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Car Accident Settlement Valuation Form

Factors to Consider When Determining What Your Claim is Worth

Below is a sample form we sometimes use to value our client’s car accident damages. This form includes factors such as lost wages, pain and suffering, loss of future earning capacity as well as medical expenses and special damages for expenses related to home modifications or the hiring of help to perform services that the injury victim was able to perform prior to the accident.

See: Sample Car Accident Settlements Won By Alan

File # ____________ 

Settlement Valuation 

Client Name: ______________________________

Age: ____________________________________

DOI: ____________________________________

Economic Damages:

Nature and Type of Injury: ___________________

Emergency Room: __________________________

Hospital Stay: ______________________________

Permanent Injuries: _________________________

Physical Limitations: _________________________

Psychological Limitations: _____________________

Past Medical Expenses: _______________________

Probable Future Medical Expenses: _____________

Past Lost Wages: ___________________________

Probable Loss of Future Earning Capacity ________

Additional Economic Damages:

Past Hired Services: ____________________

Future Hired Services: __________________

Home Modifications: ____________________

Other Expenses: _______________________

Total Economic Damages: ____________________

Non-Economic Damages:

Pain & Suffering – (Loss of Enjoyment of Life, etc.) 

Past Pain and Suffering –

# of weeks _____ @ ______  Total _____/_____

# of weeks _____ @ ______ Total _____/______

Future Pain and Sufferring: _______________

Total Non-Economic Damages: ________________

Mitigating Factors (Reductions)

Strength of Case, including Comparative Negligence: _____

No Fault Deduction (PIP and Other Set-Offs) ___________

Prior Injuries to Affected Areas: _____________________

Overall Health Conditions/Life Expectancy: ____________

Case Value: ___________

Settlement Offer: 

Low _______

High_______

Within Reasonable Range ________

Related:

Rear-End Accident Settlements Won By Alan

State Farm Settlements Won By Alan and Case Law

Quick Florida Car Accident Facts:

According to the Florida Department of Motor Vehicles, for example, in 2009 statewide there were 20,085 alcohol related traffic accidents resulting in 1,004 deaths and 14,130 injuries. Additionally, damages from auto crashes total $150 billion annually because compensation for a car accident, in most cases, includes recovery of medical expenses, property damage, lost wages and lost earning potential, pain and suffering, disfigurement, loss of consortium and emotional distress. Learn more from Alan Sackrin, an expert car accident lawyer.

Want to Know More?

Since 1982, Alan Sackrin has represented clients throughout Florida in recovering monetary damages for car accident injuries. Alan is a Board Certified Civil Trial Expert that strives to maximize the amount of compensation his clients’ receive for their claim.  Alan has spent years evaluating facts, applying the law, and effectively asking juries to render a favorable verdict for his clients.

See: Sample Case Verdicts and Settlements

Related Car Accident Topics:

• 8 important steps you should take at the time of an accident
• Car Accident FAQ
• Car Accident Insurance Claims and Coverage (PIP and Bodily Injury Coverage)
• Car Accident Damages
• Attorney Fees Are Negotiable

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Learn More: See Our Car Accident Resource Page