Is the pain and suffering based on a formula such as 3x medical bills in an auto accident? 28 Answers as of May 28, 2013

I've been doing some research on pain and suffering. Trying to avoid hiring an attorney. I was hit from behind sitting still, Speed of impact was 55 mph. She came through my truck and pushed me into the car in front of me. I sustained mainly soft tissue injuries whiplash/severe headaches, huge bruises everywhere, back/hip pain radiating down my leg. ( I had l5-s1) spinal fusion 8 yrs ago, I overcame the surgery and have worked very hard to be pain free. I've been running 5ks and workout at the gym 4 days a week. I feel like they may use the pre existing back surgery against me. My total hospital bill from day of accident was $40,000. I'm going to Physical therapy 3 days a week so who knows how much more the bills will be. Would it be safe to say they should give me 3x times medical bills or is that asking too much. It also totaled my 2009 Nissan car. Any input would be greatly appreciated . So frustrated!

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The S.E. Farris Law Firm
The S.E. Farris Law Firm | Spencer E. Farris
3X medical bills is a myth. Current Missouri Law says that the jury gets to hear the billed amount of medical bills, and the paid/insurance amount. Which bill would you think you are tripling? Further, you have a preexisting condition, which means that there will be an argument that this crash didn't cause a new injury, it aggravated an old one. Folks who hire attorneys get 4-5 times more for an injury than those without a lawyer. The notion that you will be better off settling and not paying a lawyer would be swell, if you had any chance of getting as much money on your own- you don't.
Answer Applies to: Missouri
Replied: 10/4/2012
Robinette Legal Group, PLLC
Robinette Legal Group, PLLC | Jeffery Robinette
I have written a book, Collision Care, which I provide at no cost to WV car accident victims, which answers questions like yours.
Answer Applies to: West Virginia
Replied: 10/4/2012
William C. Gosnell, Attorney at Law
William C. Gosnell, Attorney at Law | William C. Gosnell
Answer Applies to: Tennessee
Replied: 5/28/2013
Lewis B. Kaplan | Lewis B. Kaplan
Formulas like 3x medical bills are at best useful only in minor injury cases with small amount of medical bills. That does not seem to be your case . "Trying to avoid hiring an attorney." . In my humble opinion this is a bad decision . The other driver's insurance company is not your friend and will offer as little as possible.
Answer Applies to: Illinois
Replied: 10/4/2012
Sedin Begakis & Bish | Mindy Bish
No there is no formula for pain and suffering damages. The key is the method in which you present your case and articulate your pain and suffering when making a demand. I would use the testimony of other people to talk about what you were like before your injury and what it has been like after this accident.
Answer Applies to: California
Replied: 10/4/2012
    David F. Stoddard
    David F. Stoddard | David F. Stoddard
    There is no formula and you cannot assume three times medical bills. You do have what sounds like a serious injury. However, insurance companies are often reluctant to pay large settlements for "soft tissue" injuries. It does help that the car was totaled. They almost always refuse to pay much for low impart/soft tissue injuries. There are several things you need to think about. First, you need to find out how much insurance coverage exists if you haven't already done so. In addition to the other driver's liability coverage, you need to check into whether you have underinsured coverage. This will pay for any verdict in excess of the other driver's policy limits up to the amount of your underinsured coverage. Sometimes ascertaining the coverage becomes tricky because you can sometimes "stack" underinsured coverage if you have more than one vehicle. Often all your will ever recover is the amount of insurance coverage. If the other driver has minimum $25,000.00 coverage and no assets, then your claim obviously exceeds the coverage. The work in settling your claim then becomes settling all of the medical and health insurance liens so that you have some money left over for you. Before you settle for the policy limits if there is only $25,000 (or 50K for that matter), you will want to do some investigation into the other driver's assets to see if he is "judgment proof", meaning he has nothing from which you could collect a judgment. If there is plenty of insurance coverage (if a vehicle owned by a large company hit you, you needn't worry about coverage), then you need to consider the degree of pain you suffer, how the injury affects your life, and the duration of the injury. You really cannot answer these questions until you complete your medical treatment. I will assume for now that there will be some permanent impairment when you finish your treatment. However, until then, you do not know the degree of pain you will have to live with, or how the injury will affect your ability to walk, stand, sit, lift, squat, etc. In other words, you do not yet know how it will affect your life. Once you know the degree of pain you will live with, and how it will affect your life, then you need to figure out how you will preset all of this to a jury. Ultimately, your case is worth what you can convince a jury to pay you for your suffering, or what you can convince the insurance adjuster you can persuade a jury to give. I have practiced personal injury law for 18 years. I spend thousands of dollars and hours each year reading books and attending seminars to learn advanced techniques to present to juries, to educate juries, about my clients' intangible losses - pain, suffering, mental anguish, loss of quality of life). It involves psychology, communication, science, visual arts, and politics (This is in addition to the basics of Civil Procedure, Evidence, and Tort Law that I learned in law school). It is much more involved than you can imagine. I understand your desire to do this yourself. Unfortunately, It's a little like researching how to coach a football team and then taking over an NFL team. You might get enough book learning to get some things right, but the smartest person still needs experience. I learn something new with every case I handle that helps me with my next case. This is your first case.
