Get a Higher Slip and Fall Injury Payout from the Insurance Company

Preparing well before negotiations begin can result in a higher slip and fall injury payout. Here’s how to boost your insurance settlement.

If you were injured in a slip and fall accident on someone else’s property, you can usually file an injury claim with the property owner’s insurance company to seek compensation for your losses.

Insurance adjusters are trained to pay out as little as possible for slip and fall claims. After all, they want to save their employer’s money and are interested in advancing their own careers.

Adjusters are known for offering less money to claimants who are not represented by an attorney. But, all is not lost when it comes to successfully settling your own insurance claim.

Just like an attorney, your best strategy is to carefully prepare well in advance of that first discussion with the adjuster.

When slip and fall victims are prepared and confident entering negotiations, insurance companies are more likely to offer a reasonable payout.

Preparation Starts With Compelling Evidence

You won’t see a dime unless you can prove that the insured person or business was at fault for your slip and fall injuries, and the scope of your damages. Damages in a slip and fall case are the losses you’ve incurred because of your accident.

Potential damages can include losses for:

  • Medical expenses
  • Lost wages
  • Out-of-pocket expenses
  • Property damage (like broken eyeglasses)

It’s essential to request all medical records and bills connected to your slip and fall injuries and treatment. Keep in mind that some medical services will generate more than one bill.

For instance, if you’re taken to the emergency room in an ambulance, you may receive a bill from the ambulance company, the hospital, and the treating physicians. The same goes for radiology appointments where you’ll receive one bill from the radiology department that took the x-ray and another from the radiologist who looked at the films.

Your medical records will serve as evidence linking your injury to the slip and fall, and will document the medical need for you to miss time from work during your recovery. A statement from your employer documents your lost wages.

You should be compensated for the full cost of your medical tests, treatment, and medical supplies, even if your health care insurance covered some or all of the costs. Be sure to keep receipts for out-of-pocket expenses like medications and bandages.

Use our free Slip and Fall Damages Checklist and Guide to make sure you’ve gathered proof of all your hard costs.

Ensure you get a higher slip and fall payout by seeking reimbursement for every one of your injury-related expenses.

It Pays to Organize Your Evidence and Correspondence

When attorneys sit down to negotiate an insurance settlement, they have a well-organized claim file in front of them, and so can you.

Your file should have a separate section for correspondence, like letters and emails between you and the insurance company, with the latest correspondence on top.

Copies of your medical bills and treatment records can be in separate sections, also in date order. It helps to separate the bills by the provider, then by date with the latest bill on top.

If an adjuster has a question on a medical bill or expense, they’ll likely raise it with reference to a specific bill or receipt. Your claim file will make it easier to find your copy of a bill during negotiations with the insurance adjuster.

As you put your bills and medical records in order, keep in mind that adjusters don’t like to see a delay in your initial treatment or long breaks in medical treatment.

If you didn’t get prompt medical attention after the fall, or there was a long break in your treatment, be prepared to explain why that happened. For example, if you had to postpone physical therapy because of COVID lock-downs in your area.

Calculate Your Claim’s Settlement Value

You can’t successfully negotiate an insurance settlement if you don’t know what your slip and fall claim is worth.

When you’ve gathered evidence of all your hard costs, also called economic damages, you will add up the actual cost of all your medical bills, out-of-pocket expenses, lost wages, and personal property losses.

Remember to use the full cost of each medical treatment, not just the copay or deductible that came out of your pocket. If your health insurance covers some or all of your medical bills, you should still claim the full amount.

Continue the valuation process by adding all other economic damages to your medical bills. If you’ve lost wages because of your slip and fall injuries, make sure you have evidence of the amount of wages you actually lost.

When it comes to economic damages, you’re also entitled to reimbursement for out-of-pocket expenses such as medication, travel costs like gasoline and parking when visiting the doctor, and other costs resulting from your injury.

Valuing Non-Economic Losses

Economic damages are easier to tally than non-economic damages because they have a fixed value assigned to them. You can show how much a certain prescription was, for example, with a receipt that shows how much you paid.

There are no receipts, though, when it comes to non-economic losses like pain and suffering.

If you want to be compensated for non-economic damages, it’s important to specifically write down how your injury resulted in pain and suffering, even if you fully recovered from relatively minor injuries, like a pulled shoulder or sprained ankle.

Besides physical pain, you may have suffered because you: 

  • Couldn’t hold a crying baby
  • Had to have help toileting
  • Woke up with nightmares
  • Could no longer compete in sporting events
  • Missed a relatives graduation

Your personal notes should include enough information so that you can justify your claim for pain and suffering when the adjuster offers less compensation.

Calculate a fair estimate of your non-economic damages by adding up all your medical bills and other hard costs and adding one or two times that amount to account for your pain and suffering.

If your injuries are mild to moderate, most insurance companies are willing to negotiate a settlement for general damages in this range.

Example: Valuing a Slip and Fall Claim

Lisa was walking through her neighborhood garden center. She turned to go down a new aisle and tripped on a few potted plants that had fallen over. She tried to break her fall with her arms but ended up breaking her right wrist.

Two customers immediately ran towards her to help. They both stated that they’d just complained to the store manager approximately 20 minutes ago about the plants.

As a result of the trip and fall, Lisa had to undergo minor surgery for her wrist. She also had to have her wrist in a cast for seven weeks. She missed two weeks of work and had to hire landscapers to mow her grass and pull weeds until she regained the use of her hand and wrist.

Lisa endured sleepless nights because of pain, and suffered nausea and stomach upset from the pain medications and antibiotics she had to take after her surgery.

After her recovery, Lisa gathered evidence of her hard costs. Her medical bills, replacement services, and lost wages came to $18,300. She added one times that amount ($18,300) to account for her pain and suffering.

