act in good faith when handling your car accident claim. If the insurance company unnecessarily denies your claim or fails to promptly settle it, you can sue them for bad faith, breach of contract, and violations of your state’s insurance code. It is crucial that you seek out an auto accident attorney who is experienced in insurance coverage litigation if you believe your insurance company is not handling your claim fairly.
car insurance rates
Note that if your car accident claim is with the insurance company for the other driver involved in the car accident, a failure to settle promptly or fairly is not a denial of the claim. You should contact an attorney to either negotiate a settlement for you or to file suit against the responsible driver. Under some circumstances and in some states, you may also file a complaint with the State’s Department of Insurance for Third Party Bad Faith. Seek advice from an attorney to see if yours is one of those states.
car insurance rates
Evaluating Your Own Car Insurance Claim
As lay people, we’re not trained to evaluate accident claims—adjusters are. But if you are handling your own insurance claim, you must become educated in evaluating such claims or you can easily be taken advantage of and not get the compensation to which you are entitled. Here are some guidelines that will help:
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Facts
Know the facts about your accident. Be consistent with your story, especially if the other party is saying something different. This will help you to be credible in the adjuster’s eyes.
car insurance quotes
Liability
Whose fault was it? If it was clearly the other driver’s fault, liability probably won’t be an issue. However, if it was partially your fault, check out your state’s comparative or contributory negligence laws. In some states, your partial responsibility for the accident will bar you from recovering any money at all. In other states, you can get a percentage of your damages. CAUTION: When liability is not clear, or when it is shared, you would be wise to have an attorny, evaluate your case, give you advice, and/or handle the case to its conclusion.
Injuries
Were you injured? Document your injuries, treatment, prognosis for recovery, and temporary or permanent disability with copies of medical reports.
car insurance quotes
Claimed Expenses
What expenses can you claim as a result of the accident? You will be required to lay out for the adjuster all of your medical expenses, including ambulance, emergency room, hospital, doctor visits, medicines, medical equipment, etc. Will you require future medical treatment? Get an estimate of future costs from your health care providers. Did you lose any income? You’ll need proof from your employer. What about other expenses, like transportation to your appointments or hiring home assistance such as a babysitter or a housekeeper? Did your spouse stay home to care for you and lose income as a result? CAUTION: The more complicated or difficult to prove your claimed expenses are, the more you should consider turning your case over to an attorney or getting some legal advice.
Special Factors
Are there any special factors that you would like the adjuster to consider that might make your claim worth more? Such things as your age, your occupation, the fact that you cared for your elderly parent and can no longer do that. Whatever your individual situation is, it might very well add value to your claim, so don’t keep quiet about it.
Damages
You are entitled to be compensated for your medical and other expenses (special damages) along with general damages, which includes money for pain and suffering. Even though adjusters will tell you there is no formula to figure out the value of pain and suffering, if you are doing this on your own, a good place to start is in the neighborhood of three to 5 times the special damages. CAUTION: If you are convinced your claim is worth much more, consult an attorney for advice on value.
car insurance quotes
Negotiations
Be ready to negotiate! Don’t just roll over and take what the adjuster offers unless you truly think it is a fair offer. Otherwise, regard it as his opening bid and the ball is now in your court.
car insurance quotes
Facts
Know the facts about your accident. Be consistent with your story, especially if the other party is saying something different. This will help you to be credible in the adjuster’s eyes.
car insurance quotes
Liability
Whose fault was it? If it was clearly the other driver’s fault, liability probably won’t be an issue. However, if it was partially your fault, check out your state’s comparative or contributory negligence laws. In some states, your partial responsibility for the accident will bar you from recovering any money at all. In other states, you can get a percentage of your damages. CAUTION: When liability is not clear, or when it is shared, you would be wise to have an attorny, evaluate your case, give you advice, and/or handle the case to its conclusion.
Injuries
Were you injured? Document your injuries, treatment, prognosis for recovery, and temporary or permanent disability with copies of medical reports.
car insurance quotes
Claimed Expenses
What expenses can you claim as a result of the accident? You will be required to lay out for the adjuster all of your medical expenses, including ambulance, emergency room, hospital, doctor visits, medicines, medical equipment, etc. Will you require future medical treatment? Get an estimate of future costs from your health care providers. Did you lose any income? You’ll need proof from your employer. What about other expenses, like transportation to your appointments or hiring home assistance such as a babysitter or a housekeeper? Did your spouse stay home to care for you and lose income as a result? CAUTION: The more complicated or difficult to prove your claimed expenses are, the more you should consider turning your case over to an attorney or getting some legal advice.
Special Factors
Are there any special factors that you would like the adjuster to consider that might make your claim worth more? Such things as your age, your occupation, the fact that you cared for your elderly parent and can no longer do that. Whatever your individual situation is, it might very well add value to your claim, so don’t keep quiet about it.
Damages
You are entitled to be compensated for your medical and other expenses (special damages) along with general damages, which includes money for pain and suffering. Even though adjusters will tell you there is no formula to figure out the value of pain and suffering, if you are doing this on your own, a good place to start is in the neighborhood of three to 5 times the special damages. CAUTION: If you are convinced your claim is worth much more, consult an attorney for advice on value.
car insurance quotes
Negotiations
Be ready to negotiate! Don’t just roll over and take what the adjuster offers unless you truly think it is a fair offer. Otherwise, regard it as his opening bid and the ball is now in your court.
Car Accidents And Bodily Injury In A No-Fault State
If you have been injured in an automobile accident, in about a quarter of states, it does not matter who was at fault in order for you to recover money under an insurance policy. Regardless of who was at fault, in a no-fault state, your own insurance policy will protect you and provide you with immediate medical treatment. That’s the good news. The not-so-good news is that in no-fault states you are limited in your ability to sue the negligent driver for damages.
There are currently nine states that are considered “No-Fault” and three additional states which are “Choice” states, where you are given a choice of purchasing a no-fault policy or a “tort policy”. The tort policy is the same type of fault policy as in the majority of states. If you have a tort policy in a choice state, the claims procedures are the same as if you are in a fault state and you retain your right to sue the neligent party with few limitations. In general, tort policies have higher premiums.
The No-Fault states are: Hawaii, Florida, Kansas, Massachusetts, Michigan, Minnesota, North Dakota, New York and Utah. The Choice states are Kentucky, New Jersey, Pennsylvania, plus the District of Columbia.
Under a pure no-fault system, your own auto insurance policy would pay for any economic damages including medical bills and lost wages up to your policy limits. You would be prohibited from suing a negligent driver for general damages such as pain and suffering, loss of companionship, etc. Currently, there are no pure no-fault states. All of the no-fault states have somewhat of a modified system where your insurer pays for your economic damages up to the policy limits, but you may be allowed to sue for non-economic or general damages (i.e., pain and suffering, loss of services, etc.) if those damages exceed a certain level. In some states that level is $250,000; in others it is higher, and in still others, you or your family may sue only if the injuries are “serious” or resulted in death, regardless of the dollar amount.
The section of your policy that covers you for bodily injuries (and your bodily injury claims) in a no-fault state is called Personal Injury Protection, or PIP. Although different states cover different things, in general, PIP covers your medical bills, lost wages, funeral costs and death benefits up to your policy limits. Most of the states have a minimum of $10,000 coverage for PIP which can be increased for a higher premium. In some states you can decrease your premium by applying a deductible.
No-fault insurance coverage can be very complex and you may want to consult a personal injury lawyer to help you through the process. Here is an example of how complicated it is in Massachusetts. There, every driver must carry personal injury protection (PIP) coverage with a minimum of $8,000 per person which covers the following benefits:
Medical expenses (including eye glasses, prosthetic devices, funeral services and professional nursing);
Seventy five (75%) percent of lost wages or lost earning power if unemployed; and,
Payment to people for necessary services they rendered to the household, which the injured party would have performed without pay (i.e. cleaning, etc.).
Your Massachusetts PIP coverage will only pay the first $2,000 of your medical bills, but will cover up to total of $8,000, if you have no other health insurance. The expenses or losses must be incurred within two (2) years from the date of the accident.
In Massachusetts, you may sue the negligent driver for general damages only under these circumstances:
Your reasonable and necessary medical bills exceed $2,000, or
There is permanent or serious disfigurement, or
A fracture, or
Partial or complete loss of a body part, or
Loss of sight or hearing, or
Death
All of the other No-Fault and Choice states are variations on this theme, but with some major differences in limits and rules for filing suit. Check with your insurance agent, your insurance company, your state’s Department of Insurance, or a car accident lawyer if you have any questions about your state’s rules, individual coverages or your right to sue.
There are currently nine states that are considered “No-Fault” and three additional states which are “Choice” states, where you are given a choice of purchasing a no-fault policy or a “tort policy”. The tort policy is the same type of fault policy as in the majority of states. If you have a tort policy in a choice state, the claims procedures are the same as if you are in a fault state and you retain your right to sue the neligent party with few limitations. In general, tort policies have higher premiums.