    Answer Applies to: South Carolina
    Replied: 10/3/2012
    Danville Law Group | Scott Jordan
    There is no formula for compensation in an auto accident. Payments are based on the injuries, medical bills, wage loss, the insurance policy and what the insurance company perceives they can get away with. For instance, you admit you had a spinal fusion in the past, the insurance company will use this against you to reduce the value of your claim, even if you were 100% just before the accident. Have you tried to hire a personal injury attorney. Although they will take a fee, they are the ones that have to deal with the insurance company and feel the frustration with dealing with a claims adjuster. This allows you to concentrate on healing from your injuries.
    Answer Applies to: California
    Replied: 10/3/2012
    Hirsch, Closson, McMillan & Schroeder, APLC
    Hirsch, Closson, McMillan & Schroeder, APLC | Paul Schroeder
    There is no set formula. For a serious injury like this, I recommend hiring a lawyer.
    Answer Applies to: California
    Replied: 10/3/2012
    Adler Law Group, LLC
    Adler Law Group, LLC | Lawrence Adler
    There is no formula. You should hire an attorney. He will get you far more than you can get yourself, since he is knowledgeable and able to file suit. The insurance companies treat attorneys very different than those trying to save money and get it done alone. You would perform your own surgery without a doctor would you?
    Answer Applies to: Connecticut
    Replied: 10/3/2012
    Wild Sky Law Group, PLLC
    Wild Sky Law Group, PLLC | Roxanne Eberle
    Unfortunately, there is no "formula," but rather pain and suffering damages are based on the impact of the collision on your life and one's ability to convey that impact in an effective way (this is where attorneys help). I do not think that asking for $120,000 is too much, based on the information you conveyed. You also need to be aware of the jury instructions regarding prior medical conditions so you can effectively counteract them trying to use it against you, especially if you aren't going to hire an attorney you need to at least get up to speed to protect yourself. Also, please be aware that if the person who hit you doesn't have enough insurance, you have to get your own insurance company's permission to settle to preserve your right to under insured motorist benefits under your own policy so be tread carefully here. Your question raises a lot of red flags where at least consulting with an attorney for some advice would probably be a really good idea.
    Answer Applies to: Washington
    Replied: 10/3/2012
    Dwyer, Black & Lyle, LLP
    Dwyer, Black & Lyle, LLP | Kevin Habberfield
    The days of formulas are mostly gone. Unless the company is using Colossus, which they do in secret to avoid bad press. They will use your pre-x condition against you. You have to argue egg-shell plaintiff. I'd do jury verdict research in your venue to see what the case is worth along with reviewing the medical records.
    Answer Applies to: New York
    Replied: 10/3/2012
    Paul Whitfield and Associates P.A.
    Paul Whitfield and Associates P.A. | Paul L. Whitfield
    You are making a mistake trying to handle your own case. The adjuster is trained to take advantage of you and save his company money. If you have clear liability and 40000 in bills you are entitled to a large settlement. The 3x factor died 20 or more years ago. Your preexisting condition will be used against you but if your doctors say your condition was exacerbated by the collision you should prevail on that issue (but you may not. It is up to the jury) You probably don't know the amount of insurance coverage. You need to. You also need to know the assets of the driver and or owner of the car that hit you. have you checked them out wont do you any good to ask for big bucks if there is inadequate coverage and no assets to collect if you win. Sounds like you haven't thought of these things. A good personal injury lawyer usually gets a bigger settlement net for his client even after his fee is deducted than you can get for yourself. The insurance company knows he knows their tricks and can sue them. then they will have to spend 5 or 10000 to defend the case. quit trying to deal with this to save money. You wont likely save anything and you may be very disappointed at the way you are treated by an insurance company. They are in business to make money, not serve people. and the economy has the insurance companies scared to death.
    Answer Applies to: North Carolina
    Replied: 10/3/2012
    Law Offices of Susan M. Pires | Susan M. Pires
    There are many factors in evaluating a claim against a tortfeasor. You not only evaluate pain and suffering, but also list wages and medical bills.
    Answer Applies to: Rhode Island
    Replied: 10/3/2012
    The Lucky Law Firm, PLC
    The Lucky Law Firm, PLC | Robert Morrison Lucky
    No, it is not safe to say that they will pay you 3x the medical bills. Unfortunately, there is no real formula once your injuries grow more severe and the medical bills increase. There is much legal research that goes into determining case value. Further complicating your case is your prior medical problems. The insurance company will attempt to use your prior medical condition against you. It is best you get an attorney as soon as possible ti help fight the insurance company. Additionally, it has been found that attorneys get their clients 3x more than those who are represented.