Lisa’s total demand for compensation totaled $36,600.

Prepare a Negotiating Strategy

If you’re going to handle your own slip and fall claim, you’ll need to develop a plan for how you’ll work with the claims adjuster.

You’ll want to make sure you remain calm and act professionally. But this doesn’t mean you have to agree with the adjuster if they challenge you on certain issues.

While negotiating strategies may vary with the specific facts of a slip and fall case, prepare yourself by trying to anticipate what an adjuster might see as a weakness in your claim. Then you can plan what to say and which evidence you can use to overcome the adjuster’s resistance.

There are some common “weaknesses” that adjusters will exploit to justify offering less money in the average slip and fall claim. You’ll end up with a higher slip and fall payout if you plan ahead to deal with the insurance adjuster’s tactics.

Adjusters Like to Blame the Victim

Claims adjusters are always looking for ways to shift blame onto the victim. Most states have comparative negligence laws the adjuster will use to lower your potential settlement or deny your claim in its entirety.

Comparative negligence is a type of defense in personal injury cases. In a slip and fall case, a property owner (or the insurance adjuster) asserts that you helped cause your accident or shared the blame for it.

For example, you may have tripped over a ladder at a hardware store while looking something up on your phone. If you file an injury claim with the store’s insurer, an adjuster will likely say that you were comparatively negligent because you weren’t watching where you were going.

Most states in the U.S. have a system of comparative negligence laws that allow injured victims to still receive compensation in cases where they helped cause their injuries.

Ask yourself if there was any way you helped cause your accident or contributed to your injuries. Even if you might have shared in only 1% of the blame for your slip and fall, take note of it, just in case the adjuster brings it up.

Prepare a response that works to counter a claim of comparative negligence. For example, if your fall took place on an icy sidewalk, be ready to explain why your footwear was appropriate for the weather and the occasion.

Dealing With a Pre-Existing Condition

Claims adjusters often try to minimize injury claims because the accident victim had a pre-existing injury.  You might have an old injury or condition that involves the same body part that you injured in the slip and fall.

Let’s say you slipped and fell on a wet floor at a grocery store, and hurt your knee. If you had surgery three years ago on the same knee, the adjuster might say they don’t want to pay for an already bad knee.

Be ready to tell the adjuster that you were completely recovered from your knee surgery more than two years ago, and had no pain or stiffness until the slip and fall. Know which medical records confirm that your knee problems appeared after the slip and fall.

Even if you have a pre-existing condition that makes you more susceptible to injuries than the average person, such as advanced age, you are protected by the “Eggshell Skull” doctrine.

The eggshell skull doctrine says that an at-fault party can’t deny responsibility for an accident because of the victim’s frailty, weakness, sensitivity, or feebleness.

In practice, the rule works to help compensate an injury victim if the slip and fall aggravated or worsened a prior condition or injury.

Get Ready by Learning the Lingo

A real difficulty with people handling their own injury claims lies in the fact that most are unfamiliar with the terms and phrases that get tossed around when claim negotiations occur.

While not technically a weakness in your claim, adjusters might use insurance lingo to bully you or paint you into a corner. At best, they use jargon to make you feel like they know more than you do about your insurance claim.

The most effective way to avoid this adjuster tactic is to get familiar with some terms often used in slip and fall injury cases.

For example, to succeed in your claim, you’ll have to prove the property owner was negligent in causing your slip and fall. Negligence means that the business or property owner knew, or should have known of a dangerous condition and failed to take reasonable steps to correct it.

If they say you were comparatively negligent, it means you failed to act as a reasonable person and helped bring about your injuries.

The common term in the two scenarios is “reasonable.” Get used to incorporating this term in your claim statements. Show that you acted reasonably or that a property owner acted unreasonably.

Other important terms to know include:

  • Hazard. In showing negligence, you often have to prove that an owner knew of some hazard, or dangerous condition, and failed to fix it or remove it.
  • Burden of Proof. Accident victims in slip and fall cases have the burden to prove that another person or business was negligent.
  • Invited Guest. A guest is someone a property owner invites onto their property, including customers and patrons. Property owners have a duty towards invited guests to make sure their property is reasonably safe.
  • Premises Liability. This term refers to the area of the law that focuses on what happens when a person is hurt on someone else’s property because of a hazardous condition. A slip and fall case is a type of premises liability case.
  • Statute of Limitations. This is the time period in which an injury victim must either settle their injury claim or file a lawsuit. The statute of limitation varies by state.

Attorneys Get Higher Slip and Fall Payouts

Some slip and fall victims can negotiate insurance claims on their own and receive favorable settlements. Claimants can generally settle their own insurance claim when they’ve recovered from minor injuries, the facts of their case are straightforward, and fault clearly lies with the other party.

However, severe injury claims and complicated slip and fall cases are best handled by an experienced attorney to maximize compensation.

You have the right to contact a slip and fall attorney at any time before settling your claim. If, for example, you have already begun negotiating your claim, you can still contact a lawyer if you are having difficulties with an adjuster.

Most slip and fall attorneys provide free consultations to injury victims, and there is no obligation. You can consult with more than one attorney before making up your mind.

If you decide to hire an attorney, most work on a contingency fee basis. You don’t have to pay any legal fees with a contingency fee agreement unless your case settles or you receive an award in court.

You can get a higher slip and fall payout with strong evidence, advance preparation, and sound legal advice from an experienced personal injury attorney.

Dustin Reichard, Esq. is an experienced attorney with 20 years of work in the legal field. He’s admitted to the Illinois State Bar and the Washington State Bar. Dustin has worked in the areas of medical malpractice, wrongful death, product liability, slip and falls, and general liability. Dustin began his legal career as a JAG... Read More >>