The No-Fault states are: Hawaii, Florida, Kansas, Massachusetts, Michigan, Minnesota, North Dakota, New York and Utah. The Choice states are Kentucky, New Jersey, Pennsylvania, plus the District of Columbia.
Under a pure no-fault system, your own auto insurance policy would pay for any economic damages including medical bills and lost wages up to your policy limits. You would be prohibited from suing a negligent driver for general damages such as pain and suffering, loss of companionship, etc. Currently, there are no pure no-fault states. All of the no-fault states have somewhat of a modified system where your insurer pays for your economic damages up to the policy limits, but you may be allowed to sue for non-economic or general damages (i.e., pain and suffering, loss of services, etc.) if those damages exceed a certain level. In some states that level is $250,000; in others it is higher, and in still others, you or your family may sue only if the injuries are “serious” or resulted in death, regardless of the dollar amount.
The section of your policy that covers you for bodily injuries (and your bodily injury claims) in a no-fault state is called Personal Injury Protection, or PIP. Although different states cover different things, in general, PIP covers your medical bills, lost wages, funeral costs and death benefits up to your policy limits. Most of the states have a minimum of $10,000 coverage for PIP which can be increased for a higher premium. In some states you can decrease your premium by applying a deductible.
No-fault insurance coverage can be very complex and you may want to consult a personal injury lawyer to help you through the process. Here is an example of how complicated it is in Massachusetts. There, every driver must carry personal injury protection (PIP) coverage with a minimum of $8,000 per person which covers the following benefits:
Medical expenses (including eye glasses, prosthetic devices, funeral services and professional nursing);
Seventy five (75%) percent of lost wages or lost earning power if unemployed; and,
Payment to people for necessary services they rendered to the household, which the injured party would have performed without pay (i.e. cleaning, etc.).
Your Massachusetts PIP coverage will only pay the first $2,000 of your medical bills, but will cover up to total of $8,000, if you have no other health insurance. The expenses or losses must be incurred within two (2) years from the date of the accident.
In Massachusetts, you may sue the negligent driver for general damages only under these circumstances:
Your reasonable and necessary medical bills exceed $2,000, or
There is permanent or serious disfigurement, or
A fracture, or
Partial or complete loss of a body part, or
Loss of sight or hearing, or
Death
All of the other No-Fault and Choice states are variations on this theme, but with some major differences in limits and rules for filing suit. Check with your insurance agent, your insurance company, your state’s Department of Insurance, or a car accident lawyer if you have any questions about your state’s rules, individual coverages or your right to sue.
Online Insurance Policies And Settling An Auto Accident Claim
Generally speaking, negotiating settlements with an insurer is the same whether you purchased your policy from an agent or online. The largest insurers offering online policy purchasing , such as Geico, Progressive and esurance.com, have adjusters who will be assigned to you when making a claim and negotiating settlements. Online insurers generally have adjusters all over the country and may use outside adjusters to serve you. If you’re one of the few who still head down to your local insurance agent’s office to do this, buying a policy online might not be
Buying insurance policies online is still a relatively new concept and admittedly, there are still kinks that need to be ironed out. As such, make sure that your insurance contract specifies how your insurer will handle claims, adjuster issues and settlements. Also, check out the insurer’s customer satisfaction ratings to see what kind of service others have received. For company reviews, see the Free Advice Insurance Center.
Buying insurance policies online is still a relatively new concept and admittedly, there are still kinks that need to be ironed out. As such, make sure that your insurance contract specifies how your insurer will handle claims, adjuster issues and settlements. Also, check out the insurer’s customer satisfaction ratings to see what kind of service others have received. For company reviews, see the Free Advice Insurance Center.
Car Accidents And The Claims Process
After you’ve submitted your claim to your insurance company, a claims adjuster will usually be assigned to your claim to investigate. You should receive a phone call, letter or email from the adjuster introducing him or herself and informing you of the general process their company – your company – follows. The adjuster will review your policy to see what coverage and deductibles you have and evaluate the type and extent of damage and/or injuries that resulted from the accident.
Some claims are simple; some are not. Here’s what you can expect from each:
Simple claims. In cases where there is no question as to what happened (e.g.: you backed into a tree, were not injured and had $100 worth of damage to your vehicle), the adjuster may simply have you get an estimate for the cost of repairing the car and pay that amount. You’ll have to complete some paperwork, but an in-person meeting is usually not required.
Difficult claims. In difficult cases where fault is at issue, several vehicles were involved or unusual circumstances surrounded the accident (bad weather, construction, etc.), the adjuster will generally contact those involved in the accident, including drivers, passengers, witnesses, and possibly the police officer who came to the scene to get accurate details of what really happened. The claims adjuster may conduct interviews, either in person or by phone, research traffic laws where the accident occurred and review photos of damage and hospital records to collect additional information. Once the adjuster has all the information, the claim is sent for processing and payment. Again, you’ll have to complete a certain amount of paperwork and may have to meet with an adjuster in this scenario.
How long does the process take? Generally speaking, easy cases can be settled in a matter of weeks. Difficult cases may, and generally do, take much longer – especially when fault is at issue. However, because every accident has its own facts and circumstances, determining an exact amount of time is difficult. Try not to have expectations of when the matter will be resolved, but…
Don’t sit back and wait! Once you’ve submitted a claim, don’t sit back and wait. Check in with your claims adjuster from time to time, either by phone or email, to see what progress has been made on your claim. Claims adjusters usually have hundreds of claims to settle; don’t let yours fall to the bottom of the pile.
For more help on auto insurance claims, go to the Free Advice Auto Insurance Center. For information about auto accident law, check out the Free Advice Auto Accident FAQs. To find an experienced accident and injury attorney, go to AttorneyPages.com.
Some claims are simple; some are not. Here’s what you can expect from each:
Simple claims. In cases where there is no question as to what happened (e.g.: you backed into a tree, were not injured and had $100 worth of damage to your vehicle), the adjuster may simply have you get an estimate for the cost of repairing the car and pay that amount. You’ll have to complete some paperwork, but an in-person meeting is usually not required.
Difficult claims. In difficult cases where fault is at issue, several vehicles were involved or unusual circumstances surrounded the accident (bad weather, construction, etc.), the adjuster will generally contact those involved in the accident, including drivers, passengers, witnesses, and possibly the police officer who came to the scene to get accurate details of what really happened. The claims adjuster may conduct interviews, either in person or by phone, research traffic laws where the accident occurred and review photos of damage and hospital records to collect additional information. Once the adjuster has all the information, the claim is sent for processing and payment. Again, you’ll have to complete a certain amount of paperwork and may have to meet with an adjuster in this scenario.
How long does the process take? Generally speaking, easy cases can be settled in a matter of weeks. Difficult cases may, and generally do, take much longer – especially when fault is at issue. However, because every accident has its own facts and circumstances, determining an exact amount of time is difficult. Try not to have expectations of when the matter will be resolved, but…
Don’t sit back and wait! Once you’ve submitted a claim, don’t sit back and wait. Check in with your claims adjuster from time to time, either by phone or email, to see what progress has been made on your claim. Claims adjusters usually have hundreds of claims to settle; don’t let yours fall to the bottom of the pile.
For more help on auto insurance claims, go to the Free Advice Auto Insurance Center. For information about auto accident law, check out the Free Advice Auto Accident FAQs. To find an experienced accident and injury attorney, go to AttorneyPages.com.
Car Accidents And The Claims Process
After you’ve submitted your claim to your insurance company, a claims adjuster will usually be assigned to your claim to investigate. You should receive a phone call, letter or email from the adjuster introducing him or herself and informing you of the general process their company – your company – follows. The adjuster will review your policy to see what coverage and deductibles you have and evaluate the type and extent of damage and/or injuries that resulted from the accident.
Some claims are simple; some are not. Here’s what you can expect from each:
Simple claims. In cases where there is no question as to what happened (e.g.: you backed into a tree, were not injured and had $100 worth of damage to your vehicle), the adjuster may simply have you get an estimate for the cost of repairing the car and pay that amount. You’ll have to complete some paperwork, but an in-person meeting is usually not required.
Difficult claims. In difficult cases where fault is at issue, several vehicles were involved or unusual circumstances surrounded the accident (bad weather, construction, etc.), the adjuster will generally contact those involved in the accident, including drivers, passengers, witnesses, and possibly the police officer who came to the scene to get accurate details of what really happened. The claims adjuster may conduct interviews, either in person or by phone, research traffic laws where the accident occurred and review photos of damage and hospital records to collect additional information. Once the adjuster has all the information, the claim is sent for processing and payment. Again, you’ll have to complete a certain amount of paperwork and may have to meet with an adjuster in this scenario.
