Don’t trust the insurance adjuster to tell you what’s fair compensation. Learn how to calculate what your slip and fall claim is really worth.
There are no exact formulas to determine a fair settlement amount for a specific slip and fall claim.
No two personal injury cases are identical, and even if they were, they’d impact each victim in different ways. You can only determine a fair settlement by using your specific injuries.
Slip and fall damages can include medical costs, lost wages, property damage, and emotional distress.
Here’s how to estimate a settlement value for minor slip and fall injuries. You will also get some insight into the insurance adjuster’s approach to claim values.
Determine Your Slip and Fall Damages
There are two categories of personal injury damages:
- Economic damages, also called special damages
- Non-economic damages, also called general damages
The Value of Economic Damages
The first step in calculating the value of a personal injury claim is to add up your economic damages. These are the measurable costs from your injury like medical bills, service invoices, pharmacy receipts, and wage loss statements.
Economic damages are measurable because the value is already assigned by a third party, meaning the doctor or facility that sent the bill.
Special damages can include:
- Medical expenses, including emergency care, surgeries, therapy, and nursing care
- Past and future lost wages or other lost income such as commissions or bonuses
- Out-of-pocket costs, like over-the-counter medications, medical equipment, and travel expenses for medical appointments
- Replacement service costs, such as childcare, housekeeping, grocery shopping, and yard work you couldn’t do while recovering
- Personal property damage for any items broken or lost in your fall, including jewelry, clothing, or cell phones
Thoroughly consider all of the economic losses associated with your slip and fall claim to accurately arrive at a total.
It can be easy to overlook some medical bills, portions of your wages, and out-of-pocket costs. Carefully log every expense you can think of since the day of your slip and fall.
Some medical services generate more than one bill. For example, if you went to the emergency department, you’d likely receive a bill from the hospital and one from the treating physician. If you had X-rays, you may get a bill from the radiology department and another from the doctor who interpreted the results.
Medical Billing and Injury Claim Damages
Use the full amount billed for each medical treatment for your claim calculations, even if health insurance or Medicaid covered all or part of the cost.
For example:
- The hospital billed your insurance company $3,000 for your emergency room care
- The emergency room physician billed $800.
- You have a $250 copay for emergency room visits.
Your economic damages for the emergency room visit are $3,000 for the ER and $800 for the ER doctor for a total of $3,800. Don’t include your $250 copay because copays and deductibles are part of the total bill, not an added cost.
An accurate total of all your economic damages forms the base upon which you will calculate your general damages.
The Value of Non-Economic Damages
Non-economic damages in injury claims are commonly known as pain and suffering.
Compensation for non-economic damages is an important part of your total claim value. However, calculating a value for pain and suffering can be difficult, as there is no objective measurement. General damages differ widely among accident victims.
Non-economic damages can include:
- Physical pain and discomfort
- Emotional and mental pain
- Anxiety and depression
- Difficulties concentrating
- Problems sleeping
- Loss of consortium
These damages don’t come with any bills, receipts, or pre-assigned value. You can calculate a fair estimate of general damages by adding up all your economic costs, and adding one or two times that amount to account for your pain and suffering.
If your injuries are mild to moderate, most insurance companies are willing to negotiate a settlement for pain and suffering in this range. The higher the amount you ask for general damages, the harder it is to convince the insurance company to pay.
Keeping a diary to document pain levels and activities you can’t participate in after your injury can help support your demand for general damages. Include things like being unable to attend events, participate in recreation or hobbies, canceled vacation plans, or the inability to hold your child or walk your dog.
Serious injuries from a preventable slip and fall are high-dollar claims that are best handled by an experienced personal injury attorney. The attorney may seek general damages in an amount three to five times that of your special damages, or even more.
High-dollar general damages may arise from:
- Severe mental anguish: Injured people who require mental health services after their fall are more likely to receive higher compensation for their mental anguish. For example, someone diagnosed and treated for post-traumatic stress disorder (PTSD).
- Extreme pain or permanent injuries: General damages are typically more significant for claimants who suffer severe or long-term pain, or those with permanent injuries like disfigurement, amputations, or paralysis.
No one else can assign a value to your general damages. You’re the one who experiences them and lives with their consequences.
