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Someone Said The Insurance Company Will Only Pay Three Times The Total Of My Medical Bills For My Case. Is That Right?

It depends on your case.

This is a “rule of thumb” that has been restated so many different ways – and for so many different values – that it probably does not tell you what your lawsuit is worth; and it avoids the issue of having to sit down and look at your lawsuit the same way the jury would.

Lawyers, insurance companies, and juries have struggled for years with valuing personal injury claims. The problem is that no one knows what a jury will award.

And each jury is different. A better way of putting it is that no one knows what your jury will award.

Lawyers phrase this different ways: “Trials are unpredictable.” “There’s no number written in the sky.” These are things we usually say when we talk to clients – or, for that matter, to the other side when we are trying to settle a case.

The jury is supposed to award both actual economic damages – medical expenses, lost wages, mileage – and damages for “pain and suffering”. The economic damages are usually relatively easy to calculate; the jurors agree or don’t agree on what expenses were caused by the accident, and add them up.

But the pain and suffering is different. It’s a big, fuzzy cloud. It depends a lot on what happened to you, the force of the impact, whether the person who caused the accident was negligent, reckless or willful in causing your injuries, whether you were injured by a popular corporation (In Cincinnati: LaRosa’s, Skyline Chili, Proctor and Gamble) or by an unpopular corporation (for instance: maybe a toxic waste hauler from New Jersey), whether you are going to need future medical care, whether you are going to continue being able to work, what your injury “looks like” to the jurors, etc.

The list goes on.

So, at some point, attorneys and insurance adjusters – or some of them – just started trying to figure out a simple way to calculate the value of a good settlement. They decided to take the medical bills – “the medical specials” – and multiply them by a certain number.

But the “number” used has “floated” over the past 25 years between five and 1 ½.

Does this seem foggy to you? I just said that “pain and suffering” was a cloud, and calculating the total damages is not much different. I have settled one case for 60 times specials – it was for improper use of a taser on my client – and other cases for the value of the medical bills alone.

And there are practical difficulties with the rule. The jury can award as medical damages either the amount that the doctors and hospitals billed – or the amount that your health insurance company paid the doctors and hospitals, which is always a lot less than the bills. The payments can be as low as 20% of the bills. So which number do you multiply?

When I was starting out in my own practice, I thought the multiple number was five. In the nineties – when juries started getting concerned about the McDonald’s coffee case – the multiple went lower.

Now, I hesitate to use any number at all. There are too many different ways to figure the damages. Using a multiple is too likely to either result in a demand that is too high to allow for meaningful negotiation, or too low to compensate my client.

I try to get as much money as I can for my client. So when I value the case, I try to look at every factor I think will influence the jury. And I try to avoid the “multiple” rule of thumb – unless it helps me win an argument with the adjuster.

I have been a lawyer over 30 years. When I figure out what to ask for from the insurance company, I talk to you and we agree on the number we will ask for, and we talk about what we are looking to actually settle for. I consider everything that I think helps your case. If you have a personal injury case in Cincinnati, Ohio or if you want to know what your lawsuit is worth, talk with an experienced Cincinnati Personal Injury Attorney about the case. Call me, William Strubbe, at 513-621-4775.

Because all situations are different, and because there may be other facts pertaining to your case that I don’t know about, you should not rely on this answer for legal advice. I am not your attorney, and no lawyer client relationship has been formed.

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