How long does the process take? Generally speaking, easy cases can be settled in a matter of weeks. Difficult cases may, and generally do, take much longer – especially when fault is at issue. However, because every accident has its own facts and circumstances, determining an exact amount of time is difficult. Try not to have expectations of when the matter will be resolved, but…
Don’t sit back and wait! Once you’ve submitted a claim, don’t sit back and wait. Check in with your claims adjuster from time to time, either by phone or email, to see what progress has been made on your claim. Claims adjusters usually have hundreds of claims to settle; don’t let yours fall to the bottom of the pile.
For more help on auto insurance claims, go to the Free Advice Auto Insurance Center. For information about auto accident law, check out the Free Advice Auto Accident FAQs. To find an experienced accident and injury attorney, go to AttorneyPages.com.
Some claims are simple; some are not. Here’s what you can expect from each:
Simple claims. In cases where there is no question as to what happened (e.g.: you backed into a tree, were not injured and had $100 worth of damage to your vehicle), the adjuster may simply have you get an estimate for the cost of repairing the car and pay that amount. You’ll have to complete some paperwork, but an in-person meeting is usually not required.
Difficult claims. In difficult cases where fault is at issue, several vehicles were involved or unusual circumstances surrounded the accident (bad weather, construction, etc.), the adjuster will generally contact those involved in the accident, including drivers, passengers, witnesses, and possibly the police officer who came to the scene to get accurate details of what really happened. The claims adjuster may conduct interviews, either in person or by phone, research traffic laws where the accident occurred and review photos of damage and hospital records to collect additional information. Once the adjuster has all the information, the claim is sent for processing and payment. Again, you’ll have to complete a certain amount of paperwork and may have to meet with an adjuster in this scenario.
How long does the process take? Generally speaking, easy cases can be settled in a matter of weeks. Difficult cases may, and generally do, take much longer – especially when fault is at issue. However, because every accident has its own facts and circumstances, determining an exact amount of time is difficult. Try not to have expectations of when the matter will be resolved, but…
Don’t sit back and wait! Once you’ve submitted a claim, don’t sit back and wait. Check in with your claims adjuster from time to time, either by phone or email, to see what progress has been made on your claim. Claims adjusters usually have hundreds of claims to settle; don’t let yours fall to the bottom of the pile.
For more help on auto insurance claims, go to the Free Advice Auto Insurance Center. For information about auto accident law, check out the Free Advice Auto Accident FAQs. To find an experienced accident and injury attorney, go to AttorneyPages.com.
Auto Insurance Center
Generally speaking, it depends on what happened and what injuries were suffered, and to whom. If you and your family members have not been hurt, the answer is probably no. If you or anyone you care about has been injured in the car accident, especially if there is any permanent injury, or significant time is lost from work or school or household duties, then you’ll want to see a lawyer about possibly representing you in a claim against anyone else who may be responsible for your injuries. However, even if you’re not injured, don’t entirely rule it out as the facts and circumstances surrounding car accidents are always different. It is important to look at the degree of the car accident and use your best judgment. A simple fender bender where no occupants are hurt can usually be appropriately handled through your insurer. Anything other than that deserves a bit more thought – especially in this litigious environment.
When to run to an attorney and when to walk. Contacting an attorney who deals with personal injury (especially relating to auto accidents) can provide you with the peace of mind that no stone gets left unturned. Here are some tips for when you should run to an attorney and when you can just walk:
Run to an attorney when:
An injury has occurred where there has been serious injury (broken bones / hospitalization) or where injuries are likely to be permanent (paralysis);
A death has resulted from the accident;
Fault is clearly an issue;
Other parties were involved such as pedestrians or other autos;
The accident occurred in a construction area;
A police report does not accurately describe the accident and puts you at fault;
Important technical, legal or medical issues are involved;
The limits of your liability insurance are low,
You have no insurance,, or your insurance company suggests that you did not pay your premium.
Your insurer starts “acting funny.”
Your insurer involves its own attorney (in this case, sprint!).
Walk to an attorney when:
Seeking advice on the settlement value of a claim (while not an exact science, attorneys may be able to provide best and worse case scenarios);
Unsure if other insurance (homeowners, travel, etc.) may be available;
Fault may be an issue;
Determining whether your insurer may be acting in bad faith (not looking out for your best interests);
Seeking information on how to handle negotiations with an insurer;
You don’t know your rights;
Confused over the terms of your policy;
Needing an expert to review confusing paperwork or forms.
Finding an attorney is easy and most attorneys listed provide free initial consultations. If you’re not certain that you want to contact an attorney, check out FreeAdvice.com Auto Accidents for FAQs or the Auto Accidents Forums section where you can post a question to see how others may have handled similar situations.
When to run to an attorney and when to walk. Contacting an attorney who deals with personal injury (especially relating to auto accidents) can provide you with the peace of mind that no stone gets left unturned. Here are some tips for when you should run to an attorney and when you can just walk:
Run to an attorney when:
An injury has occurred where there has been serious injury (broken bones / hospitalization) or where injuries are likely to be permanent (paralysis);
A death has resulted from the accident;
Fault is clearly an issue;
Other parties were involved such as pedestrians or other autos;
The accident occurred in a construction area;
A police report does not accurately describe the accident and puts you at fault;
Important technical, legal or medical issues are involved;
The limits of your liability insurance are low,
You have no insurance,, or your insurance company suggests that you did not pay your premium.
Your insurer starts “acting funny.”
Your insurer involves its own attorney (in this case, sprint!).
Walk to an attorney when:
Seeking advice on the settlement value of a claim (while not an exact science, attorneys may be able to provide best and worse case scenarios);
Unsure if other insurance (homeowners, travel, etc.) may be available;
Fault may be an issue;
Determining whether your insurer may be acting in bad faith (not looking out for your best interests);
Seeking information on how to handle negotiations with an insurer;
You don’t know your rights;
Confused over the terms of your policy;
Needing an expert to review confusing paperwork or forms.
Finding an attorney is easy and most attorneys listed provide free initial consultations. If you’re not certain that you want to contact an attorney, check out FreeAdvice.com Auto Accidents for FAQs or the Auto Accidents Forums section where you can post a question to see how others may have handled similar situations.
Auto Insurance Center
When you are injured in a car accident and the person at fault is either the driver of the other vehicle or, if you are a passenger, the driver of the car in which you are riding, you may file a bodily injury claim with that driver’s insurance company.
The person who handles your claim is called a claims adjuster, and he or she will want to take a recorded statement from you regarding the facts of the accident, the damage to the vehicles, and in what way you were injured. Please keep in mind that it is the adjuster’s job to have you minimize your car accident claim so the insurance company doesn’t have to pay out a lot of money to settle it. If you have more than a very minor injury, you may want to speak to a lawyer first so you avoid saying or signing the wrong thing and hurting your chances of getting the settlement you deserve to make you “whole” again. Without an attorney, be prepared to answer on your own, questions such as:
What injuries do you have?
Did you leave the scene of the accident in an ambulance?
What medical treatment have you received?
What medical providers have treated you?
What was the doctor’s diagnosis?
Are you still being treated?
Do you have a history of injury to the same body parts?
When was the last time prior to the accident that you were treated for pain to these body parts?
Do you have any residual pain or injuries?
How much were your medical bills?
Whether you deal with the adjuster on your own, or with the assistance of a car accident lawyer, in addition to the above questions, here is what to expect. You will be asked to supply sufficient documentation to support your claim. This may include a request to sign a medical authorization, allowing the insurance company to obtain your medical records and bills from your treating healthcare providers. (See Medical Authorization Forms.) You will be asked for proof of lost wages or lost income. If you are self-employed, this may include your income tax records for the previous year or more. Documentation supporting other expenses you may be claiming will be requested, as well, such as receipts for travel to medical appointments, cancelled checks to pay a housekeeper if you couldn’t take care of your home yourself, etc. Then you or your attorney will have to negotiate a settlement.
Note that bodily injury claims may have a dollar limit or strict rules regarding when you can and cannot sue in some states where they have only “no-fault” auto insurance policies. Most states are “fault-based” and if the party you are filing a claim against was partially or totally at fault for the accident, you should get a fair settlement or you are allowed to sue. In a no-fault state, however, you file your injury claim not with the responsible party’s insurance company, but with a special coverage on your own policy called Personal Injury Protection (PIP). (See Bodily Injury in a No-Fault State and Bodily Injury in a Choice State.) You may still sue the responsible party, but only if there were serious injuries or death. Other rules may apply, as well. (See Fault and No-Fault Car Accidents: Who Pays the Bills? for more information about fault and no-fault laws and states.)
It is important to check with your insurance company, your state’s department of insurance or an attorney if you have any questions about your state’s rules, your individual coverages, and your right to sue.