Example: Calculating Slip and Fall Compensation
Roy was finishing up Christmas shopping for his family at a local department store. While busy focusing on finding the right clothing item for his wife, he failed to see the puddle of carpet cleaning solution spilled on the linoleum floor next to him. There were no warning signs.
He slipped and fell, hitting his head on the corner of the shelf and then on the floor.
Two women nearby immediately came to his aid, stating that they’d complained to a manager approximately 15 minutes earlier about the spill.
Due to his violent fall, Roy was in the hospital for one week recovering from a traumatic brain injury. He also required surgery to repair his broken wrist. He missed Christmas at home with his family and eight weeks of work.
Roy calculated his total damages as follows:
- Ambulance Service $950
- Hospital ER $10,500
- Dr. Surry (ER physician) $1,000
- Dr. Cabernash (orthopedist) $3,500
- Dr. Tundell (neurologist) $4,500
- Surgery $14,500
- Anesthesiologist $1,250
- Physical Therapy $2,200
- Lost Wages $12,800
- Prescription medications $1,200
Total Economic Damages: $51,200
Pain and Suffering ($51,200 x 2): $102,400
Estimated Claim Value: ($51,200 + $102,400): $153,600
Special Factors to Consider
Most slip and fall cases are resolved by negotiations with the at-fault property owner’s insurance company after a few rounds of settlement offers and counter-offers.
Even when your general damages are accurate and your specials are easily verified, other factors impact the amount of money you may be able to seek for compensation.
Limiting factors might include:
- Policy limits: If an injury claim is more than the available insurance policy limits, usually the only recourse is to file a lawsuit against the at-fault party for the difference.
- Shared fault: The insurance adjuster will always look to limit or deny your claim by shifting some of the blame on you for causing your injuries. They might say that you weren’t wearing the right footwear for the circumstances, weren’t paying attention, or were intoxicated.
- Unnecessary medical expenses: Insurance companies will only cover reasonable and necessary medical expenses. If a healthcare provider pads their billing with excessive tests, treatments, or additional unnecessary charges, the adjuster can deny payment.
- Your location: In venues where juries are more likely to return a verdict in favor of an injured person, adjusters will pay more to settle a claim out-of-court.
Beware of Faulty Calculations
It’s unlikely that the insurance adjuster will pay your full initial settlement demand. They’ll look at how you calculated your demand and check to see if you have evidence to prove their insured’s liability.
Adjusters are trained to question the reasonableness of your medical bills and your time missed from work. Then, they’ll find ways to excuse their client from any legal responsibility for your injuries.
During settlement negotiations you must convince the adjuster that:
- You have credible evidence of the dangerous condition
- Your pain and suffering damages are worth the value you gave them
- Your calculations are realistic
- You are not at fault for causing your injuries
Insurance Company Settlement Software
Injury claim computer software has grown in popularity with insurance companies over the past decade. One of the most widely-used is a software program called Colossus.
Settlement value computer programs only benefit insurance companies, not injury victims. The programs put a dollar value on different injury types, then factors in if the victim has an attorney and where they live.
Personal injury lawyers strongly oppose the use of Colossus and similar programs because there are too many ways to short-change the victim. Computer programs use statistics and data to calculate injury settlements. They can’t measure the extent of the pain and suffering the victim endured.
The insurance adjuster will use the computer evaluation to establish the most they will pay, but will do their best to get you to accept substantially less.
Ensuring Fair Compensation
To get a fair estimate of your claim value, it’s crucial to include all of your damages and double-check your calculations. Once you accept a slip and fall settlement, you can’t go back and ask for more money. It doesn’t matter if you simply forgot to add something.
Even if you decide to handle the insurance claim on your own, it’s worth your time to schedule a premises liability case evaluation with a slip and fall attorney.
Don’t let financial concerns keep you from getting the legal assistance you need after a slip and fall accident. Most injury law firms offer a free consultation to injured victims.
Should you decide to hire an attorney, you won’t need to pay anything out-of-pocket. Most injury attorneys receive payment through contingency fees. If and when they obtain compensation for your injuries, they receive a percentage for their services.
Don’t wait to seek legal advice. It costs nothing to have a skilled slip and fall lawyer review your claim.