If you’re considering whether to make a personal injury claim—after being hurt in an accident that was caused by someone else’s carelessness—you’re probably wondering whether you’re likely to get any compensation for your medical expenses and other losses—and if so, how much. We surveyed our readers across the United States to find out about their experiences with personal injury claims. Here’s what we learned about the effect of their medical treatment on the outcome of their cases.
How Medical Costs Affect a Personal Injury Payout
The amount of any “payout” (either a settlement or a court award after a trial) you can expect to receive for your personal injury claim will depend on the specific facts surrounding your case. (See our article on how different variables affected readers' personal injury settlements and awards.) For starters, you should be compensated for your medical expenses, property damages, lost income, and other economic losses. But other consequences of an accident can be hard to translate into a dollar figure—think about the more subjective impacts like anxiety, stress, pain, lost sleep, and missing school or other important events (referred to as “pain and suffering”). There’s no exact formula for determining these damages, but insurance companies (and lawyers) usually begin with the total amount of medical expenses and multiply it by a certain amount to compensate for pain and suffering. (See our article on how insurers value injury claims.)
While other factors affect the amount of a settlement or award, including how much each person is to blame for the accident, our survey bears out the connection between medical costs and payouts: In general, as medical expenses increased, the payout amounts also increased. The readers who had significant medical expenses received substantial settlements or awards—an average of $250,000 for those who had medical costs above $35,000. At the other end of the spectrum, the few readers who told us they received no medical care (because they didn’t sustain any physical injuries) received a minimal settlement or no compensation at all.
How the Type of Medical Treatment Affects a Personal Injury Payout
Along with the cost of medical care, our survey showed that the kind of medical care you receive for your injuries can predict how much compensation you receive. Medical care usually comes in stages, and most of our readers received more than one type of treatment after their accident. Not surprisingly, those with injuries serious enough to require aggressive medical intervention obtained higher personal injury settlements or awards on average.
Readers who had surgery received average settlements or awards of $215,000—more than four times the overall average. Perhaps less obvious is the effect of receiving emergency medical services at the site of the accident, such as treatment by paramedics and transportation by ambulance. Readers who were treated on-site tended to receive much higher payouts—an average of $128,500, about 140% more than the overall average. Going to the emergency room or urgent care had less of an effect; readers who received this type of treatment received about 60% more than the overall average. (This result could be explained by the fact that people sometimes go to urgent care for less serious injuries, or that ER visits include a battery of diagnostic tests—which don’t necessarily lead to higher payouts.) At the other end of the scale, readers whose treatment menu included chiropractic care tended to receive payouts that were 41% lower than the overall average.
Perhaps the most important lesson from these survey results is this: Make sure you seek immediate medical attention when you’ve been injured in any kind of accident. Often, people don’t notice symptoms or realize how badly they’re hurt at the time of the accident. (For more details, see our article on why injuries don't always show up right away.) If you avoid or put off treatment for whatever reason—because you’re worried about the costs, you aren’t in pain, or you simply assume that it’s a minor injury—you might accept a settlement before you know the full extent of your injuries. Make sure you’ve been fully evaluated by a medical professional before you sign away your rights.
It’s also probably a good idea to sit down and talk with a lawyer sooner rather than later. An experienced personal injury lawyer can estimate how high a settlement you can expect to get based on your medical treatment and costs. And our survey showed that readers who pursued their personal injury claims without the help of a lawyer were much less likely to receive a settlement or award—and got less money when they did—regardless of the seriousness of their injuries and the nature/extent of their medical treatment. (For more information, see our article on the how having a lawyer affects the outcome of personal injury cases.)