    Answer Applies to: Louisiana
    Replied: 10/3/2012
    Frank Law Group, P.C.
    Frank Law Group, P.C. | Brett E. Rosenthal
    The amount of pain and suffering is dependent on many factors, not the least of which is the venue where the action has to be filed. Proper venue is the county where the defendant resides or the county where the accident occurred. They may be the same, but if not the selection of venue can be a critical issue in case value. For instance an accident that occurs in Nevada County where the defendant lives in Alameda County is a no brainer that you would want to file in the East Bay of SF because of the liberal nature of the area, which means juries are far more willing to award larger pain and suffering verdicts. The length of treatment and residuals are also important factors, especially when you have a history of the L5-S1 fusion surgery. Before I would ever recommend considering settling your claim would want to have your low back surgery evaluated by your prior surgeon to ensure that there has been no impact on your prior surgery. Your prior history is the classic example of the "egg shell" plaintiff in that the defendant takes you as he/she find you with your prior history. The positive about your prior history is that post the surgery sounds like you had a good result and recovered with no symptoms. Therefore, your prior surgery predisposes you to suffer worse injuries in the subject accident because your spine was already weakened from the prior injury. Your prior fusion puts more pressure on the adjacent lumbar spinal discs next to the fusion. Would definitely want your primary treater, which one would assume is an orthopedic surgeon, to render an opinion on your prognosis given your residual symptoms and what impact, if any the collision had on your lumbar spine. The 3X medical specials was a place to start during the booming economic times of the 80's and early 90's, however, in this current economy juries and as result, juries are not making pain and suffering (general damage) awards anywhere near the 3X medical specials. There never was a rule, but it was a ball park to begin the discussions during that time frame. Currently, there are too many variables to make a generalization on general damages, which includes the identity of the insurance carrier that you are dealing with because some are more reasonable than others, however, they are all going to low ball you on a non represented claim.
    Answer Applies to: California
    Replied: 10/3/2012
    Michael Anthony Wing, P.C.
    Michael Anthony Wing, P.C. | Michael Anthony Wing
    No, pain and suffering is a non-special damage, and it is determined ultimately by the judge or jury. However, there is a "rule of thumb" that many insurers attempt to apply to limit their payout to approximately three times your "special damages." Special damages are those that are "easily calculable." They are basically medical bills and lost wages. That is the short answer to your question, but there is a lot more to it, and some more aggressive adjusters prefer two times specials. You don't want to settle too early, in case you have other injuries that have not surfaced yet, but you do not want to let the statute of limitations expire. You need a lawyer to at least review your case. There are so many legal aspects that will likely apply to your case, and you will most likely not receive the maximum recovery from your insurer and the defendant driver's insurer. Do you have Uninsured/Underinsured coverage? Depending on the extent and duration of your injury, you would probably be able to make an agreement based on paying a lawyer just from recovering in excess of the last offer the insurer made. Depending on the extent and duration of your injury, you may need to claim on your own policy in addition to, or in place of, the responsible party's insurance, if you have UM coverage. Your Health insurer likely has subrogation rights, which means if you are able to make the defendant's insurer settle reasonably, then your health insurer will have to be paid back, however, there are laws that would likely require them to reduce the amount they seek from your recovery from the responsible party in relation to your costs to generate the recovery in the first place. Further, depending on your health insurance policy language, you could have no obligation to them from your own policy of UM coverage, or if it is an ERISA plan, then federal statutes apply.
    Answer Applies to: Alabama
    Replied: 10/3/2012
    The Law Firm of Reed & Mansfield
    The Law Firm of Reed & Mansfield | Jonathan C. Reed
    There really is no formula. A $40,000 hospital bill for a leg amputation would be worth a lot more than a $40,000 hospital bill for some bone fractures that heal nicely.
    Answer Applies to: Nevada
    Replied: 10/3/2012
    Ferguson & Ferguson
    Ferguson & Ferguson | Randy W. Ferguson
    No. That is not the rule. You have to evaluate everything to determine what the case is worth.
    Answer Applies to: Alabama
    Replied: 10/3/2012
    Law Offices of Ronald A. Steinberg & Associates | Ronald A. Steinberg, BA, MA, JD
    Pain and suffering in a Michigan auto case is based on the seriousness of the impact on your quality of life. If it was based solely on a multiple of medical bills, then a case with a huge bill from a chiropractor would be worth more than a leg amputation.
    Answer Applies to: Michigan
    Replied: 10/3/2012
    Maurice L. Abarr  Lawyer, Inc.
    Maurice L. Abarr Lawyer, Inc. | Maurice L. Abarr
    Insurance companies frequently evaluate cases with a computer program called Colossus.

