How Does a Personal Injury Claim Work?

By Kate Bruscke

Understanding Personal Injury Claims

A personal injury claim is a means for a person to collect damages if he is injured by the actions or negligence or another entity. Personal injury claims can include physical damage---pain and suffering, long or short term disabilities, or wrongful death---but may also include emotional or psychological injury, such as emotional distress. Personal injury claims are designed to help the victim recoup monetary losses or debt incurred because of the injury, such as medical or hospital bills. Even if the injuries incurred are minor and temporary, filing a personal injury claim may award substantial financial restitution, or in the cases where damage was caused by extreme negligence, the claim may also award the victim punitive damages.

Getting Representation

It is usually recommended that someone considering a personal injury claim seek representation as soon as possible. Depending on the case, most attorneys specializing in personal injury work on contingency, or a percentage of financial damages awarded at the end of the claim. Over the past few years, there has been a growing push for individuals to settle their claims with an insurance company using mediation instead of litigation. Taking a claim through hearings and the court system is costly and can take several months---or several years. Mediation is often looked at as a way to settle claims faster and more efficiently for both the injured and the insurance company (or representative agency).

Time to File

Depending on where you live, the type of injury was sustained, and who or what caused the injury, there are time limits to filing a personal injury claim. For example, the victim may only have 120 days to file a claim against city official verses 2 to 12 years to file a worker's compensation claim for injuries received while on the job.

The Damages Formula

If and when a personal injury claim is being filed against an insurance company, an insurance adjuster usually approaches the victim with a compensation offer, usually a point where the negotiations for the final compensation amount begins. The adjuster uses a "damages formula" to determine this dollar amount. The damages formula is actually simple: the adjuster adds up the total amount of medical bills related to the injury (which are called "medical special damages") and uses that number as a base figure. The adjuster adds to that base amount any income lost because of the injury. Depending on the severity of the injury, the adjuster must also add in damages for pain and suffering and other such damages, or "general damages." If the injury is minor, that base amount of medical special damages is multiplied by 1.5 or 2, but if the injuries are severe, that factor can increase.

Who's at Fault?

Another big issue that must be taken into account when a company or representative agency determines how much to compensate a victim is determining who was at fault and to what extent. In most cases, there is little argument as to who's responsible for the injury, but there can be negotiation over what percentage. In many cases, the victim is also determined to have a percentage of fault, and that percentage can reduce the amount offered as compensation. Every personal injury claim is different, however, and the particular circumstances and local laws ultimately decide who is awarded and how much.

About the Author

A writer and professional lab assistant based in Seattle, Kate Bruscke has been writing professionally about health care and technology since 1998. Her freelance clients include "The Seattle Times," KGB.com, Reading Local: Seattle, Nordstrom and MSN/Microsoft. Bruscke holds a Master of Fine Arts from The School of the Art Institute of Chicago.