QuestionDo adjuster settle claim by the claim merits? What kind of merits? Like if the injury was cause by a bad porch which was a building code violation? also is a emg proving severe nerve also help the claim? What do it mean by adjuster settle on merits.? Thank you for your time and help in advance.
AnswerHi Gb,
Dr. Settlement has settled hundreds of personal injury claims, and I can state that the “merits” is NEVER anything each side agrees upon, so what is a meritorious claim to you and me may be a deficient claim to the adjuster. In my opinion, the adjuster and her supervisor and her alleged “review committee” ALL FOCUS ON ONE THING IN EACH CLAIM: EXPOSURE.
In other words, it is a measure of the extent to which they feel a risk of loss that will dictate the value of the claim. That is what they call their exposure.
Let me explain it a different way. The adjuster wants to settle your claim for as little as possible and as soon as possible. To the extent that “merits” of a claim can be impressed upon the adjuster, she might raise her offer. But they are NOT going to raise their offer if the claimant lives far away and his doctors and damages witnesses are in a distant state. Why? Because of the difficulty of brining the lawsuit, there is less risk or exposure to a big loss.
So, from hundreds of personal injury insurance settlements, Dr. Settlement knows the three factors that go into the determination of exposure made deep within the insurance company claims office. The first is ALWAYS liability. Assess the chances to reduce liability from 100% down to even 80% by alleging comparative negligence.
The second factor is always damages. Did all of the alleged damages flow from this accident? And what damages ARE in fact attributable to the accident; and what difficulty will the claimant have in proving damages? Can the adjuster cut into the victim’s injury claims by insisting upon a so-called “independent” medical examination (IME)?
The third factor in assessing exposure is the capability of the victim to prosecute his claim to a jury trial success. Is the claimant and his doctor and his witness all located in a distant state? The cost of going to trial is also a factor to be considered. The plaintiff’s doctors will want thousands of dollars to testify, and most often those fees must be paid in advance. Even if the victim suffered serious injury, the insurance industry is NOT going ot pay out full value if the claimant lacks the capability of financing and prosecuting a claim to trial.
I believe that this pretty well summarizes the so-called merits an insurance company will consider in settling its claims: the amount will vary based upon exposure.
I trust that my time here has produced some information that has been of value to you, and thus I would respectfully request that you take the time to locate the FEEDBACK FORM on this site and leave some feedback for me.
Best Wishes,
Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com