The person who handles your claim is called a claims adjuster, and he or she will want to take a recorded statement from you regarding the facts of the accident, the damage to the vehicles, and in what way you were injured. Please keep in mind that it is the adjuster’s job to have you minimize your car accident claim so the insurance company doesn’t have to pay out a lot of money to settle it. If you have more than a very minor injury, you may want to speak to a lawyer first so you avoid saying or signing the wrong thing and hurting your chances of getting the settlement you deserve to make you “whole” again. Without an attorney, be prepared to answer on your own, questions such as:
What injuries do you have?
Did you leave the scene of the accident in an ambulance?
What medical treatment have you received?
What medical providers have treated you?
What was the doctor’s diagnosis?
Are you still being treated?
Do you have a history of injury to the same body parts?
When was the last time prior to the accident that you were treated for pain to these body parts?
Do you have any residual pain or injuries?
How much were your medical bills?
Whether you deal with the adjuster on your own, or with the assistance of a car accident lawyer, in addition to the above questions, here is what to expect. You will be asked to supply sufficient documentation to support your claim. This may include a request to sign a medical authorization, allowing the insurance company to obtain your medical records and bills from your treating healthcare providers. (See Medical Authorization Forms.) You will be asked for proof of lost wages or lost income. If you are self-employed, this may include your income tax records for the previous year or more. Documentation supporting other expenses you may be claiming will be requested, as well, such as receipts for travel to medical appointments, cancelled checks to pay a housekeeper if you couldn’t take care of your home yourself, etc. Then you or your attorney will have to negotiate a settlement.
Note that bodily injury claims may have a dollar limit or strict rules regarding when you can and cannot sue in some states where they have only “no-fault” auto insurance policies. Most states are “fault-based” and if the party you are filing a claim against was partially or totally at fault for the accident, you should get a fair settlement or you are allowed to sue. In a no-fault state, however, you file your injury claim not with the responsible party’s insurance company, but with a special coverage on your own policy called Personal Injury Protection (PIP). (See Bodily Injury in a No-Fault State and Bodily Injury in a Choice State.) You may still sue the responsible party, but only if there were serious injuries or death. Other rules may apply, as well. (See Fault and No-Fault Car Accidents: Who Pays the Bills? for more information about fault and no-fault laws and states.)
It is important to check with your insurance company, your state’s department of insurance or an attorney if you have any questions about your state’s rules, your individual coverages, and your right to sue.
Pet Insurance and Auto Accidents
Whether it’s a drive across the country for vacation, a trip to the local burger joint to share a bag of fries, or a trip to the vet, most pet owners have their animals in the car at some point. The happy dog-face poking out from the passenger-side window is almost an iconic American image, after all. What happens to little Fido or FiFi if you’re in an accident while they’re with you, though?
The good news is that if a pet is injured or killed in a car accident, it is covered by most insurers, as part of your property damage liability insurance – pets, in this case – are considered just one more kind of property – but there are standard restrictions, and one of them is that the at-fault person is liable for the damages.
What this means is that if you’re in an accident, and it’s not your fault, the other driver’s insurance will extend to any injury to your pet, but in most cases, if it is your fault, there is no coverage. This is because bodily injury coverage has been designated for humans only, by the insurance industry. ANY damage in an accident that isn’t an injury to you or your human passengers is considered property damage.
What Do You Do to Protect Your Pet?
There are several options you have in protecting your dog or cat when they’re in the car with you. They include:
Seek out insurance companies with pet-specific auto insurance coverage. Progressive was the first to offer such a policy, but there may be others.
Crate your animal in the car. The best way to protect your pet is to prevent an injury. Restricting your dog or cat to a travel crate or pet carrier in the car protects them from being launched across the car, as well as prevents them from distracting you. Moreover, in many states having a loose animal in a moving vehicle is illegal.
Consider pet insurance. There are several pet insurance companies with inexpensive policies available to cover your pet in the case of accident or illness. While this won’t keep your animal safe in the car, it will help offset any vet fees if your dog or cat is injured in a car crash.
For many of you, pets are part of the family. Just as you require your children to wear seatbelts, and carry them on your insurance policy, so, to, should you restrict your pets’ movement in a car, and consider pet insurance in case of an accident.
The good news is that if a pet is injured or killed in a car accident, it is covered by most insurers, as part of your property damage liability insurance – pets, in this case – are considered just one more kind of property – but there are standard restrictions, and one of them is that the at-fault person is liable for the damages.
What this means is that if you’re in an accident, and it’s not your fault, the other driver’s insurance will extend to any injury to your pet, but in most cases, if it is your fault, there is no coverage. This is because bodily injury coverage has been designated for humans only, by the insurance industry. ANY damage in an accident that isn’t an injury to you or your human passengers is considered property damage.
What Do You Do to Protect Your Pet?
There are several options you have in protecting your dog or cat when they’re in the car with you. They include:
Seek out insurance companies with pet-specific auto insurance coverage. Progressive was the first to offer such a policy, but there may be others.
Crate your animal in the car. The best way to protect your pet is to prevent an injury. Restricting your dog or cat to a travel crate or pet carrier in the car protects them from being launched across the car, as well as prevents them from distracting you. Moreover, in many states having a loose animal in a moving vehicle is illegal.
Consider pet insurance. There are several pet insurance companies with inexpensive policies available to cover your pet in the case of accident or illness. While this won’t keep your animal safe in the car, it will help offset any vet fees if your dog or cat is injured in a car crash.
For many of you, pets are part of the family. Just as you require your children to wear seatbelts, and carry them on your insurance policy, so, to, should you restrict your pets’ movement in a car, and consider pet insurance in case of an accident.
I live in a state that has a limit on how much you can get for non-economic damages. Will I be compensated for the pain and suffering caused by my car accident?
When you are injured in an accident and you make a claim for damages, they are divided into economic and non-economic damages. Economic damages are those that are easily quantifiable, such as medical bills, lost wages, prescription medicines, transportation to and from the doctor, the cost of a housekeeper to do the cleaning while you are unable to, and other expenses. If the accident was the other party’s fault, you will be reimbursed for your reasonable and necessary economic losses (unless you live in a “no-fault” state).
Non-economic damages are those that are not easily quantifiable and include inconvenience and pain and suffering. In most states, there are no limitations when it comes to damages for pain and suffering, but that is changing. If you live in a state that places a limit on compensation for pain and suffering, that limit is the maximum you can get. In states that have such a limit, it is often in the amount of $250,000 or $500,000.
You indicate that you live in a state where there is a limit. Depending on your specific situation, your medical bills, lost wages, the extent of your injury, whether or not you will have problems from your injury in the future such as temporary or permanent full or partial disability and your pain and suffering will be assessed and you will be awarded an amount to compensate you. Your award or settlement, however, will not exceed the statutory amount in your state, even if you think you deserve more, or even if you would likely be awarded more in another state.
The reason some states have limits, especially in certain types of cases, such as medical malpractice and aviation, is that there have been cries for tort reform backed by claims that without such limits, large verdicts have driven up the cost of insurance and have dissuaded insurance companies from doing business in some states. The argument for caps on pain and suffering is that consumers will have to pay higher costs because insurance companies and doctors have to pay more for insurance coverage. The opposing side argues that the real reason for caps on pain and suffering is that corporations, including doctors, want to limit their financial exposure. Caps would give them a lower cost of doing business. In any event, people with serious injuries, especially children, whose quality of life may have been substantially affected, but who can only get $250,000 when their case may be worth several million dollars elsewhere, may not benefit from such limitations.
Non-economic damages are those that are not easily quantifiable and include inconvenience and pain and suffering. In most states, there are no limitations when it comes to damages for pain and suffering, but that is changing. If you live in a state that places a limit on compensation for pain and suffering, that limit is the maximum you can get. In states that have such a limit, it is often in the amount of $250,000 or $500,000.
You indicate that you live in a state where there is a limit. Depending on your specific situation, your medical bills, lost wages, the extent of your injury, whether or not you will have problems from your injury in the future such as temporary or permanent full or partial disability and your pain and suffering will be assessed and you will be awarded an amount to compensate you. Your award or settlement, however, will not exceed the statutory amount in your state, even if you think you deserve more, or even if you would likely be awarded more in another state.
The reason some states have limits, especially in certain types of cases, such as medical malpractice and aviation, is that there have been cries for tort reform backed by claims that without such limits, large verdicts have driven up the cost of insurance and have dissuaded insurance companies from doing business in some states. The argument for caps on pain and suffering is that consumers will have to pay higher costs because insurance companies and doctors have to pay more for insurance coverage. The opposing side argues that the real reason for caps on pain and suffering is that corporations, including doctors, want to limit their financial exposure. Caps would give them a lower cost of doing business. In any event, people with serious injuries, especially children, whose quality of life may have been substantially affected, but who can only get $250,000 when their case may be worth several million dollars elsewhere, may not benefit from such limitations.
