Personal Injury Claims - Value Determination
The value of damages sought by claimants under insurance policies are almost always disputed. As the name
implies, adjusters "adjust" the value of claims down. It's their job, and their future employment depends
upon reaching profitable settlements on behalf of their employer. Once a personal injury claim is filed, the position of
a carrier is transformed into the role of an adversary who is motivated by a conflict of interest. Despite
prepayment of premiums and promises of customer service, many carriers blacklist customers after two
personal injury claims and use a wide assortment of negotiating tactics designed to minimize payments under
the policy. Today, due to the success of tort reform, claims which involve either significant property
damage or bodily harm usually require legal representation in order to receive a fair offer. Also, carriers are
acutely aware that small claims cannot bear the cost of litigation and may undervalue offers by 25% to 50%
for benefits due under state laws.
Value Arguments In Personal Injury Claims
The threshold question confronting claimants is usually the amount of property damage involved - is
property damage measured by actual repair cost, estimated repair cost, new replacement value, "as-is"
replacement value, or diminution of market value? The answer depends upon the type of property involved and
the amount of damage sustained. Adjusters typically offer the lowest appraisal method until confronted with
applicable law. Similarly, the value of damages related to bodily harm are subject to even greater disputes
because of the predictability in conflicts between opinions expressed by treating physicians and company
physicians. The diagnosis of a treating physician, amount of medical expenses, and necessity for treatment
are routinely devalued based on an "independent medical audit." In practice, many of these auditing firms
are wholly owned subsidiaries of the primary carrier.
See also: Managing Law Firms for maximum plaintiff benefits in class actions lawsuits.
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