By: Karen Piso Nadeau, Esquire

Whether it is the client’s first phone call to our Cambridge law firm or an existing client finishing their treatment for injuries suffered in an accident, one of the most often asked questions is: “How much is my case worth?”  Or asked another way: “What amount of compensation do I deserve?” There is no simple answer to this. The amount of money placed on your case depends upon several factors. No two cases are alike. Often, it is difficult if not impossible to give an accurate assessment of a client’s case value in the initial call or early in the process. Moreover, it seems that so many people, who are not lawyers or insurance claims adjusters, we affectionately call “street lawyers” have already given our clients their opinions on the value of their cases. For example, a client may say that their friend got a hundred thousand or their relative got a million dollars. Often, our clients have very little information about another person’s case such as their injuries, their medical treatment, the amount of their medical bills, their disability, or time lost from work. The reality is that you can’t compare your injury case to another person’s personal injury settlement of their case without knowing some specific facts.

This blog will explore some of the main factors that are considered by an insurance company in evaluating your case value. Almost always, when you suffer injuries in an accident, whether it is a car, bicycle, pedestrian, trip and fall or other type of accident, it is the insurance company for the negligent and at fault party that evaluates and pays your claim for personal injury. Here are some of the most significant things considered when determining how much your case is worth.

1. The Type of Injuries You Suffered

The type of injuries you suffered is the most important factor considered when deciding the value to place on your injuries. Someone who suffers a leg fracture requiring surgery, in-patient hospitalization and rehabilitation will be entitled to a lot more money than a victim who suffers an ankle sprain that recovers within a few months. We look to verdict and settlement research as well as our many years of experience in estimating a range of value for an injury suffered. For example, we know that fractured ribs and sternums, despite being very painful, are not valued that high by insurers as they tend to heal on their own.  The diagnosis by your doctors of your injuries plays a key part in case value.

2. The Need for In-Patient Hospitalization and In-Patient Rehabilitation

 The need for in-patient hospitalization and in-patient rehabilitation are other important considerations. The length of time you are stuck in a hospital recovering or in a rehab facility receiving care to get back on your feet are considered. Usually, the longer you are in-patient, the worse the injury is. Some of our clients have multiple hospitalizations over time due to their injuries.

3. Broken Bones, Shoulder Tears, Meniscus Tears, and the Like

 Occasionally, a client’s injury is not diagnosed early on. Sometimes a shoulder injury with pain and difficulty with movement is simply monitored by the treating doctor for a period of time to see if there is improvement and resolution of symptoms.  After months of waiting and perhaps conservative management such as physical therapy, a doctor may then decide to order more imaging such as CT scan or MRI.  Sometimes, MRI and other imaging show damage not visible on x-rays. For example, we have clients diagnosed with shoulder tears or hip labral tears months after the accident. Surgery may occur months after the accident. Objective evidence of injury-meaning x-rays, MRI’s, CT scans revealing fractured bones or a meniscus tear of the knee etc.- carry a lot of weight when determining the value to place on your case.

Scars present another challenge when evaluating case value. Sometimes this is subjective, and insurance companies tend to minimize the value of a scar. The type of scar, the size of the scar and where it is located on the body are all factored in.  I often remind the insurance company that I would not want that scar on my face, leg, hand, or arm or that I wouldn’t want to see it on a loved one when they try to place little value on a permanent scar on a client’ body.

4. Neck and Back Injuries

Many car accident cases and even slip and fall cases have clients suffering neck and back injuries. There is a wide range when looking at the severity of neck and back injuries, and the insurance company recognizes this when placing value on your case.  A client who has soft tissue neck and back pain and treats for only several months with physical therapy or chiropractic care may have a case valued at 5K-10K by an insurance company, or even less.  Then there are neck and back cases with nerve impingement or perhaps disc herniations shown on MRI.  Some of these clients may see orthopedic doctors or pain management doctors and have a series of injections. Some of these cases may be valued at 45K-65K by an insurance company.  Then there are serious cases where a client needs neck fusion with an orthopedic surgeon performing surgery.  A case like this may be hundreds of thousands of dollars or even a million dollar or more case. The lesson here is that neck and back injuries range widely in value depending on the injury and treatment needed.

5. Head Injuries and Traumatic Brain Injuries

Like neck and back injuries, head injuries have a wide range of value. One question always asked is whether the victim suffered a loss of consciousness.  Losing consciousness is considered a more serious factor in assessing case value.  Head injures may be caused in a car accident by striking your head against a headrest or perhaps shattering the glass windshield. We have clients who hit their head on the rear-view mirror or against the door or steering wheel.  We also see a lot of serious head injury cases where clients slip and fall and strike their head on the ground.  Some clients suffer head injuries when walking across a street and being struck by a car. We also see clients injured by falling objects such as concrete blocks or in a retail store when some item falls on them. The diagnosis of a head injury and the treatment needed for you to heal are considered when determining the value of your case.

A minor concussion with no loss of consciousness and little treatment will be viewed as a smaller case. A head injury requiring staples to the head, with loss of consciousness and concussion symptoms requiring extensive medical care will be viewed as a serious case with higher value. We see clients who suffer head trauma treat conservatively at first with a wait and see approach.  Some clients develop memory loss, blurred vision, difficulty concentrating, light sensitivity, headaches, fatigue, and balance issues. These types of symptoms are typically described by medical doctors such as a neurologist or primary care doctor as “post-concussion symptoms”.  Treatment may include seeing a neurologist or physiatrist, occupational or vestibular therapy, cognitive therapy, rehabilitation specialists, or diagnostic testing such as EEG or brain MRI.