The adjuster for the other driver's car insurance company does not agree with my lawyer’s estimate of damages. Does that mean I have to file a lawsuit now?
The adjuster for the other party’s insurance company has the power to settle claims. The adjuster estimates the value of a claim based on the type of injury, medical bills, lost wages, prognosis for recovery and any other future expenses you might have because of your injury. If your lawyer disagrees on the value of the claim and negotiations fail to reach a compromise you can live with, you may have to file a lawsuit against the other driver.
That does not necessarily mean your case will go to trial. It means that the adjuster must turn the case over to an attorney who will represent the other party. However, the adjuster still holds the purse strings.
The other side's attorney will evaluate the case, tell the adjuster what he or she believes the case is worth, and make recommendations regarding any offers. Sometimes that attorney points out new issues or facts, and the adjuster realizes the case is worth more than first thought. Other times, the other party’s lawyer is in complete agreement with the adjuster. Then your only option is to move on and have your attorney prepare the case for arbitration or trial. If you do not have a lawyer yet, consult an experienced car accident attorney for advice on your situation.
That does not necessarily mean your case will go to trial. It means that the adjuster must turn the case over to an attorney who will represent the other party. However, the adjuster still holds the purse strings.
The other side's attorney will evaluate the case, tell the adjuster what he or she believes the case is worth, and make recommendations regarding any offers. Sometimes that attorney points out new issues or facts, and the adjuster realizes the case is worth more than first thought. Other times, the other party’s lawyer is in complete agreement with the adjuster. Then your only option is to move on and have your attorney prepare the case for arbitration or trial. If you do not have a lawyer yet, consult an experienced car accident attorney for advice on your situation.
If after a car accident someone is unable to perform a job they previously could, should diminished earning capacity damages be awarded in the accident lawsuit?
The damages recovered in a car accident lawsuit often include compensation for lost wages for a job you already have. But if a claim for loss of earning capacity is based on anticipated future losses, it is difficult to determine proper damages. Consult an experienced accident attorney for specific questions about including loss of earning capacity in your car accident damages claim.
How Do You Show Damages for Loss of Earnings Capacity?
Any party seeking damages must prove there is a reason for the award, and demonstrate a way to calculate it. The uncertain nature of anticipated earnings capacity can make this confusing. While one side may argue that the loss of earnings should cover the difference between what the party made before the car accident and is currently making, the other side may argue that the party should be retrained in another area of his or her job, or even in a completely different field. Whether or not an injured party can claim loss of future earnings depends on the facts of each case, and can be difficult to predict.
If the injured party was up for a promotion, and the promotion was lost because of the car accident, this can be a factor in favor of recovering loss of earnings capacity damages. A party’s age at the time of the car accident is also taken into consideration. For example, if the person injured is twenty years old, the court will take the average number of working years left in his or her life to determine the damages for loss of earning capacity, which would be much higher than for someone who is closer to retirement age.
How Do You File a Claim for Loss of Earnings Capacity?
Filing a car accident lawsuit for loss of earning capacity can be complicated, because it rests on so many variables. The best thing to do if you believe that you have a claim for loss of earning capacity is to contact an experienced personal injury or automobile accident attorney. After reviewing your case, an attorney will be able to weigh all the relevant factors in your claim, and come up with fair assessment of car accident damages to negotiate with the insurance company, or present to the jury if the car accident lawsuit goes to trial.
How Do You Show Damages for Loss of Earnings Capacity?
Any party seeking damages must prove there is a reason for the award, and demonstrate a way to calculate it. The uncertain nature of anticipated earnings capacity can make this confusing. While one side may argue that the loss of earnings should cover the difference between what the party made before the car accident and is currently making, the other side may argue that the party should be retrained in another area of his or her job, or even in a completely different field. Whether or not an injured party can claim loss of future earnings depends on the facts of each case, and can be difficult to predict.
If the injured party was up for a promotion, and the promotion was lost because of the car accident, this can be a factor in favor of recovering loss of earnings capacity damages. A party’s age at the time of the car accident is also taken into consideration. For example, if the person injured is twenty years old, the court will take the average number of working years left in his or her life to determine the damages for loss of earning capacity, which would be much higher than for someone who is closer to retirement age.
How Do You File a Claim for Loss of Earnings Capacity?
Filing a car accident lawsuit for loss of earning capacity can be complicated, because it rests on so many variables. The best thing to do if you believe that you have a claim for loss of earning capacity is to contact an experienced personal injury or automobile accident attorney. After reviewing your case, an attorney will be able to weigh all the relevant factors in your claim, and come up with fair assessment of car accident damages to negotiate with the insurance company, or present to the jury if the car accident lawsuit goes to trial.
If after a car accident someone is unable to perform a job they previously could, should diminished earning capacity damages be awarded in the accident lawsuit?
The damages recovered in a car accident lawsuit often include compensation for lost wages for a job you already have. But if a claim for loss of earning capacity is based on anticipated future losses, it is difficult to determine proper damages. Consult an experienced accident attorney for specific questions about including loss of earning capacity in your car accident damages claim.
How Do You Show Damages for Loss of Earnings Capacity?
Any party seeking damages must prove there is a reason for the award, and demonstrate a way to calculate it. The uncertain nature of anticipated earnings capacity can make this confusing. While one side may argue that the loss of earnings should cover the difference between what the party made before the car accident and is currently making, the other side may argue that the party should be retrained in another area of his or her job, or even in a completely different field. Whether or not an injured party can claim loss of future earnings depends on the facts of each case, and can be difficult to predict.
If the injured party was up for a promotion, and the promotion was lost because of the car accident, this can be a factor in favor of recovering loss of earnings capacity damages. A party’s age at the time of the car accident is also taken into consideration. For example, if the person injured is twenty years old, the court will take the average number of working years left in his or her life to determine the damages for loss of earning capacity, which would be much higher than for someone who is closer to retirement age.
How Do You File a Claim for Loss of Earnings Capacity?
Filing a car accident lawsuit for loss of earning capacity can be complicated, because it rests on so many variables. The best thing to do if you believe that you have a claim for loss of earning capacity is to contact an experienced personal injury or automobile accident attorney. After reviewing your case, an attorney will be able to weigh all the relevant factors in your claim, and come up with fair assessment of car accident damages to negotiate with the insurance company, or present to the jury if the car accident lawsuit goes to trial.
How Do You Show Damages for Loss of Earnings Capacity?
Any party seeking damages must prove there is a reason for the award, and demonstrate a way to calculate it. The uncertain nature of anticipated earnings capacity can make this confusing. While one side may argue that the loss of earnings should cover the difference between what the party made before the car accident and is currently making, the other side may argue that the party should be retrained in another area of his or her job, or even in a completely different field. Whether or not an injured party can claim loss of future earnings depends on the facts of each case, and can be difficult to predict.
If the injured party was up for a promotion, and the promotion was lost because of the car accident, this can be a factor in favor of recovering loss of earnings capacity damages. A party’s age at the time of the car accident is also taken into consideration. For example, if the person injured is twenty years old, the court will take the average number of working years left in his or her life to determine the damages for loss of earning capacity, which would be much higher than for someone who is closer to retirement age.
How Do You File a Claim for Loss of Earnings Capacity?
Filing a car accident lawsuit for loss of earning capacity can be complicated, because it rests on so many variables. The best thing to do if you believe that you have a claim for loss of earning capacity is to contact an experienced personal injury or automobile accident attorney. After reviewing your case, an attorney will be able to weigh all the relevant factors in your claim, and come up with fair assessment of car accident damages to negotiate with the insurance company, or present to the jury if the car accident lawsuit goes to trial.
I can't have relations with my wife as a result of my car accident injury. Can she sue, too?
Yes. If you can't have sexual relations with your spouse as a result of your injury, she is suffering from a “loss of consortium." You and/or your spouse may make a claim for loss of consortium as part of your lawsuit against the other driver.
Loss of consortium is usually awarded where the spouse no longer can enjoy the company and pleasure of the injured spouse in the same way as before the accident. The loss may be temporary or permanent. It may be due to physical injury or mental distress caused by the physical injury. Beyond sexual relations, loss of consortium can extend to other aspects of your relationship. For example, if you can no longer help care for the kids, clean the house, mow the lawn, take out the trash or cook dinner, your injuries have likely interfered with your spouse's reasonable expectations of marriage. Loss of consortium may also include the loss of care, affection, and companionship between husband and wife, even without the loss of sexual intimacy.
Loss of consortium sometimes extends to parents who have lost a child or whose child was severely injured, or to a child whose parent has been injured or has died in an accident. This type of claim is referred to as “filial consortium” and it pays damages for the lost love, companionship and care of the child or parent. Not all states allow filial consortium claims. An experienced auto accident attorney can explain what laws apply to your situation.
