Do Insurance Companies Pay for Pain and Suffering?

February 2, 2023 | David Abels
Do Insurance Companies Pay for Pain and Suffering?

Do insurance companies pay for paint and suffering? After suffering an injury that was the result of the negligent actions or inactions of another person or party, you have legal rights. You have the right to seek legal help from an experienced personal injury attorney. You also have the right to seek compensation, which your attorney can help with. The amount of compensation you receive arises from the types and amounts of damages you have from your injuries.

Typically, when an injury occurs, pain and suffering is compensable damage. Therefore, insurance companies must pay for pain and suffering. This applies in many different injury or accident scenarios, including those involving:

  • Car accidents
  • Semi-truck collisions
  • Pedestrian accidents
  • Motorcycle crashes
  • Bicycle crashes
  • Boating accidents
  • Premise liability, such as slip and falls
  • Dog bites

It’s best to consult a personal injury attorney after sustaining an injury in any of these scenarios. Your lawyer can navigate your personal injury claim and tell you what your claim might be worth, including your claim for pain and suffering.

Compensation Offered by Insurance Companies

Do Insurance Companies Pay for Pain and Suffering?

Insurance adjusters will provide you with their calculations regarding the value of your personal injury claim. Can you trust that their valuation represents your losses? Most of the time, the answer is a resounding no. Your claim can be worth much more than what they offer you. This is why many injured individuals choose to hire a personal injury attorney.

Unfortunately, there is no one formula to determine the exact amount of compensation you deserve, especially for pain and suffering damages. Fair compensation is often difficult to determine, but many factors can help you estimate what you should receive for your damages. Keep in mind that no two personal injury cases are exactly the same. How much you receive depends on your medical expenses, lost income, and the extent of your pain and suffering. Determining what our injury claim is really worth involves many factors.

How Much Compensation Could You Receive?

This is a common question for anyone considering a personal injury claim, whether it is due to injuries in a car accident or a premise liability case. Settlements and monies awarded by the court for personal injuries usually vary significantly in value.

Your injury resulted in various types of losses, often referred to as damages by insurance companies.

Damages fall into two categories; most injured individuals will have some from each.

  • Special damages: These damages are also known as economic damages. They are easily calculable and represent the monies you lost due to the negligence of the other person or party. Special damages include elements such as lost wages and medical expenses.
  • General damages: These are also called non-economic damages, representing the intangible losses you have suffered or will suffer in the future. They include pain and suffering, loss of society, loss of enjoyment of life, loss of consortium, humiliation, scarring, disfigurement, and mental anguish.

Determining the Value of Pain and Suffering Damages

Insurance companies, judges, and juries calculate your pain and suffering damages by first determining how many days you anticipate the pain and suffering to continue. A daily rate is sometimes applied to each of those days and multiplied by the number of days you will endure the pain and suffering. Another way to determine the value of pain and suffering is by using the multiplier method. Courts and attorneys can also look to similar cases in their jurisdiction as a guideline for how much a case can be worth.

Valuing Special Damages

Calculating special damages is usually straightforward. Your lawyer will add the monetary costs and expenses of your injury and accident together.

They might include:

  • Past and future lost income
  • Medical expenses, including therapies and nursing care
  • Related out-of-pocket expenses such as medication, transportation to medical appointments, and medical devices like crutches or braces
  • Costs for things you cannot do because of your injuries, like childcare, grocery shopping, housekeeping, and yard work
  • Lost or damaged personal items, also known as property damage

Medical expenses are a necessary element of a personal injury claim. Include the total of your medical and prescription costs, even if your health insurance covered some or all of the bill. You should also be sure to include all of your bills related to your services.

For example, if you had imaging like MRIs, CT scans, or X-rays, you will likely receive a bill from the hospital or facility and also from the radiologist who interpreted the test and provided the results. If you went to the emergency room, you will usually receive separate bills for the hospital and the physician who treated you.

Valuing General Damages

General damages are undoubtedly more difficult to assign a value to as they are subjective. There is no way to measure each claimant’s general damages monetarily, and every case is different.

Even if you sustained the exact same injury as someone else, your pain and suffering will differ. You might develop anxiety and depression, and the other person may not. Your injury might prevent you from working while another person may still do their job.

Often referred to simply as pain and suffering, general damages can include:

  • Physical pain
  • Emotional distress
  • Anxiety and depression
  • Loss of consortium
  • Lack of concentration
  • Sleep disturbances

If you sustained significant injuries, hire a skilled personal injury attorney who will ensure the insurance company provides you with fair compensation for your pain and suffering.

Personal injury calculations for high-dollar personal injuries take into consideration:

  • Severe mental anguish: You should receive more compensation if your mental anguish is severe. This can be easier to establish in your case if you need to see a mental health professional for your mental anguish.
  • Permanent injuries or persistent pain: General damages can also be greater if you have long-term pain, permanent physical injuries, scarring, amputations, disabilities, or paralysis.
  • Shocking events: If your injury happened due to a traumatic event such as a shooting, an aviation crash, or entrapment in a burning vehicle, your general damages will likely be worth more.

