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How Insurance Adjusters Calculate Settlement for a Personal Injury

Thursday, June 23, 2016

When you’ve been injured and are looking to settle with the insurance company regarding compensation for your personal injury, you may wonder how the insurance adjuster calculates the value of your claim. There are no set rules and no guide that helps the adjuster determine the amount: It’s generally an educated guess.

The insurance adjuster must investigate your claim and document enough information so the insurance company can set the adjuster’s requested reserve on your claim. Once that is approved, the adjuster attempts to settle at or below that set amount.

Evaluation of Injury Claims

One way or another, insurance companies must evaluate insurance claims. Over time, they’ve relied on a few tactics in order to establish the claim reserve, and they’ll use that reserve as a guide to settle the claim.

Some adjusters use a method that triples the “specials”. These are the components of a settlement that pertain to the lost wages and medical bills. The adjuster would try to settle for three-times that total amount, adding in the cost of pain and suffering, along with other damages.

Personal Affect

Some insurance companies understand they cannot evaluate all claims in the same manner. Sometimes adjusters need to consider how the injuries affect the personal life of the injured. They’ll ask themselves questions such as can the injured person work, can he do household chores, can he still maintain an intimate relationship with his spouse? These are questions that require a bit more personal detail, but those factors are considered.

Computer Evaluation

Some adjusters just input the information into a computer and rely on the calculations that come from the data. This is more of a “one-size-fits-all” adjustment which can be manipulated when needed.

The bottom line is, your injuries are personal to you, and you want to ensure you receive a fair settlement. When you're ready to settle, contact us and we will make sure the insurance adjuster gives you an offer you can live with.


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From our offices in Woodland Hills, California, Freeman & Freeman, LLP, provides legal advice and representation for clients in communities throughout the state, including those in Burbank, Glendale, Encino, Sherman Oaks, Van Nuys, Tarzana, Santa Clarita, Agoura Hills, Reseda, Canoga Park, Chatsworth, Northridge, Granada Hills, Pacoima, Panorama City, North Hollywood, Thousand Oaks, Simi Valley, Lancaster, Palmdale and Alhambra.