    The method of case evaluation is formulized but certainly not simply 3 times the medicals.

    That was the method used in the '70's and '80's.

    You need to find out how much coverage the other guy has and offer to settle for the limit. They won't pay it most of the time but you will at least get their best offer.

    Watch what you say. Everything you say will be used against you . . . just like in a criminal case.
    Answer Applies to: California
    Replied: 10/3/2012
    Law Office of Stuart M. Nachbar, P.C.
    Law Office of Stuart M. Nachbar, P.C. | Stuart M. Nachbar
    In NJ, it first would depend on whether you have the verbal or zero tort threshold. If you had a verbal, then based on your injuries you would get zero.
    Answer Applies to: New Jersey
    Replied: 10/3/2012
    The Carlile Law Firm, LLP
    The Carlile Law Firm, LLP | D. Scott Carlile
    I do not believe that you will get an insurance company to pay both your medical bills and pay 3X medical for pain and suffering.

    A lot depends on where the accident occurred and what court you would have to file suit in. In my experience the typically conservative jury would award medical plus 1 to 1.5 times medical for pain and suffering.

    You are correct that they will argue that your preexisting back condition is a factor.

    In the end you must decide if you can get more money by handling the claim yourself or hiring an attorney.

    In general, you will get more with an attorney. Best of luck.
    Answer Applies to: Texas
    Replied: 10/3/2012
    Downriver Injury and Auto Law | Michael Heilmann
    There is no formula. Each case is judged on it's own merits.
    Answer Applies to: Michigan
    Replied: 10/3/2012
    Meyer & Kiss, LLC
    Meyer & Kiss, LLC | Louis J. Meyer
    A lot depends on the county you are in.

    The insurance companies look at the county to see what juries award. Part of that 3X is factoring in an attorney.

    The insurance company is pretty confident that you will not have a jury trial pro se.

    If you structure it correctly, you prior back injury can be used in your favor and not against you. I know you want to avoid having an attorney, but an experienced attorney can help maximize your compensation.

    There is a reason people hire lawyers!
    Answer Applies to: Illinois
    Replied: 10/3/2012
    Law Office of Lisa Hurtado McDonnell | Lisa Hurtado McDonnell
    That were I would start for medical compensation unless you have unresolved medical issues: example possible future surgery or permanent injury with impairment rating. Plus loss of wages and car damages or value your of your car. You should settle until medical issue are resolved after you have finished therapy.
    Answer Applies to: Utah
    Replied: 10/3/2012
    Fairlie & Lippy, P.C.
    Fairlie & Lippy, P.C. | Steven Fairlie
    3X medical bills is not a fair analysis of the case and is like bidding on a house without going inside it.

    For a case of this magnitude you should really get a good attorney - who will add more than the 1/3 contingency fee in value to your case.
    Answer Applies to: Pennsylvania
    Replied: 10/3/2012
    Rothstein Law PLLC
    Rothstein Law PLLC | Eric Rothstein
    There is no formula. In an auto case you need to show "serious injury" as defined by the Insurance Law. Representing yourself is a bad idea. How do you know what your case is worth? The insurance company does and it will try to take advantage of you.
    Answer Applies to: New York
    Replied: 10/3/2012
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