Insurance companies and law firms tend to have different methods for evaluating claims. Insurance companies may attempt to dilute the value of your claim and only with the assistance of experienced counsel can you achieve the full value of your claim. The value of any injury case is what it takes to get you back to the way your life was before the accident -- it's the gestalt of the damage you have suffered.
Here are some of the elements that factor into valuing your claim:
Property Damage. Can I get my property replaced? Yes. Perhaps your automobile or motorcycle was damaged or totaled in an accident. You should be restored to the position you were before the accident, whether that means repair or replacement of your property.
The measure of damages to a motor vehicle is the difference between its market value immediately before the crash and immediately after the collision. Falter v. Toledo, 169 Ohio St. 238; 158 N.E.2d 893 (1959), paragraph one of the syllabus.
If the accident victim’s vehicle was damaged and it is going to be repaired, then consider the residual diminution of value caused by the accident. Braum v. Kinderdine, 2nd Dist. No. 26298, 2015-Ohio-696; Rakich v. Anthem Blue Cross & Blue Shield, 172 Ohio App.3d 523, 2007-Ohio-3739, 875 N.E.2d 993 (10th Dist.).
Maximize the value of your reimbursement for your vehicle by obtaining estimates for its repair, obtaining quotes for a comparable replacement vehicle, and getting photos of the damaged vehicle in daylight.
Here's the formula for calculating the value of the property damage claim:
Actual Cash Value at time of crash
- Auto Insurance Policy Deductible
Settlement Amount
If you replace your damaged vehicle within a month of the crash, then the sales tax from that purchase will be reimbursed, as well. See A.C. 3901-1-54(H)(7)(f).
Ambulance Squad Transportation.Will an insurance company pay for my ambulance trip? Yes. Emergency transportation should be paid for by the insurance of the individual causing your injury.
Medical Bills. Will the insurance company pay my medical bills? Yes.
Medical bills for the treatment of your injuries, which were caused by the accident, should always be covered up to the reasonable value of those medical services. This includes the follow-up appointments with your primary care physician. Your health is the priority, and you should not worry about the costs of your medical bills. Follow your physician's recommendations for testing and diagnosis, treatment and therapy. *
The expense of medical bills are an important factor used in the valuation of the injured party’s claim. A proper evaluation requires knowing how the value will present in various situations. An increasing number of injured parties present without health insurance.
While any evidence of liability insurance is excluded by operation of the Rules of Evidence, the existence of health insurance adjustments, health insurance payments, and medical provider write-offs are relevant and admissible. Robinson v. Bates, 112 Ohio St.3d 17, 2006-Ohio-6362.
The Robinson effect is to diminish the value of your case due to the accident victim’s health insurance company paying and/or negotiating medical bills.
An unpaid and un-negotiated bill is the largest that the “Robinson number” will ever be.
However, it’s critical that the injured party is aware of the effects of unpaid medical bills: (a) collection, (b) credit reporting, and (c) liens against their recovery.
In an effort to stave off collection efforts, it may be suggested to provide a letter of protection to the medical provider informing them that you will protect their right to subrogation.
Lost Income. Can I be compensated for the time I missed from work? Yes.
Your lost wages are part of your damages. Had you not been injured, you would have been paid for working those hours. You should still receive that pay.
Lost wages are a common portion of the claim, and here's a simple formula to help calculate lost wages:
Hourly Employee: (Days * Hours) * (Hourly Rate) = Total Lost Wages
Salary Employee: (Days) * (Weekly Salary / 5 Days) = Total Lost Wages
Be sure to include vacation time and sick time lost due to the accident.
Physical Therapy / Chiropractor. If I saw a chiropractor or physical therapist, can I be repaid for those bills? Yes.
Those bills are part of your medical treatment. Your chiropractor or physical therapist is the best suited person to make the assessment as to when your treatment is complete.
Permanent Injury. I lost use of my leg in an accident, how is that valued? The loss of a limb is generally one of the more extreme injuries an individual can suffer. There are other injuries that can be permanent as the result of an accident.
Future Medical Bills. “A study by Radanov found that patients who reported pain immediately after their accidents were more likely to have pain at two years post-injury. It is generally recognized that patients with immediate symptoms are at a higher risk of long-term pain from whiplash.” See Radanov, BP, Sturzenegger M, De Stefano G. Long-term outcome after whiplash injury. A two-year follow-up considering the features of injury mechanisms and somatic, radiologic and psychosocial findings. Medicine 1995; 74(5): 281-476.
Pain & Suffering. Yes, you should be compensated for pain and suffering. A traumatic accident can cause anxiety, post traumatic stress disorder, and other emotional suffering. We have experience where client's of ours were completely incapable of driving -- not because of a physical injury, but because of an emotional injury. Further, you may have an inability to engage in traditional hobbies or family activities.
Ohio limits “pain and suffering” or non-economic damages by statute. R.C. 2315.21(D). The initial limit is that the non-economic damages cannot be greater than two times the compensatory damages from that defendant. (i.e. Consider whether there are multiple defendants – dram shop, respondeat superior).
Ohio’s “pain and suffering” statutory limits exempt attorney fees from that calculation. R.C. 2315.21(D)(2)(c). So if you’re in a case with low medical specials, but the facts demand higher punitive damages, then itemize your attorney fees. Nobody is going to be surprised that you don’t work for free.
Another critical exception to the statutory limits is that if the basis of the civil action is a felony for which the defendant was convicted or pled guilty to and the culpable mental state is purposeful or knowingly. R.C. 2315.21(D)(6). (Consider felony OVIs, drug abuse offenses, etc.)
Pain and suffering is an umbrella – it’s the category. Pain doesn’t have to be physical, it’s also emotional pain. Suffering doesn’t have to be physical, it’s also emotional suffering. Within that category, you have to consider the various elements that may be at play in a given case. There is, at least, a portion of your demand that comes in a narrative, in this area, I start this off with an introduction of the parties. Some of those elements or factors that you should be considering are:
(1) egregiousness of the tortfeasor’s conduct;
a. history of bad driving (search local courts)
b. alcohol related (history of OVIs / drug possession charges)
c. distracted driving (phone, music, map)
d. suspended license
(2) how good was victim’s life before the accident?
a. physical health
b. mental health
c. employment
d. relationships
(3) during the accident
a. driver’s fear in seeing the accident coming
b. driver’s physical pain
c. driver’s fear in seeing amount of blood, feeling pain, being strapped to a backboard
(4) long-term effects
a. driver’s physical and emotional pain (medical records, medical bills, fear of driving)
b. driver’s physical and emotional suffering (counseling, effect on relationships)
Loss of Consortium. My spouse wasn't in the vehicle, do they have a claim? Yes.
Your spouse will likely have to compensate for your unavailability to maintain your family home, pickup children, and maintain the marital relationship. There is value to this claim, and it needs to be calculated into the damages of your claim.