The principal factors in settling personal injury claims are same as the factors in settling any conflict -- the willingness of the two sides to reach an agreement.In personal injury cases this generally involves whether the injured party is willing to accept the settlement offer the defendant or his insurance company is willing to make... or whether the injured party can do anything to persuade a higher offer that would be acceptable.
Will your case settle? Depends on whether you want to accept what they offer. It is that simple.
If the question is, "How do you get the defendant or the insurance to increase their settlement offer to something you might find acceptable", you've asked a more difficult question. But in short you will need to persuade the claims adjuster that the insurance company faces a serious enough risk of a large enough loss if the case goes to trial, that the insurance company needs to raise its settlement offer sufficiently to get you to accept it.
To do that you need to persuade the claims adjuster or the defense attorney regarding the following general areas.
Fault
While insurance companies look at several factors in deciding what to offer in settlement, one of the most important on their list is fault. They want to know that their insured was at fault before they are going to pay anything... and they are also interested in knowing whether they could persuade a jury that you were also at fault.Fault can be based on intentional conduct, reckless conduct, or negligence. (There are some circumstances involving dams, defective products, inherently dangerous activities like use of explosives, or dangerous animals in which fault is not an issue -- if the defendant owned or controlled the "instrumentality of injury" and if the plaintiff did not intentionally cause his or her own injury, then the defendant is liable for the damages, but these are the exception and not the rule.)
Most personal injury cases are a result of negligence. (And since I offer no particular knowledge or expertise regarding products liability cases, I specifically warn that this may have very little application to such cases -- I simply do not know.) Tennessee is a comparative fault state, meaning an injured person's recovery is reduced by the percentage to which they were at fault in causing their own injury. For example, in damages were $10,000 and the plaintiff was 10% at fault, the plaintiff would only be entitled to recover 90% of their loss, or $9,000. Except that if the plaintiff is more than 50% at fault the plaintiff is entitled to recovery nothing, meaning that if the claims adjuster thinks a defense attorney can persuade a jury you were more than 50% at fault in the accident causing your injury, the claims adjuster may well offer nothing.
It's important to remember that there is no formula for assigning a percentages fault. (Different juries may look at the same set of facts and one jury could find the plaintiff 15% at fault while the other jury could find the plaintiff was not at all responsible for his or her injury. This sometimes happens because one person on the jury doesn't want to award anything and essentially holds the rest of the jury hostage until they compromise with that juror on what is a clearly unreasonable position.) During claim negotiations, you will come up with one number regarding percentage of fault, and the claims adjuster or defense attorney will come up with another, generally assigning most of the responsibility to you. The different percentages you each arrive at then simply go into the negotiating hopper along with the other factors you each consider in concluding what you feel the claim is worth. But remember that just as with all other issues in discussing settlement the real question is not what the claims adjuster says regarding fault, but what the claims adjuster believes, and ultimately what a jury is likely to believe.
Extent & Nature of Injury
Claims adjusters are often skeptical about any serious injuries claimed in auto accidents involving little damage to the plaintiff's car. Claims adjusters are also generally skeptical of any "soft tissue injuries", neck or lower back injuries, cartilage or ligament damage, ruptured discs... or pretty much anything that does not involve broken bones. Claims adjusters are simply by their nature predisposed to believe that all claims involve some degree of fraud... and they will deal with you operating under that assumption until they are persuaded otherwise. Often it is impossible to ever persuade a claims adjuster otherwise.While a good attorney is likely to value the case based on what is expected to happen at trial, and as a result will give a great deal of weight to what kind of impression you're likely to make at trial, a claims adjuster is far more likely to focus almost entirely on other things; medical history, history of any prior claims for personal injury, the medical reports in your case, and the total dollar figure from adding up medical bills, future medical expenses, length of time required for recovery, lost earnings, and property damage, also giving some weight to the length of any incapacity, the nature and extent of any permanent disability, and exactly what kind of injury you had -- a soft tissue injury where the defense attorney can argue you were faking... or a compound fracture where you had a broken bone jutting out of your arm.
