When you file a claim with your insurance company in a no fault state, you are limited in how much you can expect to receive from your insurance company. Under no fault state rules governing compensation, you are not allowed to file a claim with your insurance company for pain and suffering, emotional damage, or loss of opportunity. If you wish to receive compensation for damages not covered by PIP in no fault states or damages exceeding your PIP limits, you must sue the party responsible for the accident or file a liability claim with his insurance company . At this point, you are entitled to seek compensation for any and every form of damage and loss you have suffered because of the negligence of the other driver.
Types of Injury Claims That Determine Settlement Amount
Damage to Property
If your insurance does not cover the cost to completely repair or replace property damaged in a car accident, you are entitled to sue or file a claim of liable to receive compensation.Insurance companies often & mistakenly equate the extent of the property damage to the value of your injury
As with damage to property, there are limits to how much your insurance carrier will pay for medical expenses. In catastrophic car accidents, this amount is quickly exceeded. You are within your rights to sue or file a claim of liable to receive your due compensation for all of your medical related expenses . Outside the type of injury this is usually the single biggest factor considered by an insurance company in evaluating a claim
Type of injury
Insurance companies make determinations of claim values ( adjusting a claim )by classifying the type of injury – soft tissue or a strain/ sprain , fractures of bones-whether or not they are weight bearing, surgical cases , disfigurement & scarring . They also look at the type & length of treatment . Thus a hip fracture necessitating a surgical replacement with attendant hospitalization & follow up will be evalued much ,much higher than a neck strain /sprain with chiropractic treatment for 4 weeks.
There are strict limits to how much your insurance company is willing to pay for lost work. Unfortunately, those that receive massive injuries in car accidents often exceed that amount quickly. Recovering from and rehabbing a significant injury can take months or even years. If you are out of work due to someone’s negligence behind the wheel, you are entitled to additional compensation.
Pain and Suffering
Pain and suffering is tough to quantify, but it is no less real. Under no fault state rules, pain and suffering is not covered under PIP benefits. In order to receive compensation for pain and suffering, you will have to pursue a liability claim, a claim against the at fault driver or file suit.
Lost Opportunities and Prospects
Lost opportunities and prospects can be a greater challenge to define and quantify than pain and suffering. Again these are not covered by PIP benefits in no fault states. You will need to speak to a car accident lawyer and pursue a liability claim or a lawsuit.
Taken together these components make up the sum of your car accident settlement or award. If you think you are owed more than you have been given under your PIP benefits, please contact my law firm through the contact form found on this site. I will be happy to go over your case with you and determine if we can move forward.