Some clients show objective findings on brain CT or MRI like skull fractures or brain bleed. In catastrophic cases involving head trauma, we see clients with traumatic brain injuries known as TBI’s. Several cases involve drivers or passengers in a vehicle thrown into the windshield and violently ejected from the vehicle resulting in tragic brain damage whereby they may be unable to speak or care for themselves or make decisions and require 24-hour care. Some have permanent brain damage whereby they have memory loss and can’t function independently. The type of head injury, treatment needed, and disability are considered when the insurance company places a dollar value on your case.

6. Type of Treatment, Amount of Treatment and Length of Treatment

The 3 T’s are important factors in evaluating your personal injury case value: 1. Treatment type; 2. Treatment amount; and 3. Treatment length.  The type of treatment such as the specialists needed to treat you, the diagnostic testing required, the rehabilitation, physical therapy, procedures needed, and surgery required are all reviewed. How often you must treat for your injuries is considered.  The number of times you need to go to a specialist or have therapy is reviewed. The length of treatment is a very critical factor in evaluating the value to place on your case.  If your treatment period is short, it is given less value than a victim who needs to treat for a year or more to alleviate their symptoms and get better.

7. Future Medical Needs

Future medical care and costs cannot be overlooked when evaluating the range of value to place on a personal injury claim. Some injuries may require treatment indefinitely into the future. When this happens, we look to experts such as our client’s treating doctors or a life can planner to provide an opinion on our client’s future medical needs. This may add significant value to a case because it shows the injured party has not recovered and has ongoing medica issues from the accident that require medical care. Some examples of future medical needs may be physical therapy, future surgery, follow up care with specialists, need for medical equipment or replacement of such equipment over time. The amount of medical bills, past and future, is a significant consideration in evaluating the case value.

8. Lost Wages & Loss of Earning Capacity.

The time period an injured party is unable to work due to the injuries suffered in the accident and lost earnings of a victim may add significant value to a case. Some clients are totally disabled from their employment due to the injuries suffered in an accident. Two things are needed to prove a lost wage claim: 1. a disability note from your doctor stating the period of time you are unable to work and 2. A wage verification whereby your employer sets forth your job title, your hours worked, your hourly wages and or salary and the dates you were out of work due to the injuries preventing you from working.

We have clients who have $50,000.00, $100,000.00 or more lost income due to injuries that prevent them from doing their job. Some clients have severe injuries that permanently disable them from ever working their job again. In these cases, the number of expected years left working and lost earning capacity are taken into consideration. Vocational experts and economists are sometimes retained on cases involving a loss of future earnings to assist in providing an expert opinion of lost future earnings. This may be a significant number.

Self-employed victims often turn to tax returns and business records to assist in establishing the lost income they suffered from being unable to run their business due to the injuries from the accident.

Final Thoughts On: How Much Is My Case Worth?

In summary, the question clients want answered is:

How much is my case worth?

The truth is- no one knows for sure at the beginning of your case. Your medical diagnosis, prognosis, treatment, lost wages, current and future medical expenses all need to play out before an estimated range of case value may be determined.

The big take away is this-

Every client’s case is different. No two cases are the same. Comparing your case to a friend’s or relative’s case may not be a fair assessment. There are many factors that play into how an insurance company determines the compensation to pay. As your lawyers, Nadeau Harkavy LLC have the years of experience and perform the research needed to evaluate a range of case value specific to your case and what is best for you.  More often than not, actually, almost always, the insurance company will low ball you and offer you less than you deserve to see if you will bite. The first offer is usually unfair and feels like you are the victim all over again. Sometimes, negotiations take time and persistence to get you the money you and your family deserve.

Two Final Obstructions That May Negatively Impact Ultimate Settlement

Insurance coverage and comparative negligence may ultimately decrease the settlement value of your case.  These two things can’t be ignored when settling a case.  A case may be worth millions, but if the at fault party only has 100k in insurance and no assets to chase, you may never get more than 100K. This is not easy to accept when you are a victim who suffers a tremendous loss at the hands of another’s wrongful acts. Case value is not the same as what your case may settle for. You often can’t get more than the insurance coverage.  It doesn’t mean it is just or fair.  It is reality. There are things that can be done to explore the negligent party’s assets and if additional insurance coverage exists to get you as much as possible. However, insurance policy limits may be all you can ever obtain.

Also, if you are partially to blame for the accident, an insurance company will say you are comparatively negligent and decrease your case value by the percentage you are at fault.  For an easy example, if your case value is 100K but the insurer says you are 30 percent responsible for the car accident, the insurance company will decrease the value of your case by 30 percent or 30K leaving you with only 70K to recover in settlement.  Insurance companies will use comparative negligence every chance they get to minimize your case value and pay you less.  An example of this is a pedestrian in a car accident. The insurer may say the pedestrian is partially to blame for not walking in a crosswalk and place a percentage of blame with the pedestrian injured to reduce the value of their case and ultimately what the insurance company pays out.

At Nadeau Harkavy LLC, we have over 60 years combined experience representing injured people and their families when they have been involved in an accident. We have recovered millions of dollars in compensation for our clients over the years to help them get on with their lives after suffering the consequences of a serious accident.  We make sure everything is done to protect your interests while you and your family concentrate on getting better. We handle all types of accident cases including wrongful death, brain injury, car accidents, bicycle accidents, pedestrian accidents, trip and fall, slip and fall, dog bite, construction site, and catastrophic injury accidents. If you or a loved one has been harmed as a result of another’s wrongdoing, call us today for a free consultation about your legal rights at 617-674-7640.