Beware of These 5 Factors That Will Affect Your Settlement Payout

The most frequently asked question from personal injury claimants is, “How much are my injuries worth?” Many factors are involved in calculating the final amount your claim will settle for. It’s often more complicated than simply adding up your bills and tacking on an amount for pain and suffering.

Other factors affecting the settlement include proof of liability, the county or city where the injury occurred (known as “venue”), whether medical treatments were “reasonable and necessary,” the at-fault party’s driving record, and the claimant’s level of comparative fault. Let’s take a closer look at these factors to see how they might affect your claim.

1. Questions of Liability

Successfully settling your bodily injury claim depends first and foremost on establishing liability. If you can’t convince the adjuster their insured was liable for the accident, you’ll get zero compensation. Without liability, there is no settlement.

In a car accident claim, you must prove to the at-fault driver’s insurance company that their insured’s negligence was the direct and proximate cause of your injuries. Once you establish their insured’s liability, the rest of your claim should fall into place.

2. Where the Accident Happened (or “Venue”)

Where your accident occurred can have a big impact on the amount of compensation you receive. Verdicts for personal injury lawsuits in some cities and counties are much higher than in others, and average out-of-court settlements often reflect average jury awards in the area.

Attorneys often research jury verdicts in previous cases with similar fact patterns. By reviewing the historical case record, and how much compensation was awarded in those cases, attorneys can get a good idea of what a personal injury case might get if it went to trial. There are no guarantees with a trial of course, but this method does offer a yardstick for case values.

You can do your own jury verdict research for previous cases similar to yours. Visit or to learn more. These sites provide a wealth of information to help you better determine what kind of settlement you can expect.

3. Comparative Fault

You may live in a comparative fault state. Depending upon your state’s law, the amount an adjuster agrees to pay can be based upon both parties’ percentages of fault. That means the liability for an accident can be shared by the at-fault party and the victim. The settlement amount you receive is then based on the percentage of the insured’s liability.

Example of Comparative Fault in a Car Accident

Jim was stopped at a red light when his car was struck from behind. He was injured in the collision, and made a settlement demand of $10,000 to the other driver’s insurance company.

Normally, a driver who rear-ends the car in front would be 100 percent liable. But in this case, Jim’s brake lights weren’t working when he was hit, so the adjuster blamed a portion of the collision on him. She decided Jim was 20 percent at fault for the accident, and her insured was 80 percent at fault. Instead of $10,000, she only offered Jim $8,000.

If comparative fault is an issue in your claim, you don’t have to automatically accept what the insurance adjuster says. Use your jury verdict research to get a feel for how similar cases have settled. Verdict information often includes the types of injuries, percentages of liability, and the corresponding award amounts.

Use your research to convince the adjuster that your percentage of fault is minimal. Once the adjuster knows you went through the time and effort of researching jury verdicts, she may presume you won’t hesitate to file a lawsuit if you’re not satisfied with her offer. That’s great leverage in a settlement negotiation.

4. “Reasonable and Necessary” Medical Costs

You can’t assume the claims adjuster will simply agree with the amount of medical and chiropractic bills you present for reimbursement. The adjuster is only going to pay what she believes are the reasonable and necessary costs of treatment for similar injuries.

If the reasonable costs of treatment for your soft-tissue injuries were $3,000, and you instead ran up chiropractic bills of $5,000, the adjuster may still only agree to pay $3,000. Then you’d be personally responsible for paying the $2,000 balance.

It’s important that you receive treatment from a reputable physician. Keep away from doctors and clinics who advertise themselves as “personal injury specialists.” These medical practices are always suspect to adjusters. They often run up exorbitant treatment bills, hoping to get paid as much as possible when the claim settles.

5. Multi-car Accidents and Policy Limits

When multiple vehicles are involved in an accident, determining who’s liable for your injuries becomes more complicated. Also, although your injuries may be real, and the costs of treatment reasonable and necessary, your settlement amount may be limited by the insurance policy limits of the at-fault driver.

Example: Distributing Insurance Funds in a Multi-car Accident

Three cars were involved in an accident. Driver A was the at-fault party. He ran a red light and collided with Drivers B and C, both of whom were injured. Driver A had the bare minimum liability insurance of $20,000 for all injured parties. He had no other assets.

Driver B’s reasonable and necessary medical treatment came to $12,000, and driver C’s amounted to $13,000. The total treatment costs for both victims came to $25,000.

Because the at-fault driver only has $20,000 in coverage, both injured drivers will have to try and convince the adjuster to pay them in full for their treatment bills. The reality is, each of them will have to give up a little, since there’s not enough insurance money for both of them.

To increase your chances of getting the highest amount of available funds in a multi-car accident, you must be able to convince the adjuster your costs were reasonable and necessary, and your pain and suffering was greater than anyone else’s.

You can’t argue against the other drivers’ costs since you won’t have access to that information. You won’t be able to compare their damages with yours. In these cases, the adjuster usually favors the victim whose bodily injury claim is best presented. Therefore, you must do everything possible to make sure your claim is the most persuasive.

You must always keep in mind the at-fault driver’s insurance policy limits. Most drivers carry the bare minimum required by law. If your injuries surpass the driver’s policy limits, the insurance company may simply give you the full amount, known as “tendering policy limits.”

If this happens, your only option to obtain the remainder of your damages is to file a lawsuit against the at-fault party’s personal assets. Hopefully they’ll have some assets of value that can compensate for your legitimate damages.

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