Visitor Question

Does auto insurance pay less if my health insurance paid medical costs?

Submitted By: Autumn (Springfield, OH)

Eight months ago, I was in a car accident on the interstate due to a woman merging from the right lane to the middle lane, and then continuing into my lane (the left lane). The impact caused my car to spin across the 3 lanes of the interstate and I came back and hit the cement median (head on).

I was transported by ambulance to the hospital and diagnosed with back strain, contusions on both my knees, and whiplash.

Other than the soft tissue damage, I had no other injuries (no broken bones, etc.). I do however, have extreme anxiety being in a vehicle ever since the accident.

I also had my plans of having my car paid off dashed, along with the added stress of finding a car ASAP and finding rides in the mean time.

Anyway, the car insurance company said that my medical bills would have been about $6,800, but due to the discounts that my health insurance had, my bills only equaled out to about $2,500 (for the reimbursement of my health insurance, and the medical bills that would have come out of my pocket).

The insurance company tried to offer me $2,000 for pain and suffering, but that seemed very low to me.

Should they be using the original $6,800 for the multiplier, or should they be using the $2,500?

I’ve also read varying things on what goes into the multiplier, should I be putting the property loss (my car) and medical bills into the multiplier when trying to figure out how much I am getting, or just go off of my medical bills?

This is all so confusing and trying to figure out whether I need a lawyer or not is proving to be a headache within itself. Thanks for any info you can provide.

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.


Dear Autumn,

There is no exact manner in which to calculate a settlement using a multiplier “effect.” It is true that some attorneys rely on a multiplier. However, there is no exact science to it. When attorneys do rely on a multiplier, they generally take medical and therapy bills and multiply them by anywhere from 1½ to 5, or higher, depending upon the severity of the injuries sustained. An attorney’s estimate is heavily based on experience.

However, insurance companies rely on more sophisticated ways to arrive at settlement offers. Some insurance companies rely on computer programs, such as “Colossus,” which review such factors as severity of injuries, whether or not an attorney is representing the injured party, the attorney’s track record of filing lawsuits or settling them, and more.

When relied upon, a rather low multiplier is used for “soft tissue” injuries. Soft tissue injuries normally include back strain, minor contusions, whiplash, strains and sprains to muscles, tendons, ligaments, minor burns, cuts and abrasions, and other relatively minor injuries. Multiples for soft tissue injuries are normally 1½ to 2 times the amount of medical and therapy bills.

However more serious “hard injuries” including fractures, 3rd degree burns, deep cuts and gashes usually requiring stitches, spinal injuries, head trauma, and other serious injuries demand multiples of anywhere from 2 to 5, and even higher.

In your case, you sustained soft tissue injuries including back strain, contusions on both my knees, and whiplash. You would be fortunate to receive 2 times the amount of your medical and therapy bills. You should of course begin negotiations at an amount higher than that, perhaps 3 times medical bills, so you have room to negotiate.

Learn more here: Calculating Pain and Suffering Costs

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney.

Find a local attorney to give you a free case review here, or call 888-972-0892.

We wish you the best with your claim,


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