Factors That Can Limit The Value Of Your Case

Jeff Sevey

When you’ve been injured in an accident, and the medical bills start piling up, you begin to wonder how much your injuries are really worth. It doesn’t matter whether you are filing a claim with the insurance company, or filing a personal injury lawsuit…the compensation you receive for your injuries and financial losses could very well be limited by various factors. These limitations may still occur even if you’ve been badly injured and are experiencing a great deal of pain and suffering due to your injuries. In this article, we’ll outline these possible limitations and help explain how they could affect the compensation you ultimately receive.

While lost wages and medical bills make up one portion of your damages after an accident, there are other factors such as pain and suffering that are more difficult to quantify. Medical bills and lost wages have a finite value – pain and suffering don’t. It is therefore often challenging to evaluate all your damages and come up with a value that fits.

Various factors that affect your compensation award can include (but are certainly not limited to):

  • Proof of liability;
  • The venue where your accident occurred;
  • The permanence of your injuries;
  • Necessary future medical treatments;
  • Level of scarring present;
  • Whether the medical treatments you have received were reasonable and necessary;
  • Your own level of fault in the accident;
  • Time taken off work to recuperate; and
  • Insurance policy limits.

If this seems confusing, you’re not alone. Consulting an experienced personal injury attorney such as the attorneys at The Sevey Law Firm should be one of your first steps after you’ve been injured in an accident. They will help decide which of these factors could apply in your particular case, and can then give you the proper legal advice so that you know how to proceed.


Before you receive any compensation for your damages, you have to prove who was legally responsible for the accident that occurred. Legal responsibility, or liability, can rest with either an individual or an entity such as a business or a government agency. Proving who was negligent, and how, will help demonstrate liability. This is important because your attorney will need to prove to the insurance adjuster that the at-fault party was negligent in their actions if you are to receive any compensation for your damages. If negligence can’t be proven, no compensation will be awarded in a settlement, or in court.


Where the accident happened, also called the venue, may also limit the amount of compensation that you receive for your damages. Certain areas of the country are known for awarding higher damages than others, whether it be by an out-of-court settlement between you and the insurance company, or by a jury. Your attorney will be aware of these differences in venue, and will also be well-versed in the personal injury laws in these areas. They will have represented cases with facts and situations similar to yours, and they’ll be able to use these past cases to gain a better understanding of the value of your case, and the amount of damages they should request on your behalf.

Comparative Fault

If you were partially responsible for the accident that caused your injuries, the compensation that you receive will be reduced by your percentage of fault. This is called comparative fault. Essentially, if the liability for the accident that occurred is shared by both the plaintiff and the defendant, each party will be assigned a percentage of fault that will affect the damages that are awarded. For example, if the plaintiff was struck from behind by a distracted driver, and was injured in the accident, the defendant would be 100% at fault for the accident that occurred.

Now, let’s change the details of the scenario a bit and say that the plaintiff’s brake lights weren’t working properly at the time of the accident, and that contributed to the accident occurring. Both the plaintiff and the defendant are partially at fault for the accident that happened. After investigating, the insurance adjuster concludes that the plaintiff was 10% at fault due to the non-working brake lights, and the defendant was 90% at fault. If the plaintiff requests $100,000 in damages, and the insurance company deems this acceptable, they would reduce the amount of damages awarded by the 10% the plaintiff was found at fault. Instead of receiving a settlement award of $100,000, the plaintiff would only receive $90,000.

It is important to note here that you do not have to automatically accept the insurance adjuster’s allocation of fault. If you believe that you have been blamed for a percentage of fault in the accident, and you were not guilty, you should immediately contact a personal injury attorney to discuss the situation.

Medical Costs That Were Reasonable and Necessary

Insurance claims adjusters won’t pay for any medical treatments or medical costs that they deem unnecessary or unreasonable. They will review your medical records and compare them to what is considered normal treatment under the circumstances. You and your medical team may disagree with what the insurance adjuster thinks of as reasonable and necessary, and in this case, it pays to have legal representation from an attorney experienced in these types of negotiations. You may need to file a lawsuit to get the compensation you deserve for your damages, and proper legal representation is vital to the successful outcome of your case.

Insurance Policy Limits

The person or entity at fault for the accident that caused your injuries will have limits on their insurance policy. If your damages exceed the policy limits, the insurance company may attempt to settle for the full amount of the policy, also known as “tendering policy limits.” Of course, you may be entitled to more than these policy limits, and in that case, you will be required to file a lawsuit in order to receive full compensation for your damages.

Next Steps

Now that you’re aware of some of the limitation that can occur, the most intelligent step you can take is to contact the attorneys at The Sevey Law Firm to set up a free consultation. Let us evaluate the strength of your claim, and give you an estimate of what your claim is worth based on our extensive experience in California personal injury law. You can reach our office by phone at (916) 788-7100, or by using our online contact page.