Loss of consortium claims can be difficult to prove and usually don't yield a large amount of money, because the court may regard the claim as "speculative." It can be difficult for the jury to pin a dollar amount on an injury that is emotional in nature. Keep in mind that if you or your spouse pursue a loss of consortium claim, not only do you need to prove the loss, but then the subject becomes fair game for the other party’s attorney. You will likely have to answer intimate questions about your current and your previous sex life, either in depositions or at trial. If the loss is severe and you are willing to answer invasive questions, by all means, you and/or your spouse should include a loss of consortium claim in your lawsuit. Even if speculative, your attorney can potentially use the claim as leverage in settlement negotiations.
Loss of consortium is usually awarded where the spouse no longer can enjoy the company and pleasure of the injured spouse in the same way as before the accident. The loss may be temporary or permanent. It may be due to physical injury or mental distress caused by the physical injury. Beyond sexual relations, loss of consortium can extend to other aspects of your relationship. For example, if you can no longer help care for the kids, clean the house, mow the lawn, take out the trash or cook dinner, your injuries have likely interfered with your spouse's reasonable expectations of marriage. Loss of consortium may also include the loss of care, affection, and companionship between husband and wife, even without the loss of sexual intimacy.
Loss of consortium sometimes extends to parents who have lost a child or whose child was severely injured, or to a child whose parent has been injured or has died in an accident. This type of claim is referred to as “filial consortium” and it pays damages for the lost love, companionship and care of the child or parent. Not all states allow filial consortium claims. An experienced auto accident attorney can explain what laws apply to your situation.
Loss of consortium claims can be difficult to prove and usually don't yield a large amount of money, because the court may regard the claim as "speculative." It can be difficult for the jury to pin a dollar amount on an injury that is emotional in nature. Keep in mind that if you or your spouse pursue a loss of consortium claim, not only do you need to prove the loss, but then the subject becomes fair game for the other party’s attorney. You will likely have to answer intimate questions about your current and your previous sex life, either in depositions or at trial. If the loss is severe and you are willing to answer invasive questions, by all means, you and/or your spouse should include a loss of consortium claim in your lawsuit. Even if speculative, your attorney can potentially use the claim as leverage in settlement negotiations.
The car insurance company's attorney says my injury was pre-existing. How do I prove it wasn't?
If you suffer an injury in a car accident, the insurance company for the party at fault will process your injury claim. In doing so, the insurance company can argue that any injury incurred during the accident was the result of a pre-existing medical condition. If they suspect the nature or severity of your injury is due to a pre-existing condition, the insurance company may legally demand your medical history with a subpoena and identify any previous injuries similar to the one suffered in the car accident. If the insurance company can prove that you had a pre-existing condition that contributed to your current injury, then your recoverable damages may be reduced.
If you have injuries similar to the one you suffer in a car accident that you’ve incurred in the past, it does not mean that a negligent party can escape liability by pointing to a pre-existing condition. However, you may end up having to defend your current injury as being caused by the car accident. This can be done through a thorough review of your medical records, and possibly via testimony provided by a doctor or other expert witness. If your medical records show that the injury or condition was completely healed, you will usually have no difficulty demonstrating that the injury was not pre-existing.
Even if you have a pre-existing condition similar to the one suffered in the car accident, the defense still has the burden of showing that the pre-existing condition had a causal relationship to the current injury. This is also done through doctor’s testimony. Sometimes, during the treatment for an injury incurred by a car accident, a doctor will discover a degenerative condition, like arthritis, that was not on your record before. In this context, the arthritis would most likely be considered an incidental finding, and would probably not limit your recoverable damages. You will need to be prepared to defend your medical history and demonstrate that the current injury you suffer was primarily due to the car accident, and not a pre-existing medical condition.
Insurance companies will do the best they can to limit the amount they pay out for your damages after a car accident, and you should not try to challenge them alone. If you are in a car accident, you should contact an automobile accident attorney right away, so that you can ensure the best recovery for your injuries.
If you have injuries similar to the one you suffer in a car accident that you’ve incurred in the past, it does not mean that a negligent party can escape liability by pointing to a pre-existing condition. However, you may end up having to defend your current injury as being caused by the car accident. This can be done through a thorough review of your medical records, and possibly via testimony provided by a doctor or other expert witness. If your medical records show that the injury or condition was completely healed, you will usually have no difficulty demonstrating that the injury was not pre-existing.
Even if you have a pre-existing condition similar to the one suffered in the car accident, the defense still has the burden of showing that the pre-existing condition had a causal relationship to the current injury. This is also done through doctor’s testimony. Sometimes, during the treatment for an injury incurred by a car accident, a doctor will discover a degenerative condition, like arthritis, that was not on your record before. In this context, the arthritis would most likely be considered an incidental finding, and would probably not limit your recoverable damages. You will need to be prepared to defend your medical history and demonstrate that the current injury you suffer was primarily due to the car accident, and not a pre-existing medical condition.
Insurance companies will do the best they can to limit the amount they pay out for your damages after a car accident, and you should not try to challenge them alone. If you are in a car accident, you should contact an automobile accident attorney right away, so that you can ensure the best recovery for your injuries.
I was in a car accident. Who is going to pay for my property damage and medical bills?
The answer to this question depends on your own financial resources and the circumstances of the accident.
Typical sources of compensation for damages sustained in a car accident include:
(1) Out-of Pocket - When the damages sustained are minor and do not cost a lot of money, paying for the loss "out-of-pocket" should be considered. There is no third party involvement when you pay for your own loss, no long investigation, no change in your insurance and generally less hassle. When your losses exceed what you can handle, other sources of compensation should be explored.
(2) Your Car Insurance Company - Whether your insurance will compensate you for your loss depends on your insurance contract. In many contracts, there are considerations for both the first party (you and your vehicle) and any third parties (passengers, other drivers and their property). Some contracts provide medical coverage for personal injury of the insured and your passengers. The policy may pay for collision repairs and possibly for a car rental while your damaged car is being fixed. Before making a claim with an insurance company, many people consider whether it will be less expensive for them to pay for the loss "out-of-pocket" before relying on their insurance, because accident payments could raise your premiums. The potential of increases in your premium must be balanced against your ability to pay "out-of-pocket," including any deductibles. The larger the loss, the more likely you are to want recovery from your insurance company.
(3) Your Health Insurance Provider - You may have private health insurance or belong to an HMO (Health Maintenance Organization). In the event of a personal injury from a car accident, you can ask your health insurer to pay for medical treatment. Sometimes, private health insurance plans or HMOs require you to seek recovery from your auto insurance company before the health organization will pay or provide medical treatment.
(4) Other People Involved In the Accident - In addition to the three sources above, you may be able to seek recovery from other people who were involved in the accident. Your ability to recover money from another driver may be limited by the laws of the state in which the accident occurred (not necessarily the same state where you live). The state where the accident occurred may have a "no-fault" law where each person involved in an accident pays for their injuries through their own insurance, or a "fault" law, where the party "at fault" or who caused the accident pays for damages. If you are "at-fault" for an accident that occurred in a "fault" state, contact your insurance company. It is the company's job to defend you in court or to negotiate a settlement. When the other party is at fault in a "fault" state, you would seek compensation from their insurer in that case, or your insurer would seek compensation from their insurer.
Typical sources of compensation for damages sustained in a car accident include:
(1) Out-of Pocket - When the damages sustained are minor and do not cost a lot of money, paying for the loss "out-of-pocket" should be considered. There is no third party involvement when you pay for your own loss, no long investigation, no change in your insurance and generally less hassle. When your losses exceed what you can handle, other sources of compensation should be explored.
(2) Your Car Insurance Company - Whether your insurance will compensate you for your loss depends on your insurance contract. In many contracts, there are considerations for both the first party (you and your vehicle) and any third parties (passengers, other drivers and their property). Some contracts provide medical coverage for personal injury of the insured and your passengers. The policy may pay for collision repairs and possibly for a car rental while your damaged car is being fixed. Before making a claim with an insurance company, many people consider whether it will be less expensive for them to pay for the loss "out-of-pocket" before relying on their insurance, because accident payments could raise your premiums. The potential of increases in your premium must be balanced against your ability to pay "out-of-pocket," including any deductibles. The larger the loss, the more likely you are to want recovery from your insurance company.
(3) Your Health Insurance Provider - You may have private health insurance or belong to an HMO (Health Maintenance Organization). In the event of a personal injury from a car accident, you can ask your health insurer to pay for medical treatment. Sometimes, private health insurance plans or HMOs require you to seek recovery from your auto insurance company before the health organization will pay or provide medical treatment.
(4) Other People Involved In the Accident - In addition to the three sources above, you may be able to seek recovery from other people who were involved in the accident. Your ability to recover money from another driver may be limited by the laws of the state in which the accident occurred (not necessarily the same state where you live). The state where the accident occurred may have a "no-fault" law where each person involved in an accident pays for their injuries through their own insurance, or a "fault" law, where the party "at fault" or who caused the accident pays for damages. If you are "at-fault" for an accident that occurred in a "fault" state, contact your insurance company. It is the company's job to defend you in court or to negotiate a settlement. When the other party is at fault in a "fault" state, you would seek compensation from their insurer in that case, or your insurer would seek compensation from their insurer.
