If you want to settle your personal injury claim, you need to know the full value of the claim. This is the starting to point to calculating how much a case is worth.
Knowing the full value can be helpful in other ways as well. For example, knowing the full settlement value may reduce the amount that you may need to pay your health insurance company from your settlement. Yes, health insurers are often entitled to get repaid from your personal injury settlement.
Here, I’ll tell you what insurance companies don’t want you to know about the full value of injury claims.
Some insurance companies refer to the full value as the pure exposure value. I’ve also heard a claims adjuster call the full value the “face value“.
What is the full value of claim?
It is the most probable full jury value of alleged injury (accepting all that is alleged as true).
The full value does not consider liability, comparative negligence, or other factors that affect personal injury claims. The full value is based on a reasonable jury’s likely verdict.
How do I know that at least one insurance company uses the term “pure exposure value”?
Search hard enough and you will find. The Hartford Insurance Company asks their attorney’s to state the claim’s pure exposure value. (The Hartford does this in its Attorney Report.)
Here is a screenshot from the Hartford Attorney Report:
If the Hartford asks their attorney’s to calculate a claim’s full value, it likely asks its adjusters to do the same.
Side note: The Hartford has a much better reputation for making fair offers than many other insurers.
Why you need to know the full value of a claim
Prospective clients, current clients and other attorneys often ask me how much their case is worth.
In order to know the full value of a case, you need to know the full value of pain and suffering for each claimed injury. You also need to know the total medical bills and lost wages. Medical bills, lost wages, pain and suffering are called damages.
Once you know the full value of the damages, you can then apply any factors that discount the value of your case.
How to Calculate the Full Settlement Value (Car Accident Example #1)
Here is an example that can help you understand the term “Full Value” as it applies in a personal injury case.
Let’s assume that you are driving a car in Florida. You aren’t paying attention. Thus, you crash into the back of the car in front of you.
We’ll assume that you’re claiming that the car accident caused your herniated disc. You’re 40 years old. Assume your out-of-pocket medical bills are $5,000.
In Florida, the “full value” of pain and suffering for a herniated disc that I use as a starting point for settlement purposes is $25,000 to $50,000. I know this range because I exclusively practice personal injury and have done so for about 10 years. I wrote an article that gives you average starting points for settlement values of pain and suffering in Florida injury cases and cruise ship cases.
There are no guarantees as to what will happen should a case go to trial. However, insurance companies run their business based on probabilities. Thus, they use settlement ranges to resolve cases.
Here are some abbreviations that I use when calculating the full value of an injury case.
“P & S” is Pain and Suffering.
“OOP” is Past and Future Medical Bills.
Now we look at the formula to determine the full value.
Full Value of Damages = (Medical Bills + Lost Wages + “P & S”)
Let’s look at the “full value” of this case:
“P & S” is the abbreviation for Pain and Suffering.
“OOP” is the abbreviation for Medical Bills You Owe.
Full Value of Damages = (Medical Bills + Lost Wages + “P & S”)
= ($5,000 + 0 + $25,000)
= $30,000
In this example you are at completely at fault, but the “full value” of your personal injury case is still $30,000.
This is true even if the liability claims adjuster may deny or minimize the existence, cause or severity of your herniated disc.
How is the “full value” still $30,000 if the other driver did nothing wrong?
It is because the “full value” of a personal injury case doesn’t consider factors that reduce case value.
How to Calculate Full Value (Slip and Fall Case)
Let’s look at another example of how to calculate the full settlement value.
Angela is staying at a hotel in Lake Buena Vista, Florida. Basically, she is at a hotel near Orlando, Florida. Walt Disney World and Universal Studios are in or near Orlando.
While Angela uses the bathtub, she slips and falls. Unfortunately, she breaks her arm.
At the hospital, she undergoes emergency surgery. The doctor puts a plate and screws into her arm. He also does a procedure called a biceps tenodesis. Biceps tenodesis is a surgery to repair the biceps tendon. Angela has a scar from this surgery. A scar increases the full value of an injury case.
Shortly after her accident, Angela opted to Get a Free Consultation to see if I could represent her. I accepted her case and became her lawyer.
Philadelphia Insurance Company insured the resort. (I’ve settled several personal injury claims with Philadelphia Insurance Company.)
