How Insurance Companies Evaluate Pain and Suffering in Personal Injury Claims

In personal injury claims, compensation doesn’t solely cover medical bills and property damage. It also includes an often intangible element known as “pain and suffering.” This encompasses the physical and emotional distress a person experiences due to an injury caused by someone else’s negligence. Insurance companies play a significant role in evaluating and compensating for pain and suffering in personal injury claims. In this blog post, we will delve into how insurance companies assess pain and suffering and factors that influence these evaluations.

Understanding Pain and Suffering

Pain and suffering are non-economic damages, meaning they are not easily quantifiable like medical bills or lost wages. These damages include:

1. Physical Pain: Compensation for the actual physical discomfort, pain, and limitations caused by injuries.
2. Mental Anguish: Compensation for emotional distress, including anxiety, depression, and post-traumatic stress disorder (PTSD).
3. Loss of Enjoyment: Compensation for the loss of the ability to enjoy activities or hobbies you once did because of your injuries.
4. Loss of Consortium: Compensation for the strain on personal relationships, including the impact on a spouse’s companionship and affection.
5. Disfigurement: Compensation for any permanent physical changes or scars resulting from the accident.

How Insurance Companies Evaluate Pain and Suffering

Evaluating pain and suffering is subjective, and insurance companies use various methods to assess these damages:

1. Multiplier Method: One common approach involves multiplying the total economic damages (medical bills, lost wages, etc.) by a certain factor, typically between 1.5 and 5. The more severe the injuries and the greater the pain and suffering, the higher the multiplier.
2. Daily Rate Method: This method assigns a daily rate for pain and suffering, often based on the daily earnings of the injured person. The total is then calculated by multiplying the daily rate by the number of days the person experienced pain and suffering.
3. Per Diem Method: Under this approach, a fixed amount is paid for each day that the injured person experiences pain and suffering. This method is less commonly used and typically reserved for specific cases.
4. Expert Opinions: Insurance adjusters may consult with medical experts, psychologists, or psychiatrists to assess the impact of injuries on an individual’s mental and emotional well-being.

Factors Influencing Pain and Suffering Evaluation

Several factors influence how insurance companies evaluate pain and suffering:

1. Severity of Injuries: More severe injuries often result in higher pain and suffering awards. Permanent or disabling injuries generally lead to larger settlements.
2. Duration of Recovery: A more extended recovery period can lead to a higher evaluation of pain and suffering.
3. Medical Treatment: The type and frequency of medical treatment, including surgeries, therapy, and medications, play a role in the evaluation.
4. Impact on Daily Life: How injuries affect the injured person’s daily life, including their ability to work, engage in hobbies, or maintain relationships, is considered.
5. Evidence and Documentation: Strong evidence, such as medical records, photographs, and expert opinions, can bolster a claim for pain and suffering.
6. Credibility: The injured person’s credibility and consistency in presenting their pain and suffering claims are essential.
7. Pre-Existing Conditions: The presence of pre-existing medical or psychological conditions may complicate pain and suffering evaluations.

Negotiating Pain and Suffering Settlements

Insurance companies often start with low initial offers for pain and suffering. Negotiating a fair settlement requires:

1. Thorough Documentation: Provide complete medical records, photographs, and expert opinions to support your claims.
2. Legal Representation: Consider hiring an experienced personal injury attorney who can negotiate on your behalf and present your case effectively.
3. Persistence: Be prepared for a potentially lengthy negotiation process, and don’t settle for less than fair compensation.
4. Staying Calm: Avoid accepting a low offer out of frustration. Maintain a calm and patient approach during negotiations.

Pain and suffering are significant components of personal injury claims, but they can be challenging to evaluate. Insurance companies use various methods and consider several factors when assessing these damages. If you’ve suffered injuries and believe you’re entitled to compensation for pain and suffering, consult with a personal injury attorney to help you navigate the complex process of evaluating and negotiating these non-economic damages. An attorney can work to ensure you receive fair compensation for the physical and emotional toll of your injuries.

A personal injury lawyer can help you understand your legal options and negotiate a fair settlement on your behalf. Click here to schedule a free consultation with one of our skilled California lawyers to learn more about your options. Or call our offices at 707 549 8166.