What kind of compensation can I qualify for after a car accident?
Millions of car accidents occur each year injuring people and damaging property. Where an accident is minor, many people simply file police reports, inform their insurance company, but pay the losses out of their own pocket. However, when an accident isn't minor, it's important to realize that you can be compensated not only for the damage to your vehicle, but for other damages as well.
If you're injured in a car accident, you'll likely incur expenses related to the accident such as medical treatment, rehabilitation, renting a car or using a taxi while your car is being repaired. It's likely that while your expenses increase, you may lose income due to your inability to work. In addition, you may also lose the ability to perform various activities of normal daily living, in both the short and long term, and may also endure pain and suffering as a result of the accident.
You can be compensated for these types of injuries and expenses. Generally, auto accident victims seek what are known as compensatory damages. These are intended to "make you whole again" and place you back in the same position you were before the accident occurred. There are two types of compensatory damages - economic and non-economic. Economic damages are awarded for those "out of pocket expenses" that you've incurred, while non-economic damages are awarded for any "pain and suffering" you may have experienced. Both types may be available to auto accident victims.
In addition to normal compensatory damages, in extreme cases punitive damages may be available, if the injury was the result of the other driver's reckless or irresponsible behavior, or if the accident or the injury was caused by something about the car that is dangerous or defective that the manufacturer should have corrected.
If you're injured in a car accident, you'll likely incur expenses related to the accident such as medical treatment, rehabilitation, renting a car or using a taxi while your car is being repaired. It's likely that while your expenses increase, you may lose income due to your inability to work. In addition, you may also lose the ability to perform various activities of normal daily living, in both the short and long term, and may also endure pain and suffering as a result of the accident.
You can be compensated for these types of injuries and expenses. Generally, auto accident victims seek what are known as compensatory damages. These are intended to "make you whole again" and place you back in the same position you were before the accident occurred. There are two types of compensatory damages - economic and non-economic. Economic damages are awarded for those "out of pocket expenses" that you've incurred, while non-economic damages are awarded for any "pain and suffering" you may have experienced. Both types may be available to auto accident victims.
In addition to normal compensatory damages, in extreme cases punitive damages may be available, if the injury was the result of the other driver's reckless or irresponsible behavior, or if the accident or the injury was caused by something about the car that is dangerous or defective that the manufacturer should have corrected.
What Is Your Car Accident Injury Claim Worth?
The best way to determine how much your injury claim is worth when you are injured in a car accident is to look at how an insurance company would value your claim. An insurance carrier will first look to the types and amounts of damages suffered and then to percentage of fault.
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Types of Damages You May Recover
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The types of damages an insurance company will typically pay for include the following:
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Medical Expenses: This includes medical expenses incurred to treat an injury, such as doctor’s visits; hospital expenses; emergency room expenses; fees for chiropractic care; physical therapy; and any type of medical devices that may be needed for your recovery, such as neck braces or crutches. These expenses are recoverable if they result from your injury. The cost of a medical examination done for the purposes of litigation is generally not recoverable. If you are able to guesstimate how much your overall medical treatment will cost, you and your attorney may well be able to ballpark how much your entire claim is worth. Medical expenses are typically used as a benchmark for determining the reasonableness of damage awards.
Future Medical Expenses: These are recoverable if the injured party can show that he or she is likely to need continued medical care as a result of the accident or injury. This amount may be determined by the advice and opinions of your doctors and/or other medical specialists seen for treatment.
Pain and Suffering: Pain and suffering damages may be granted for physical pain resulting from an accident or injury. A jury will look to the nature of the injury, the severity of the pain, and how long the plaintiff is likely to be in pain to determine the damage amount to be awarded.
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Mental Anguish: Recovery for any type of mental or emotional distress suffered as a result of an accident or injury. This could include apprehension, fright, anxiety, nervousness, worry, loss of dignity, humiliation, grief, shock, and/or embarrassment. If the injured party has been disfigured by the accident/incident, mental suffering is recoverable for this type of emotional injury.
Lost Wages: You may recover the amount of money you would have earned between the time of the injury to the time of a judgment or settlement had you not been injured. If you were unemployed at the time of injury, you may still recover lost wages if you can effectively show what you could have earned during that same period.
Loss of Earning Capacity: You may recover damages for lost earning capacity if you can show that your ability to earn money in the future has been impaired. Past earnings will be used to determine an appropriate damage award, but a jury will likely focus on what might have been earned had the accident or injury not occurred.
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Loss of Consortium: This relates to the loss of the benefits of married life when one spouse is injured. The uninjured spouse makes the claim and only has a chance of recovering if the injured spouse succeeds in recovering damages. Sometimes, however, the injured makes the claim as well. Married life benefits, the loss of which recovery is based, include companionship, affection, comfort, solace, help, and sexual relations. When determining the value of the loss, a jury will look to the stability of the marriage, the couple’s individual life expectancies, how much care and companionship were given to the uninjured spouse, and the degree to which the above-mentioned benefits were lost.
Property Damage: Recovery for the value of property that was damaged.
Amount of Damages You May Recover
An insurance company typically looks first to how much money has been spent and/or lost by the injured person when determining recovery. You may expect to recover any money spent or lost as a result of your injury. There are damages, however, that are harder to place a dollar value on. This includes pain and suffering or mental anguish. An insurance company may use a formula to ascertain what an appropriate damage amount might be for these types of claims.
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The formula might work like this: First, the insurance company’s adjuster adds up the total amount of medical expenses relating to the injury. These damages are referred to as “medical special damages,” or “specials.” This base amount is then used to calculate the “general damages,” such as damages for pain and suffering, emotional damages, or other non-monetary losses.
Next, if the injuries are relatively minor, the adjuster will at most double the amount of special damages. If the injuries are more serious or painful, the adjuster may multiply specials by up to 5. In extreme cases, the adjuster may even multiply by up to 10.
After the adjuster adds on damages for lost income, an amount from which to begin negotiations is then ready to present.
How Fault Affects Your Recovery
Beyond the damages suffered, the degree of fault is probably the most important factor in determining how much you may finally recover for your injury. In most cases, both you and the insurance company will know (by the circumstances surrounding the accident) the level of fault for both parties. Was the other party completely at fault? Mostly at fault? Or only a little at fault? An adjuster will reduce your recovery amount by your percentage of comparative fault. If you were only 10% at fault, your damages total will be reduced by 10%. Your recovery will not be reduced by any amount if the accident was clearly someone else’s fault.
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Types of Damages You May Recover
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The types of damages an insurance company will typically pay for include the following:
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Medical Expenses: This includes medical expenses incurred to treat an injury, such as doctor’s visits; hospital expenses; emergency room expenses; fees for chiropractic care; physical therapy; and any type of medical devices that may be needed for your recovery, such as neck braces or crutches. These expenses are recoverable if they result from your injury. The cost of a medical examination done for the purposes of litigation is generally not recoverable. If you are able to guesstimate how much your overall medical treatment will cost, you and your attorney may well be able to ballpark how much your entire claim is worth. Medical expenses are typically used as a benchmark for determining the reasonableness of damage awards.
Future Medical Expenses: These are recoverable if the injured party can show that he or she is likely to need continued medical care as a result of the accident or injury. This amount may be determined by the advice and opinions of your doctors and/or other medical specialists seen for treatment.
Pain and Suffering: Pain and suffering damages may be granted for physical pain resulting from an accident or injury. A jury will look to the nature of the injury, the severity of the pain, and how long the plaintiff is likely to be in pain to determine the damage amount to be awarded.
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Mental Anguish: Recovery for any type of mental or emotional distress suffered as a result of an accident or injury. This could include apprehension, fright, anxiety, nervousness, worry, loss of dignity, humiliation, grief, shock, and/or embarrassment. If the injured party has been disfigured by the accident/incident, mental suffering is recoverable for this type of emotional injury.
Lost Wages: You may recover the amount of money you would have earned between the time of the injury to the time of a judgment or settlement had you not been injured. If you were unemployed at the time of injury, you may still recover lost wages if you can effectively show what you could have earned during that same period.
Loss of Earning Capacity: You may recover damages for lost earning capacity if you can show that your ability to earn money in the future has been impaired. Past earnings will be used to determine an appropriate damage award, but a jury will likely focus on what might have been earned had the accident or injury not occurred.
