Elements of a Good Case: What Insurance Companies Care About

A comprehensive overview of the evaluation criteria utilized by insurance companies when assessing General Damages and Pain and Suffering Awards in auto accident cases in the state of Utah. Understanding these factors is essential for accurately estimating payouts and effective representation.

  1. Nature and Extent of Injuries:• Severity, permanence, and impact of injuries sustained in the accident.
    • Medical records, diagnostic reports, and expert opinions are crucial in establishing the extent of physical harm. Photos of the injury, location, cars or equipment involved and property damage to both vehicles is helpful to assess the severity of the impact forces calculated by experts based on damage.
  2. Medical Expenses:• Total medical costs incurred, including hospitalization, surgeries, medications, therapy, and rehabilitation.
    • Receipts, bills, and documentation must be meticulously gathered and presented.
  3. Loss of Earnings and Future Earning Capacity:• Determining the extent of lost income due to the accident, including any future loss of earning potential.
    • Pay stubs, tax returns, and expert testimony may be required to support these claims. Also copies of logs for all household services provided to you from any source while you were restricted by doctors or by pain itself. Your lawyer can provide you with weekly log sheets to keep track.
  4. Pain and Suffering:• This encompasses physical pain, emotional distress, and mental anguish caused by the accident.
    • Detailed accounts from the victim, therapist assessments, and psychiatric evaluations can be used as evidence. Photos and X-rays can speak volumes to the pain a patient may have suffered. How long will a client be facing the pain and restrictions caused by the accident.
  5. Impact on Daily Life and Enjoyment:• Assessing the disruption to the victim’s routine activities, hobbies, and overall quality of life.
    • Testimonies from the victim and witnesses, as well as documentation of lifestyle changes, are relevant. Photos of scarring can emphasize the nature of a person’s lifelong struggle to accept their new look and the constant reminder it will be in the future. Impairment ratings can quantify your restrictions and a life expectancy table can show how many years a client may continue to suffer from accident injuries .
  6. Pre-existing Conditions:• Consideration of any pre-existing injuries or medical conditions that may have been exacerbated by the accident.
    • Expert medical opinions are essential in establishing the causal relationship between the accident and exacerbation. Be sure not to omit any prior injuries you may have suffered to your lawyer. He has to know ahead of time. This affects value of the damages but also the credibility of the client. A client who falsely hides their prior injuries prevents their lawyer from properly addressing those injuries but also receives a black mark from insurance companies and juries as to when the client should be believed in other areas of damages. Credibility is everything to insurance companies .
  7. Comparative Negligence:• Utah follows a comparative negligence system, which means that if the victim is found partially at fault, their compensation may be reduced proportionately. But in particular, in Utah a finding of 50 % or more fault on the injured party can defeat a case all by itself. You must alert your attorney ahead of time to the good and bad facts surrounding your case otherwise the insurance company can magnify the fault you will receive. Undisclosed thorns in your case can severely damage the ability to represent you effectively.
  8. Insurance Policy Limits:• Evaluating the coverage limits of the at-fault party’s insurance policy to determine the maximum potential payout. If the limits are low, your case may need special attention to prevent health insurance from taking all of your settlement to pay themselves back. Read my article on avoiding health insurance liens and tell me about you accident as soon as possible so I can truly help you avoid this problem.
  9. Legal Representation and Strategy:• The quality of legal representation, strategy, and advocacy can impact the outcome of the case and subsequent settlement negotiations. By reducing or even avoiding health insurance liens we can often double the net proceeds to you from insurance companies. Sometimes clients just wait too long to hire us and it costs them tens of thousands of dollars . Some strategies can only be implemented in the first week or two after the accident.
  10. Case Precedents and Jury Awards:• Reviewing past cases with similar circumstances in Utah to gauge potential awards and settlements. Fortunately hiring an attorney with over 35 years of experience who has successfully resolved over $100 million in claims against insurance companies gives us our own precedence of cases to cite to insurance companies and about which we have great insight into the factors of why each case settled as it did.