How Insurance Companies Value Car Accident Claims
How Insurance Companies Value Car Accident Claims
If you have been involved in a car accident, understanding how insurance companies evaluate car accident claims is crucial. The process can be complex, and without proper documentation and legal representation, you may receive a settlement that does not fully compensate you for your injuries and losses. Here, we break down how insurance companies determine the value of your car accident claim and what you can do to maximize your compensation.
The Role of Medical Treatment in Car Accident Claims
One of the most significant factors affecting car accident claims is the extent of medical treatment received. A lack of medical treatment can severely limit your ability to recover compensation. Large insurance carriers such as Progressive, State Farm, GEICO, Allstate, National General, and USAA handle thousands of claims daily. Due to the sheer volume, they rely on standardized computer models to determine payout amounts rather than assessing each case individually.
These insurance companies use sophisticated software that analyzes various factors, including:
- Medical expenses
- Diagnosis codes
- Wage loss
- Accident location
- Vehicle damage and total loss assessment
Of these, medical bills and diagnosis codes play a particularly crucial role in determining the final settlement amount.
Understanding Diagnosis Codes and Their Impact
Diagnosis codes are alphanumeric codes assigned to specific medical conditions. Based on the International Classification of Diseases (ICD), they are used for health insurance billing, data analysis, and importantly, insurance claim evaluations. When an insurance company processes a car accident claim, it heavily weighs these codes in determining the settlement offer.
For example, consider two medical providers treating the same injury. If one provider documents multiple diagnosis codes accurately while another provides only one or two, the insurance company’s algorithm may assign drastically different values to their respective car accident claims. Thorough documentation is critical in maximizing compensation.
The Demand Package: Presenting a Strong Case
At our firm, every car accident claim is supported by a meticulously prepared demand package. This package includes:
- A detailed demand letter explaining liability, damages, and the legal basis for compensation
- Medical records and bills
- Diagnosis codes, highlighted and itemized for clarity
- Police reports
- Witness statements
- Photos and videos of the accident scene
- Vehicle repair estimates
- Evidence of injury, including photos from different stages of healing
By clearly presenting this information, we ensure that no crucial details are overlooked by the insurance company’s software or claims adjusters.
Below is an example of how our car accident attorneys do that to increase a car accident claim and to ensure nothing is missed:
Dr. Smith diagnosed her with the following:
Abdominal wall contusion S30.1XXA
Ventral hernia K43.9
Right hip pain M25.551
Cephalohematoma S00.93XA
Head injury S09.90XA
Documenting Injuries for Maximum Compensation
Photographic evidence of injuries is essential in car accident claims. We include:
- Photos immediately after the accident
- Images showing the healing process over time
- Documentation of any permanent scarring or disfigurement
- Video showing recovery and the need for medical devices
- Radiology films showing hardware from surgery
In cases of severe scarring injuries, we may also consult with plastic surgeons to obtain estimates for future corrective treatments. These projected medical costs can significantly impact the value of a car accident claim, making a substantial difference in the final settlement.
Challenges with Insurance Adjusters and Low Settlement Offers
Even with comprehensive documentation, insurance companies often undervalue car accident claims. Their evaluation systems focus on objective data and fail to consider subjective factors like pain, suffering, and the impact of injuries on daily life. For instance, a construction worker suffering from a spinal injury may experience far greater challenges than someone with a desk job, yet insurance algorithms fail to account for such personal circumstances.
Their evaluation systems focus on objective data and fail to consider subjective factors like pain, suffering, and the impact of injuries on daily life.
Insurance adjusters, often handling hundreds of cases at a time, may not take the time to advocate for fair compensation. Many adjusters are bound by the limitations of the software-generated offers and lack the authority to negotiate higher settlements.
The Impact of Injuries on Caregivers
The same principle applies to individuals who have young children at home. A parent responsible for caring for infants or young children may face significant challenges due to their injuries, making daily tasks such as lifting, feeding, and playing with their children difficult or even impossible. The physical strain and emotional distress of being unable to care for their family can be substantial.
Similarly, individuals with elder dependents may experience heightened anguish when their injuries prevent them from providing necessary care. The inability to assist an aging parent with mobility, medical needs, or daily activities can create additional stress and emotional hardship. These factors, while deeply impactful, are often overlooked by insurance adjusters when evaluating car accident claims. Ensuring that these personal circumstances are properly documented and presented is critical in obtaining fair compensation.
Why Litigation May Be Necessary
When an insurance company refuses to offer fair compensation, litigation may be the only option. By filing a lawsuit, we ensure that the defense attorneys thoroughly investigate our client’s injuries and the impact on their life. This process includes:
- Depositions, where clients detail how the injury has affected their daily activities
- Testimony from pain and suffering witnesses, such as family members and coworkers
- Expert witness testimony on future medical needs and financial losses
Choosing the Right Attorney for Your Car Accident Claim
Given the complexities involved in securing fair compensation for a car accident claim, choosing the right legal representation is crucial. At Piccuta Law Group, LLP, our experienced personal injury attorneys have a proven track record of litigating high-value car accident claims and obtaining substantial settlements and verdicts. We are committed to fighting for the maximum compensation our clients deserve.
If you or a loved one has been injured in a car accident, contact our firm today for a free consultation. We are ready to help you navigate the claims process and, if necessary, take your case to court to ensure you receive the justice and compensation you deserve.
About the author: The content on this page was written by California personal injury attorney and civil rights lawyer Charles “Tony” Piccuta. Piccuta graduated with honors from Indiana University-Maurer School of Law in Bloomington, Indiana (Previously ranked Top 35 US News & World Report). Piccuta took and passed the State bars of Arizona, California, Illinois and Nevada (all on the first try). He actively practices throughout California and Arizona. He is a winning trial attorney that regularly handles serious personal injury cases and civil rights lawsuits. He has obtained six and seven figure verdicts in both state and federal court. He has been recognized by Super Lawyers for six years straight. He is AV Rated by Martindale Hubble. He is a member of the Consumer Attorneys of California, American Association for Justice, National Police Accountability Project, Arizona Association of Justice, and many local county and City bar associations.
Disclaimer: The information on this web site is attorney advertising and is for informational purposes only. It does not constitute legal advice. Reading and relying upon the content on this page does not create an attorney-client relationship. If you are seeking legal advice, you should contact our law firm for a free consultation and to discuss your specific case and issues.