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Loss of Consortium: This relates to the loss of the benefits of married life when one spouse is injured. The uninjured spouse makes the claim and only has a chance of recovering if the injured spouse succeeds in recovering damages. Sometimes, however, the injured makes the claim as well. Married life benefits, the loss of which recovery is based, include companionship, affection, comfort, solace, help, and sexual relations. When determining the value of the loss, a jury will look to the stability of the marriage, the couple’s individual life expectancies, how much care and companionship were given to the uninjured spouse, and the degree to which the above-mentioned benefits were lost.
Property Damage: Recovery for the value of property that was damaged.
Amount of Damages You May Recover
An insurance company typically looks first to how much money has been spent and/or lost by the injured person when determining recovery. You may expect to recover any money spent or lost as a result of your injury. There are damages, however, that are harder to place a dollar value on. This includes pain and suffering or mental anguish. An insurance company may use a formula to ascertain what an appropriate damage amount might be for these types of claims.
comparison car insurance
The formula might work like this: First, the insurance company’s adjuster adds up the total amount of medical expenses relating to the injury. These damages are referred to as “medical special damages,” or “specials.” This base amount is then used to calculate the “general damages,” such as damages for pain and suffering, emotional damages, or other non-monetary losses.
Next, if the injuries are relatively minor, the adjuster will at most double the amount of special damages. If the injuries are more serious or painful, the adjuster may multiply specials by up to 5. In extreme cases, the adjuster may even multiply by up to 10.
After the adjuster adds on damages for lost income, an amount from which to begin negotiations is then ready to present.
How Fault Affects Your Recovery
Beyond the damages suffered, the degree of fault is probably the most important factor in determining how much you may finally recover for your injury. In most cases, both you and the insurance company will know (by the circumstances surrounding the accident) the level of fault for both parties. Was the other party completely at fault? Mostly at fault? Or only a little at fault? An adjuster will reduce your recovery amount by your percentage of comparative fault. If you were only 10% at fault, your damages total will be reduced by 10%. Your recovery will not be reduced by any amount if the accident was clearly someone else’s fault.
Automobile Accidents and Bodily Injuries
Have you or your loved ones ever been the victim of a motor vehicle accident and not sure where to turn? Being involved in an accident can be somewhat frightening and also overwhelming, especially in dealing with the insurance company and their appointed adjusters. If you are not familiar with insurance terms, guidelines, procedures, and have sustained a bodily injury, and need assistance on pursuing a claim, you’ve come to the right place.
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A car accident or car crash is an incident in which an automobile collides with anything that causes damage to the automobile, including other automobiles, telephone poles, buildings or trees, or in which the driver loses control of the vehicle and damages it in some other way, such as driving into a ditch or rolling over. Sometimes a car accident may also refer to an automobile striking a human or animal.
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An automobile to people can mean many things. For some, it is one of the most expensive purchases they will ever make. An automobile is a symbol of freedom, status or a way of life. The automobile is also is a lethal weapon that can injure and kill, destroying property or ruin lives. When a fatality occurs, automobile insurance can replace the vehicle and pay for medical bills but it cannot bring the dead ones back to life.
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If you have or know someone involved in an accident, you’re lucky if you walked away with just a few bumps and bruises. There is a death every 13 minutes caused by a motor vehicle accident.
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A car accident or car crash is an incident in which an automobile collides with anything that causes damage to the automobile, including other automobiles, telephone poles, buildings or trees, or in which the driver loses control of the vehicle and damages it in some other way, such as driving into a ditch or rolling over. Sometimes a car accident may also refer to an automobile striking a human or animal.
car insurance quote comparison
An automobile to people can mean many things. For some, it is one of the most expensive purchases they will ever make. An automobile is a symbol of freedom, status or a way of life. The automobile is also is a lethal weapon that can injure and kill, destroying property or ruin lives. When a fatality occurs, automobile insurance can replace the vehicle and pay for medical bills but it cannot bring the dead ones back to life.
car insurance quote comparison
If you have or know someone involved in an accident, you’re lucky if you walked away with just a few bumps and bruises. There is a death every 13 minutes caused by a motor vehicle accident.
How Do Insurers Value an Injury Claim?
Figuring out how much your accident injuries are worth is a critical aspect of any personal injury claim, and it's the part of a claim that is most difficult to determine; the amount varies depending on your very particular circumstances. Here is an overview of how insurance companies determine the value of a claim.
What an Insurance Company Must Compensate
To determine what your claim is worth, you must first know the types of damages for which you may be compensated. Usually, a person who is liable for an accident -- and therefore his or her liability insurance company -- must pay an injured person for:
medical care and related expensesincome lost because of the accident, because of time spent unable to work or undergoing treatment for injuriespermanent physical disability or disfigurementloss of family, social, and educational experiences, including missed school or training, vacation or recreation, or a special eventemotional damages, such as stress, embarrassment, depression, or strains on family relationships -- for example, the inability to take care of children, anxiety over the effects of an accident on an unborn child, or interference with sexual relations, anddamaged property.The Insurance Company's Damages Formula
When determining compensation, it is usually simple to add up the money spent and money lost, but there is no precise way to put a dollar figure on pain and suffering or on missed experiences and lost opportunities. That's where an insurance company's damages formula comes in.
At the beginning of claim negotiations, an insurance adjuster adds up the total medical expenses related to the injury. These expenses are referred to as "medical special damages" or simply "specials." That's the base figure the adjuster uses to figure out how much to pay the injured person for pain, suffering, and other nonmonetary losses, which are called "general" damages.
When the injuries are relatively minor, the adjuster multiplies the amount of special damages by 1.5 or 2. When the injuries are particularly painful, serious, or long-lasting, the adjuster multiplies the amount of special damages by up to 5. (The multiplier may be as great as 10 in extreme cases. For information on exactly how an adjuster determines the multiplier, see How to Win Your Personal Injury Claim, by Joseph L. Matthews (Nolo).)
The adjuster then adds on any income lost as a result of the injuries.
That's all there is to the formula. However, this figure -- medical specials multiplied by a number between 1.5 and 5, then added to lost income -- is not a final compensation amount but only the number from which negotiations begin.
Percentage of Fault
The extent each person is at fault is the most important factor affecting how much the insurance company is likely to pay. The damages formula gives you a range of how much your injuries might be worth, but only after you figure in the question of fault do you know the actual compensation value of your claim -- that is, how much an insurance company will pay you.
Determining fault for an accident is not an exact science, but in most claims both you and the insurance adjuster will at least have a good idea whether the insured person was entirely at fault, or if you were a little at fault, or if you were a lot at fault. Whatever that rough percentage of your comparative fault might be -- 10%, 50%, 75% -- is the amount by which the damages formula total will be reduced to arrive at a final figure.
What an Insurance Company Must Compensate
To determine what your claim is worth, you must first know the types of damages for which you may be compensated. Usually, a person who is liable for an accident -- and therefore his or her liability insurance company -- must pay an injured person for:
medical care and related expensesincome lost because of the accident, because of time spent unable to work or undergoing treatment for injuriespermanent physical disability or disfigurementloss of family, social, and educational experiences, including missed school or training, vacation or recreation, or a special eventemotional damages, such as stress, embarrassment, depression, or strains on family relationships -- for example, the inability to take care of children, anxiety over the effects of an accident on an unborn child, or interference with sexual relations, anddamaged property.The Insurance Company's Damages Formula
When determining compensation, it is usually simple to add up the money spent and money lost, but there is no precise way to put a dollar figure on pain and suffering or on missed experiences and lost opportunities. That's where an insurance company's damages formula comes in.
At the beginning of claim negotiations, an insurance adjuster adds up the total medical expenses related to the injury. These expenses are referred to as "medical special damages" or simply "specials." That's the base figure the adjuster uses to figure out how much to pay the injured person for pain, suffering, and other nonmonetary losses, which are called "general" damages.
When the injuries are relatively minor, the adjuster multiplies the amount of special damages by 1.5 or 2. When the injuries are particularly painful, serious, or long-lasting, the adjuster multiplies the amount of special damages by up to 5. (The multiplier may be as great as 10 in extreme cases. For information on exactly how an adjuster determines the multiplier, see How to Win Your Personal Injury Claim, by Joseph L. Matthews (Nolo).)
The adjuster then adds on any income lost as a result of the injuries.
That's all there is to the formula. However, this figure -- medical specials multiplied by a number between 1.5 and 5, then added to lost income -- is not a final compensation amount but only the number from which negotiations begin.
Percentage of Fault
The extent each person is at fault is the most important factor affecting how much the insurance company is likely to pay. The damages formula gives you a range of how much your injuries might be worth, but only after you figure in the question of fault do you know the actual compensation value of your claim -- that is, how much an insurance company will pay you.
Determining fault for an accident is not an exact science, but in most claims both you and the insurance adjuster will at least have a good idea whether the insured person was entirely at fault, or if you were a little at fault, or if you were a lot at fault. Whatever that rough percentage of your comparative fault might be -- 10%, 50%, 75% -- is the amount by which the damages formula total will be reduced to arrive at a final figure.
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