Claims adjusters tend to rank injuries along the following scale, with the injury justifying the lowest settlement offer listed first and the then continuing in descending order as each subsequent listed injury is generally viewed as worth a greater settlement offer.
Soft tissue
Dislocations, separations, and ligament or cartilage tears
Serious wounds and scars
Psychological injury
Broken bones
Spinal disc or vertebrae injury (that clearly show up in X-rays or other diagnostic imaging tests and
that are clearly the result of the accident and not the result of long-term degeneration)
Amputations, brain damage, and catastrophic injuries:
Wrongful death
Type of Treatment
Claims adjusters tend to doubt the merit of anything other than traditional treatment. One reason they doubt the merit of such treatment is that they know juries tend to doubt such treatment. This means that even though you may bet some benefit from alternative practitioners (including chiropractors, naturopaths, massage therapists, acupuncturists, acupressurists and herbalists), claims adjusters and juries are unlikely to feel that such treatment was needed or helpful and therefore unlikely to either include it in their settlement calculations or in the case of juries in awarding damages. Some claims adjusters and juries will even suspect that such treatment was not needed at all but was simply an effort to run up your medical bills to get a larger settlement or damage award. Because of this it is very important to make sure that any such alternative treatment is something you discuss with your treating physician. If your physician agrees and recommends the treatment you can generally overcome this problem.
Frequency and Length of Treatment
Claims adjusters and juries both tend to believe that a person who is actually injured will seek medical treatment and will follow a doctor's advice and will keep all of his medical appointments. Treatment that is immediate and continues for a some time until your physician tells you that you are as well as you are going to get, is considered stronger evidence of injury and will cause claims adjusters to make higher settlement offers because it also encourage juries to return larger damage awards. Insurance company generally brief view treatment as an indication the injury was not very severe.A person claiming serious injury with major effects on his or her life is not likely to be believed if he or she never went to the doctor. If treatment is not sought immediately after the injury, claims adjusters tend to believe they were not very serious, and may be entirely fraudulent.
By the same token if an injured person goes to the doctor "too much", claims adjusters will expect jurors to think the plaintiff is simply doing this to "drum up the claim," and will offer little by way of settlement.
Venue
The venue of the case is the place where the case will be tried, the county or the Federal Court District. Some counties or cities tend to be more favorable than others in awarding damages in personal injury cases.Insurance companies keep track of these things and raise or lower their settlement offers accordingly. Hamilton County tends to have very conservative juries, meaning small damages awards and juries finding plaintiffs were at fault when juries in other counties would not. Claims adjusters know this and tend to make lower settlement offers as a result.
While a lawsuit can only be brought in one court at a time, sometimes the plaintiff has an option of filing suit in different courts, each of which could properly hear the case. In these situations the choice of where to file suit will be an important factor influencing how much the insurance company offers to settle a case.
Attorney's Reputation
Another important factor in settlement is the reputation of the plaintiff's attorney, and how he or she handles the case in getting it ready for trial. Attorneys with a good track record at trial will create considerable pressure on a claims adjuster or defense attorney to offer a settlement figure you will accept. The prospect of the insurance company needing to pay a defense attorney to take the case to trial and to then lose in trial is not attractive to an insurance company and can do wonders to help settle a case.By the same token, if your attorney has a reputation for settling everything, or doesn't know his way around the courthouse well enough to find the restrooms, the claims adjuster and defense attorney will know... and they will lower their offer accordingly, knowing that your attorney really isn't a trial lawyer.
If you try representing yourself, the claims adjuster will likewise know that you are not likely to be able to take the case to trial, and that the more you delay in getting an attorney the harder it will be to find a good attorney willing to take your case and the harder it will be to properly prepare the case for trial... and the claims adjuster will reduce his offer accordingly. Studies have shown that simply having an attorney represent you, regardless of the attorney's skills, will increase figure a case settles at by an average of 100% -- having an attorney doubles the settlement value of the average case.
Likeability of Plaintiff and Defendant
As I've said, this is something your attorney is likely to give much more weight to than the claims adjuster or defense attorney, but jurors make their decisions based on feelings at least as much as on facts. These are important factors to consider in deciding whether to accept a settlement offer.
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