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Calculation of Reasonable Car Accident/Injury Settlement

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partiallypeeved

Junior Member
What is the name of your state (only U.S. law)? WI

Hi, my wife was injured in a car accident earlier this year. With it already established that the accident was 100% the fault of the other party, we decided to hold off on hiring an attorney - figuring we would go that route only if the settlement offer was insufficient.

That said, in order to arrive at what is "sufficient", I consulted mighty Google and found two approaches at calculating a "reasonable" settlement amount that includes an allowance for pain and suffering: the Per Diem approach and the Multiple of Specials approach.

The Per Diem approach is straight-forward enough. But when I am compiling medical costs for the Multiple of Specials approach, what figure is appropriate to use? For instance, if:

* the health care provider bills $250 to my medical insurance company, and
* the "approved" amount works out to $150 after the discount for being an in-network provider, and
* my co-pay is $15?

On the one hand, using $250 makes sense because the other party's car insurance company would be benefiting from the fact that I have personal medical insurance. On the other hand, $150 makes sense because that was the actual cost that was incurred. Of course, using $15 wouldn't make sense because my personal medical insurance company would need to be reimbursed for any money that it paid out to the health care providers.

Again, I am only doing this calculation exercise to try to gauge reasonableness of the settlement offer. If push comes to shove, we will involve an attorney. Your input is greatly appreciated. Thanks.
 


partiallypeeved

Junior Member
Here are the facts:

Fact 1: I am endeavoring to use the "Multiple of Specials" approach to determine the reasonableness of a yet-to-be-made car accident/injury settlement offer.

Fact 2: A component of the "Multiple of Specials" approach multiplies the sum of the medical costs by a multiplier that is based on the severity of the accident.

Fact 3: Medical costs could refer to (a) the amount billed from the health care provider, or, because the health care provider is processing my wife's accident-related medical bills through our medical insurance (and not directly billing the car insurance company of the other party), medical costs could refer to (b) the "approved amount" as determined by the contract between the health care provider and my medical insurace company.

In that context, I am asking for someone to advise me on the appropriate definition of medical costs.

Any constructive help would be greatly appreciated in the sense that the comparison between the yet-to-be-made settlement offer and my "reasonableness calculation" will, in large part, determine whether we accept the settlement offer or hire an attorney.

Thank you in advance.
 

ecmst12

Senior Member
You cannot expect a calculator to give you a realistic idea of a settlement because all cases are evaluated based on the individual merits. When calculating your medical bills, you will want to add up your out of pocket costs, plus whatever you are going to have to pay back to your health insurance company, and make sure your settlement is at LEAST that amount, plus a reasonable amount for pain and suffering.
 

Bestauto

Junior Member
Consult an attorney

There's no way any "online calculator" can tell you what it "reasonable". A "reasonable" settlement from one insurance company may be 1/2 of what a "reasonable" settlement may be from another insurance company.

Consult an attorney. You may find you're entitled to a LOT more than you think you are.
 

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