5 Factors Car Insurance Companies Consider When Evaluating Accident Claims

5 Factors Car Insurance Companies Consider When Evaluating Accident Claims

Car accidents happen far too often in Florida. While an individual may be responsible for an accident, it is typically their insurance company that is responsible for evaluating your injury claim and paying out compensation. While the insurance company may look at a variety of factors, there are a few main factors that I have found to be commonly mentioned when discussing claims. Therefore, here are 5 factors car insurance companies consider when evaluating accident claims that come up most often.

Severity of Injuries After A Car Accident

Injuries are always going to be a primary factor when it comes to accident claims. Someone that is more injured is likely going to have suffered from more pain, is going to have more current medical bills and is going to have more future medical bills. Therefore, the insurance company is willing to compensate more, if policy limits permit of course, to protect their insured. For example, the insurance company often asks if there is any visible bruising, scarring, loss of consciousness or broken and fractured bones. These typically signify more severe injury which leads to more pain and suffering and more medical bills than other types of injuries. The bigger the injuries, the more attention this factor is given.

Permanency of Injuries After A Car Accident

After seeing the doctor, you may be told that you have a “permanent injury.” Why is the insurance company concerned if you have suffered a permanent injury? It is because they know that permanent injuries often lead to prolonged pain and suffering and future medical bills. For example, if you were to have a herniation in your lumbar spine, your back, many may consider this to be a permanent injury that may require treatment if the future. This future treatment may include but is not limited to physical therapy, chiropractic care, diagnostic imaging and monitoring by an orthopedic. However, if the herniation is severe enough, some have to undergo surgery in the future. Therefore, the insurance company will have to consider the future need for medical treatment in their evaluation based on the permanency of the injuries.

Significance Of The Accident

Your car accident attorney will often ask for photos of the accident and specifically, photos of your vehicle. That is because they want to be able to link your injuries to the significance of the property damage. This linkage is also know as causation. The more significant the damage, the more likely that severe injury occurred. If the property damage is minor, then the insurance company will likely argue that you injuries may have been pre-existing, degenerative, or may go as far as saying you are embellishing your injuries. With that, you need a car accident attorney that is going to fight for you and to be able to explain the science behind accidents and injuries. For example, some have noted that whiplash can occur at as little as 5 mph. While the car may not show much damage, that does not mean that your body was not injured.

Current Medical Bills

Should a car accident occur of no fault of your own, you should be put in the position you were in prior to the accident, or as close to as possible. Mounting medical bills are no fault of your own and you should be compensated. With that, make sure to have uninsured motorist on your policy to protect yourself and your family should the other party be underinsured. The insurance company very much considers the medical bills that you incurred due to accident.

Moreover, they have an obligation to reasonably compensate you on behalf of their insured if the policy limits allow it. This is where the argument often ensues for multiple reasons. The insurance company may try to to argue that you over-treated because they have some alleged guidelines that they use after they attempt to downplay your injuries. For example, they may try to argue that you do not have a permanent injury and a reasonable conservative care treatment timeline based on their guidelines is 3-4 months. You treat for 6 months which is beyond their guidelines. They then attempt to argue that they should not be responsible for the treatment beyond the 4 months because your injuries should have resolved. Or, they are going to argue that you did not treat enough or even quick enough based on the injuries you are alleging if there are gaps in treatment. They may allege that because there are gaps, you must not be that hurt. Regardless, when in doubt, it is best to follow the treatment plan prescribed by your doctor.

Loss Wages & Inability To Work

The insurance company is going to look to see if you missed any work due to the accident or the resulting treatment. They are also going to inquire as to if you are able to still perform your job after the car accident or if you are able to work in the future. Now, this again is another argument that the insurance company tries to work to their advantage. For example, you install flooring, which is a labor intensive job. You complain of a back injury, yet still continue your job. They may try to argue that you are not that hurt if you are still working. However, if you are the head of household for a family of 4 and are the sole provider, you have to do something to feed your family and good jobs can be hard to come by. It does not mean that you are not hurt, but you have to do what you can to provide for your family. Therefore, you need an experienced accident attorney to argue those points.


All in all, the insurance companies will often consider and then attempt to argue the common factors above in their favor. You need someone that is going to stand up for you. I understand that the process after getting into a car accident can be difficult and stressful. This is especially true if the accident results in injuries like referenced above. Although these may be 5 factors car insurance companies consider when evaluating accident claims most often, as I said above, many other factors are considered.

You likely have questions and few answers as to the next steps to take. Allow me to be there for you from the beginning. I offer a FREE no-obligation consultation where we can discuss your claim. I will review your accident claim with you personally at one of the office locations in TampaZephyrhillsSaint PetersburgBrandonClearwater, Plant City or Sun City Center. Cannot make it to me? I will come to wherever is convenient to you at NO charge. You deserve to be compensated and I want to get justice for you!

Contact Car Accident Attorney Kevin L. Sullivan II TODAY at (813) 598-4868 for a FREE no-obligation consultation. I look forward to assisting you with your claim!

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