Current valuation method for pain and suffering settlement in Texas?

by PC
(Denton, TX, USA)

I understand that the older multiplier method may no longer be valid, but I am trying to arrive at a fair settlement for pain and suffering. I need some ball park valuations for my demand for a pain and suffering settlement.

I had a premises fall in a local community theater on 04/15/2014. They have adequate liability insurance. While walking across the audience seating area to get to the stage, I took a step where one used to be, but it wasn't there.

I worked as a volunteer in costuming for a year, and had gone this way many times in the past. What was different this time, was that there was no lighting and the steps were redone, but we were not told or warned. The floor was painted black, so that area was black-on-black without the lighting.

There was recent construction in that area, with no warning signs, no caution tape, no reflective tape on steps, etc. Others have fallen in the same area after my injury, but were not hurt as badly as I was, because they were already aware of my injury and were being extra-careful.

Also, I later found out that another person had fallen about a month before I fell and had a broken hip.

After my fall, I was transported to the local ER by ambulance, and after initial evaluation I was transported to an adult Level 2 Trauma Center by ambulance. I was there 8 days. I had two surgeries, an external fixator applied then removed, and a permanent ORIF (open reduction, internal fixation) device inserted.

According to the pre-op report, I suffered a closed, highly comminuted left bicondylar tibial plateau fracture, with extension into the proximal diaphysis consistent with a Schatzker VI type tibial plateaus fracture, with significant ligament damage.

I was transferred from the Level 2 trauma center by ambulance to a Rehabilitation Hospital for another 10 days. My leg was in an immobilizer for about a month. Later, I had a knee brace that restricted my movement while healing.

I also had a stroke due to a blood clot about 3 months after surgery. I suffered permanent loss of vision in my left eye. Although we cannot link it directly to the injury, underlying medical causes like hypertension, high cholesterol, and diabetes have been ruled out by the Cardiologist and Neurologist after testing and consultation.

Testing included an MRI of of my brain, TEE at Baylor Heart Hospital, and an ultrasound of carotid arteries at the Cardiologist's office. Currently, I'm testing for blood disorders at Texas Oncology Hospital, to rule that out as a cause.

I'm still in outpatient physical therapy 2 days a week, and still on pain medication. I was off work for 3 months after the injury, and now I'm taking my first two weeks back at work part time. My billed medical expenses are in excess of $260,000. The contracted amount of medical through my PPO is in excess of $145,000. My loss of income to date is $11,000 plus.

My future medical expenses include probable full knee replacement and/or removal of the internal fixator hardware at different times. I guesstimate $125,000 to $150,000 for future medical expenses, plus $6,000 of physical therapy, plus 2 months loss of income during my recovery period.

The insurance company is ready to settle. I don't want to get low balled. I talked to some attorneys locally. They all say they are interested in my case, but want me to retain them. They claim they cannot give me an indication as to settlement value until they do more research and retain economic specialists.

What would be a good way to evaluate my compensation for pain and suffering? Do you have any recommendations for this case? Thanks for any information and perspective you can give.

Visitor Question:
Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter. Our response does NOT create an attorney-client relationship. Always get a formal case review from a licensed attorney in your area.

ANSWER for "Current valuation method for pain and suffering settlement in Texas?":

PC (Denton, TX, USA):

While today most insurance companies rely on a software program called "Colossus" to determine settlement offers, the traditional multiplier method is still a reasonable way for a victim to determine a fair settlement demand.

The Colossus program takes into account many factors, especially whether or not the victim is represented by an attorney. When a victim is not represented by an attorney, the insurance company settlement offer is almost always substantially lower than to an attorney representing a victim.

The reasoning is rather simple...

When a victim decides to represent him or herself, they immediately place themselves at a severe disadvantage. The insurance company has all the leverage. Without an attorney, a victim can only argue what he or she believes to be fair settlement. Self-representation can work in minor claims, but not in serious injury claims.

If the insurance company says no, then what's the victim going to do? In almost all cases, the insurance company knows the victim isn't going to file his or her own lawsuit. If that were to occur, the company would unleash one of its many seasoned attorneys against the victim. The victim would be crushed in the courtroom.

Unfortunately, when the injuries are less serious soft tissue injuries, like sprains and strains, minor cuts, abrasions, etc., retaining an attorney may just not be economical. There just may not be enough compensation in the settlement to pay the attorney's fees and the victim's medical bills, etc.

If your injuries are as serious as you state, you would be remiss in not retaining an attorney. Without an attorney, you will receive only what the insurance company wants to give you and no more.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

P.S. Please help us out by sharing this site...

Comments for Current valuation method for pain and suffering settlement in Texas?

Click here to add your own comments

Get an attorney
by: Anonymous

I was thrown from a chair at my place of work that was held together by spring tension. The incident happened on Thursday night and I spoke to the workmans comp insurance on Friday, when only my upper back was hurting.

By Monday I was having serious pain in my lower back and down my leg. I called the insurance company and told them, and they told me they were not going to cover those injuries because I didn't tell them on Friday, the day after the accident.

I was out of work for over a year and a half. The medications I had to take caused a bleeding ulcer which I almost died from, then 2 months later my stomach perforated where the ulcer was.

My whole life was changed. I have been on paid medication since the first day of the incident, and am still on medication because I am still in severe pain.

The insurance company had a doctor determine my MMI and she chose a date when I was in the ICU at the hospital. I refused to accept that date and had another MMI exam. That doctor set the MMI date about 6 months later.

The insurance company seems concerned that the first MMI date sticks, however they determined 0 comprehensible percentage for both dates. The insurance company also told me in Texas they do not pay for pain and suffering.

So here I am with pain from the original injury, I can not do the things I used to do, and as far as I can see they are not going to offer any settlement.

The doctors they sent me to refused to speak about my lower back because if they mentioned it they said Workman's comp would not pay them for that visit.

If you are injured in Texas, tell the insurance company your whole body hurts and get an attorney immediately. I have never seen a system so one sided, for the insurance company. If you are hurt in Texas you need all the help you can get.

Click here to add your own comments

Return to Injury Compensation Questions.

How Much Is Your Claim Worth?

Find out now with a FREE case review from an attorney...

How Much Are Your
Injuries Worth?

Find out with a
free attorney review: