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Factors Affecting Injury Traffic Accident Compensation Amount

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While there is no definitive formula or method of calculation that will determine the average car accident settlement amount, there are many factors that can come into play in how your claim or case with the insurance company will be evaluated by the insurance company and the jury. We can list these factors as follows:

1. Concrete Situation

Your “own” concrete situation is very important, as the concrete situation will vary from case to case. Factors such as the amount of damage to your vehicle, which city in Texas can be sued, where the competent court is, whether you have a witness or any other evidence that you can prove the other party’s fault in the accident, whether the defect rates in the accident are controversial, whether you are not wearing your seat belt, etc. may be in your favor. It could be against you too.

2. Medical Treatment

Your amount of medical treatment will definitely affect your compensation amount. For example, if you went directly to the emergency room by ambulance from the accident scene and then continued your treatment with the relevant doctors, this will affect you positively while determining the compensation amount. A stable medical treatment, which is verified by doctor/hospital reports and invoices, is one of the most important factors in calculating the injury accident compensation amount.

3. Severity Of Injury

The severity of your injuries is just as important as your medical treatment amount when determining compensation. The more serious your injuries are, the higher the compensation will be, considering other factors are in your favour.

4. Insurance Policy Limits

The limits of the other party’s insurance policy significantly affect the amount of compensation you can receive. For example, suppose the other party’s insurance policy has a minimum coverage for bodily injury. Minimum limits in Texas are $30,000 per person and $60,000 per accident. In this case, the other party’s insurance will be liable within the limits specified in the previous sentence. In this case, if you have a driver’s coverage that does not have sufficient insurance in your own policy, you can apply for this coverage. Or, if you do not have such a guarantee and your losses exceed the minimum limits of the other party’s insurance, you can sue the party that caused the accident for compensation for your losses. However, suing a person who is already unable to pay his debts/bankruptcy may be fruitless.

5. Previous Claims

Each insurance company examines whether the injured victim has filed another claim in the past. If a large number of claims have been filed in the past, insurance companies may use this as a justification for reducing the amount of compensation or rejecting the claim altogether. When they see a large number of pre-opened requests or they feel suspicious about an already filed request, they will turn your request over to the fraud department, also known as the Special Investigation Unit, for review.

6. Insurance Company

Just like any other product and service on the market, the insurance you buy comes in different quality levels. In return for very cheap premiums, they write only minimum policies, specify “specific driver names” in the policies they write, only cover these drivers, and when there is another person driving the vehicle other than these names, they exclude the damages caused by the accident they have done, that is, they are filed against them. There are also insurance companies that do everything they can to get every claim covered in some way. The good news is that; As of January 1, 2020, it is no longer legal to write insurance policies by specifying only certain driver names. If you had to deal with such an insurance company,

7. Mutual Defect

Texas has adopted the Modified Mutual Fault rule. This means: If you are also at fault in the accident, the compensation you will receive for your damages will be reduced in proportion to your fault. For example, let’s say you are 50% at fault in the accident and your total damage is $100,000. In this case, you are entitled to compensation for 50% of your losses, ie $50,000. Also, according to this rule, you are not entitled to compensation for your losses if you are more than 50% at fault.

8. Health Insurance / Medicaid / Medicare

If your health insurance, Medicaid, or Medicare has paid for some or all of your treatment bills, this may adversely affect the injury car accident compensation amount. Texas Civil Practice and Remedies Act Section 41.0105  and Texas Supreme Court,  Haygood v. DeEscabedo  and  Daughters of Charity Health Serv. of Waco v. Linnstaedter has considered  cases where a source of coverage, such as health insurance, pays a lower amount for the injured party’s treatment bills and how this will affect the amount of compensation the injured party can receive. Haygood According to the case, reimbursement of treatment bills paid by these sources on behalf of the injured person is limited to the amount actually paid. That is, if your health insurance, Medicaid, or Medicare pays a lower amount for your treatment bills, the amount of damages you claim may also be reduced.

9. Plaintiff’s Profile

The claimant’s treatment history and whether they have any pre-existing conditions have a major influence in determining the amount of compensation. In addition, the plaintiff’s age, gender, occupation, criminal record and physical appearance also affect the settlement amount. The age of the claimant may affect the amount or amount of compensation for certain damages, for example, depending on whether the injury aggravates a pre-existing condition (eg, degenerative disc disease). Insurance companies may also consider the plaintiff’s gender and occupation when assessing whether the plaintiff can paint a strong and credible portrait before a jury. Juries see certain professions as more reliable (eg nurses). These facts affect the amount of injury car accident compensation.

10. Defendant’s Profile

This is true of the defendant’s background, just as juries tend to view certain characteristics of the plaintiff as either negative or positive. For example, important factors such as the defendant’s past accidents, i.e. driving record or whether the defendant is a “company”, significantly affect the amount of injury car accident compensation. In cases where the defendant is a company, the amount of compensation tends to increase.

11. Aggravating Factors

If the defendant drove while intoxicated and caused an accident or was hit and run, the insurance company would be more willing to allocate a larger amount of funds to settle the outcome of the case to avoid paying punitive damages, taking into account the gross negligence of its insured. In such cases, the risk is certainly greater for insurance companies. Therefore, the value of such cases is greater.

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