Determining the value of your general damages is up to you. Only you know the pain and suffering you are going through. What makes these claims difficult is that you must prove your pain and suffering to the insurance company, convincing them that they need to pay you what you deserve.

Proving Your Fair Compensation

Once you determine what your personal injury claim is worth, the next step is for your personal injury attorney to establish that:

  • The person or party they insured owed you a duty of care or had an obligation not to harm you
  • That person or party breached their duty to you and was negligent in their actions
  • Their negligence directly caused your injuries
  • Your injuries caused damages, which the insured is liable for

Establishing these critical points is done by providing photographs of your injuries or the accident, witness statements, medical records, supporting documentation and bills, and other evidence. You or your attorney will send your demand for compensation along with copies of your medical records and other relevant evidence.

The estimate of your claim is the sum of your special and general damages. This sum should be your demand for compensation.

Personal Injury Calculators and Insurance Carriers

Most of the time, the insurance adjuster will deny your first demand for compensation. The adjuster should carefully examine your demand for compensation to determine how you calculated the amounts and if the evidence you provided supports your demand.

They will also determine if their insured person or party is entirely liable for the injuries you sustained. They will also review evidence for your special damages for legitimacy.

The adjuster will determine how much they believe is appropriate for general damages and compare it to the amount you requested. Their assessment will always be less than yours because they want to pay as little as possible for all injury claims. If insurance companies paid everyone what they wanted for their claim, their profits would be much lower.

Settlement negotiations rely heavily on you or your personal injury attorney convincing the adjuster that the evidence you provided fully supports your calculations. Unless you are a skilled and successful negotiator, this is a job best left up to your attorney. There’s too much at risk for an amateur to attempt negotiations themselves.

Settlement Calculators

Personal injury settlement calculators do exist, and many insurance companies use them to reduce their payouts. Colossus is one of the most common computer programs of this type. These programs are created specifically for insurance companies. They assign values to your special damages and other elements of your personal injury claim.

Colossus and other similar applications rely on hundreds of factors in your claim, such as if you hired a personal injury lawyer and the average settlement amounts for similar injuries in your region.

Personal injury attorneys aggressively contest programs like Colossus as they cater to the insurance company itself, and multiple variables can unfairly decrease the claimant’s compensation. Even a simple clerical error in the system can unfairly reduce the value of your damages.

Even more concerning is that these programs don’t have the capacity to calculate the depth of your pain and suffering and don’t account for the negative impact of your injuries on your life. Instead, they generalize how much you are owed based on statistics that cannot measure an individual’s pain and suffering.

Other Factors of Pain and Suffering Compensation

Other factors that can significantly impact the insurance company’s calculations for personal injury settlements include:

  • Policy limits: If the ceiling of the insured’s policy is less than your damages, you will need to file a lawsuit against the negligent person for the difference. For example, suppose your claim is worth $50,000, and their insurance policy was only for $30,000. In that case, you can potentially receive the full $30,000 from the insurance company but might need to file a personal injury civil lawsuit to recover the other $20,000 from the party who caused your injuries.
  • Inconsistent medical expenses: The insurance company will only pay for medical costs that they feel are reasonable and necessary. If a personal injury medical provider inflates your medical bills with excessive tests and treatments, the adjuster can refuse to calculate your damages with them. By working closely with a well-versed personal injury attorney, you can ensure that you aren’t receiving unnecessary medical care and that your medical costs are appropriate. Remember that your pain and suffering compensation often depends on the value of your economic damages.

Increase Your Pain and Suffering Injury Compensation Representation with an Experienced Personal Injury Attorney

Gary Annes Attorney for Car Accident Cases near Chicago
Gary Annes Personal Injury Lawyer

Insurance companies do pay pain and suffering but prefer that you reach a settlement with the assigned adjuster in your claim without representation from a personal injury attorney. They know that injured parties with legal counsel usually receive more for their damages than those without. The last thing they want is for you to hire your own personal injury attorney.

If your claim winds up in a trial, there is always a risk to the insurance company that a jury can determine that your damages are worth far more than even your original settlement demand. It’s also risky for injured individuals to go to trial, as the jury can determine they deserve far less or nothing. Sometimes, however, a trial is necessary to get the full amount you deserve.

Your personal injury lawyer can negotiate a fair settlement that will keep both parties out of a courtroom facing risk. They can help you determine if an offer covers full and fair compensation for your pain and suffering, as well as other damages. Keep in mind that your rights to seek compensation depend on the statute of limitations in your state, so it’s best to get legal help as soon as possible.

Abels & Annes, P.C.

Address: 100 N LaSalle St #1710,
Chicago, IL 60602

Phone: (855) 529-2442
David Abels Author Image

David Abels


David Abels has carved a niche for himself in the personal injury law sector, dedicating a substantial part of his career since 1997 to representing victims of various accidents. With a law practice that spans over two decades, his expertise has been consistently recognized within the legal community.

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