How are insurance settlements calculated?

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How are insurance settlements calculated?

I am waiting for an injury claim settlement from an insurance company. Their client rear-ended me. Based on CT laws, do insurance companies use the full medical charges, the adjusted/discounted charge or the amount I actually paid out of pocket to formulate settlement amounts?

Asked on November 1, 2010 under Accident Law, Connecticut

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 13 years ago | Contributor

Insurance is designed to make people (more or less) whole--not to enrich them. That means that the amount you could personally recover for--for medical costs, that is--is limited to what you are personally out of pocket; you can't recover more in medical costs than you've paid, though if you are expected to have future or continuing medical costs (e.g. need on-going therapy or assistance), those future out-of-pocket costs should be factored into your settlement, too. Note that in that case, there may also be a "reduction to present value"--i.e. given that $1 today is worth more than $1 in a year, because of inflation and investment opportunities, future awards are reduced to what they are "worth" today using certain mathematical formula.

Don't forget that you should also be compensated for: 1) lost wages; 2) future diminished earning capacity; 3) possibly property damage; 4) other out of pocket costs (e.g. transportation and assistance); and 5) possibly pain and suffering, for serious and/or long-lasting injuries.


IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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