WHY YOU SHOULDN’T ACCEPT AN INSURANCE COMPANY’S FIRST OFFER
June 24, 2021
According to the Florida Department of Highway Safety and Motor Vehicles, the state saw an average of 1,101 vehicular accidents per day in 2019. The department reported 401,867 accidents statewide involving 689,474 drivers, resulting in 236,753 injuries and 3,185 fatalities.
If you’re one of the tens of thousands who suffer injuries on Florida's highways and byways each year, you may be wondering what happens once you submit your claim to your insurance company, which is where you must start under the state’s no-fault insurance rules.
Will you get a fair settlement? Should you accept the first offer? Should you even deal with your insurance company — or the other driver’s insurer — on your own?
If you’ve been injured in an automobile accident in or around Altamonte Springs, Florida, or in the neighboring communities of Orange, Seminole, Osceola, or Volusia, contact me at the Law Office of Mark A. Cornelius P.A. I have been representing clients in Central Florida with their personal injury claims for more than 25 years. I bring the experience and knowledge necessary to help you seek the best available settlement.
How Insurance Companies Determine Settlements
Insurance companies rely on a highly paid team of professionals known as “claims adjusters” to determine settlements in personal injury cases. Adjusters will search for any factor available to try to keep your settlement as low as possible since they’re paid to protect the insurance company’s bottom line.
Generally, after the adjusters do their fact-finding — which will include interviewing you — they will assemble what they call the “specials” — the total of medical and related expenses, along with lost wages.
From that figure, they will apply a “multiplier,” which ranges from 1.5 to 5, to determine what they consider to be a “fair” settlement. If the specials add up to $10,000, a 1.5 multiplier yields a $15,000 settlement by their calculation.
The higher the multiplier, generally speaking, the more serious your injury. Other factors weigh in as well, however, including your share of the fault for the accident (using Florida’s comparative negligence standard).
The first offer they’ll present is usually a percentage of the fair value they’ve determined through the multiplier process. It could be 40%, or higher or lower, since there is no single industry standard. Each company is different. In other words, a first offer is not going to be at full value, and you shouldn’t accept it.
In some cases, you may never even get to the settlement offer stage. The adjuster assigned to you may keep stalling or making excuses — or the company may even switch adjusters in midstream to start the process over again — with the hope that you simply give up or the statute of limitations runs out.
Determining True Medical Expenses
Your injury may be a lingering one that requires repeated medical treatment, which is another factor to consider in any settlement. Once you accept a settlement, even if your injury flares up again, you cannot go back and ask for further compensation. A settlement is forever.
You may want to consider the long-term medical implications of your injury, but the insurance company may invoke the principle of maximum medical improvement (MMI). MMI means that your injury has healed to the fullest extent possible and/or that further treatment will not yield additional benefits to your healing process. In short, you will receive no further compensation.
If You Reject the Settlement, What Comes Next?
If you deem your settlement offer to be insufficient, you certainly have a right to decline it. What happens then? Without legal counsel, you’re probably at the mercy of the insurance company, which will likely stick to their proverbial guns and not budge. They’ll move into waiting-game mode until you give up or time runs out from a legal standpoint.
Your only recourse is to write a demand letter to the insurance company, detailing every medical procedure, treatment, medication, physical therapy, or rehabilitation expense you’ve incurred, along with lost wages. Describe your pain and suffering, but don’t be overly dramatic. Be professional in tone. Attach supporting documents. Finally, state the settlement figure you’ll accept, but leave wiggle room for further negotiations.
A demand letter is your best and only remaining option if the insurance company has dug in their heels on a settlement offer that you consider to be too low. After submitting the demand letter, negotiations may resume, and the two sides can pursue a mutually acceptable figure.
How a Personal Injury Attorney Can Help
The question is: After reading about adjusters and the settlement process, do you really want to endure all of it by yourself? A personal injury attorney can handle the negotiations for you while you recover from your injuries.
This discussion also assumes that you’re working only through your own insurance company, which is your starting point. The other driver’s insurance company will also likely be involved, trying to establish comparative fault.
Though Florida has historically had "no-fault", PIP, insurance as mandatory coverage, adjusters still use the comparative negligence standard to assign blame for an accident. If you’re determined to be 20% responsible for a collision that resulted in your injury, for instance, your settlement offer will be reduced by 20% to account for your portion of fault.
On top of this, this doesn’t take into account the potential for a personal injury lawsuit against the other driver. A lawsuit expands the potential for your compensation and should be weighed as a valid option. Florida sets conditions for personal injury lawsuits, so you definitely need legal counsel if you wish to proceed in this direction.
As mentioned above, I have been dealing with insurance companies, adjusters, personal injury claims, and civil lawsuits for a long time. I have a track record of achieving solid results. If you’ve been injured in one of those 1,000-plus daily Florida auto accidents, call me immediately at the Law Office of Mark A. Cornelius P.A. I serve clients throughout Central Florida, and so call or reach out to my office to learn more about how I can help you with your case.