Angela’s orthopedic doctor also diagnosed her with cubital tunnel. Fortunately, it went away after some time.
Several months later, she still had pain in her shoulder. Therefore, the doctor performed another surgery to remove the hardware. This left another scar on her shoulder. Now, Angela has two scars on her upper arm.
In order to know the value of Angela’s personal injury case, I first had to calculate the full settlement value. I assigned various amounts to the full value of the pain and suffering component of the claim.
Warning!
Unless you’ve settled hundreds of personal injury claims, don’t attempt to assign a full value for each injury. It takes years of experience and settling hundreds of injury cases to understand how to assign a full value to certain injuries.
That said, here are the full values that I assigned for Angela’s different injuries.
Full Settlement Value of Humerus fracture and surgery (With Issues) $250,000.00
Biceps tenodesis surgery $50,000.00
First scar from surgery $25,000.00
Cubital Tunnel diagnosis $20,000.00
Hardware removal surgery (under general anesthesia) $125,000.00
Second scar value $20,000.00
But calculating full value doesn’t end there. She also had other damages that I needed to add to the full value of her injuries. Her health “insurance” plan paid a little over $23,000 of her medical bills. And Angela’s out of pocket medical bills were around $3,265.34.
If you add all of these amounts together, it equals about $519,000. Thus, the approximate full settlement value of her case is $519,000.
Remember:
This full value does not take into account factors that may decrease the value of her case. As you may imagine, the resort’s insurer made several arguments as to why she believed that the resort wasn’t liable. And these defenses resulted in us accepting a $250,000 settlement for her slip and fall.
Check out the actual settlement check:
In a moment, we’ll get to the hotel’s defenses (and how they cut down the full value).
2. Full value is different from the Estimated Settlement Value of a case.
Now, your case could have a high “full value” but it still may still not be worth a penny. This is true in the car accident example above. This is because estimating the “full value” is the first step when calculating the settlement value in a personal injury case.
Now let’s use the formula below to take a look at how the “full value” of an injury case affects the settlement value. I will use the same abbreviations from the car accident example above. The formula to determine settlement value is:
Settlement Value = (Medical Bills + Lost Wages + “P & S”) x (% Chance of Defense Verdict) (100% – Your % of Comparative Fault)
Let’s plug the figures from the car accident example into this settlement formula:
Settlement Value = ($5,000 + 0 + $25,000) x (100% – 100%)
= ($30,000) x (0)
= 0
So, in the car accident example, even though the “full value” of your case is $30,000, your case is worthless because you were 100% at fault.
3. Why Settlement Value Doesn’t Always Equals Full Value.
Claimant refers to someone who is injured in an accident. Sometimes an injured person will compare their settlement offer to someone else’s settlement. If the injured person gets a smaller offer, he or she may think that his or her attorney is doing a bad job.
For example, let’s say that Mike is offered offered $10,000 for his claim. Assume that he had shoulder surgery as a result of an accident.
On the other hand, Bill has shoulder surgery from a car accident. Bill gets a $130,000 settlement.
Although the full value of their cases may both be $130,000 (or more), the settlement value is different. This is because Mike’s claim may have had factors that greatly reduced the his case value.
Let’s take the Car Accident Example 1 But We’ll Change Liability
Now let’s take example #1 but change a few things. Let’s assume that the front of the other driver’s car hit the back of your car and the other driver admits fault. You are 18 years old.
The property damage to your car was huge. Your out-of-pocket medical bills are $5,000. The “full value” of your damages is also 30,000, just as in example #1.
This is because “full value” doesn’t take into account things that help or hurt your case. But in example #2, the settlement value is $30,000. Let’s see why:
Settlement Value = (Medical Bills + Lost Wages + “P & S”) x (100% – Your % of Comparative Fault)
Let’s plug the figures from Example #2 into this settlement formula:
Settlement Value = ($5,000 + 0 + $25,000) x (100% – 0%)
= ($30,000) x (100%)
Settlement Value = $30,000
Hopefully, you now understand the term “full value”. Now, you’ll have a better shot at understanding case value. As a result, the other articles on this blog will make more sense.
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Editor’s Note: This post was originally published in March 2013 and has been completely revamped and updated.