How Cases Are Evaluated for Claims Adjusters and In Court

Claims adjusters and juries evaluate cases similarly, with the exception of evidence. A jury will not have access to the Accident Report, or other "hearsay" evidence.
Clayton T. Hasbrook
Managing Attorney
Hasbrook & Hasbrook Personal Injury Lawyers

Evaluation of Auto Accident Injury Cases in Oklahoma Courts

When an auto accident occurs in Oklahoma, evaluating injury cases in court involves examining various factors to determine liability and compensation. Oklahoma’s “fault” system requires the party at fault to compensate the injured party for damages, including personal injuries and property damage.

Factors Considered in Court vs. Adjusterdamaged car and settlement evaluations

The evaluation of auto accident injury cases hinges on several key elements:

  • Police Report (Insurance Adjuster Only): Serving as a foundational piece of evidence, the police report plays a pivotal role in establishing who was at fault for the accident. It contains details about the incident, observations made by the responding officers, and sometimes, preliminary determinations of fault. However, gathering additional evidence is vital as the police report may not always be comprehensive or entirely accurate. The jury will not be shown the accident report. Accident reports are generally considered “hearsay.”
  • Witness Testimonies: Accounts from eyewitnesses can shed light on the accident’s circumstances, offering perspectives that may not be apparent from the police report alone. It’s important to corroborate these statements with other evidence due to the potential for unreliability or bias. A third-party witness – who doesn’t know either of the people in the wreck – can make a difference in which side “wins.”
  • Medical Records: Documentation of injuries, treatments received, and the recovery process is crucial. These records help quantify the compensation for medical expenses and understand the extent of the injuries sustained. Ensure that medical records from all healthcare providers who treated the injured party are obtained and verified for completeness and accuracy.
  • Loss of Income: The financial impact of the accident, especially any loss of income resulting from the inability to work, is carefully assessed. This includes both past and future losses. Document all lost wages and other income due to the accident with proof of income, such as pay stubs or tax returns.
  • Pain and Suffering: Compensation for non-economic damages like emotional distress, pain, and suffering is also considered. These are subjective and require thorough documentation and sometimes expert testimony to quantify. Evidence of the injured party’s physical and emotional distress can include medical records and testimony from family and friends.
  • Punitive Damages: In instances of egregious negligence, the court may award punitive damages. These are intended not just to compensate the victim but to punish the at-fault party and deter similar conduct in the future.

Factors That Can Affect CompensationScales of justice: Car accident vs Damages

Certain factors can adjust the compensation an injured party may receive:

  • Comparative Negligence: Oklahoma’s comparative negligence law may reduce the compensation if the injured party is found to have contributed to the accident. The reduction is proportional to their degree of fault.
  • Failure to Mitigate Damages: If the injured party did not take reasonable steps to minimize the impact of their injuries, such as delaying medical treatment, the compensation could be reduced.
  • Pre-Existing Medical Conditions: If the injured party already had the same or similar injury, this generally reduces the damages. For example, before the wreck, the plaintiff is receiving Social Security Disability payments for a back injury and is unable to work. The car accident further exacerbates the back injury, but future lost income will be hard to prove because the plaintiff was already unable to work.
  • Claim vs. Lawsuit: Many (if not most) insurance companies will assign a different adjuster to a case once a lawsuit is filed.

Causation and Damages

The primary objective is to ascertain the extent of an injury’s impact on an individual’s functioning, both currently and in the foreseeable future. This involves:

  1. Functioning Prior to the Injury: Establishing a baseline of the individual’s condition before the accident.
  2. Functioning During/Just After the Injury: Assessing the immediate effects of the injury.
  3. Functioning Between Injury and Evaluation: Documenting the ongoing impact and recovery process.
  4. Functioning at the Time of the Evaluation: Offering a snapshot of the current condition.
  5. Functioning in the Future: Projecting the long-term effects and any ongoing treatments or limitations.

Establishing Causality

These injuries and the damages must be linked or caused by the defendant’s actions. This generally involves medical testimony from the treating doctors. The doctors must demonstrate how the incident in question has uniquely impacted the plaintiff, distinguishing these effects from other unrelated factors.

The Role of Diagnosis

While diagnoses can be part of the evaluation, the emphasis is on the functional impairments resulting from the defendant’s actions. Compensation is determined based on the severity of these impairments rather than the diagnosis itself.

Personal Injury Evaluation FAQs

What is Oklahoma’s “fault” system for auto accidents?

Oklahoma’s “fault” system requires the party responsible for an auto accident to compensate the other party for any injuries and property damage. The plaintiff has the “burden of proof” to show this.

How is fault determined in an auto accident case?

The fault is determined based on evidence such as the police report, witness testimonies, and any relevant documentation that illustrates how the accident occurred.

What types of damages can be compensated in an auto accident injury case?

Damages can include medical expenses, loss of income, pain and suffering, and, in some cases, punitive damages.

What is comparative negligence?

Comparative negligence is a legal principle that reduces an injured party’s compensation based on their percentage of fault in causing the accident. Oklahoma allows the injured party to recover if their percentage of fault is less than 50%.

Can the compensation be reduced if the injured party didn’t mitigate their damages?

Yes, if the court (typically the jury) finds that the injured party didn’t take reasonable steps to minimize the impact of their injuries, their compensation may be reduced.

What is the purpose of a personal injury evaluation?

This is generally the first step in evaluating what a case is worth. The purpose is to assess the impact of an injury on an individual’s functioning and well-being, comparing their condition before and after the injury. This evaluation helps dictate settlement negotiations and trial strategy.

How is causality established in a personal injury case?

Causality is established by demonstrating a direct link between the defendant’s actions and the plaintiff’s injuries, differentiating these impacts from other potential factors.

Is a diagnosis necessary for compensation in a personal injury case?

While a diagnosis can be part of the evaluation, compensation is based more on the extent of functional impairments caused by the injury. The best testimony for this is the treating doctors, followed by co-workers and family members. The “before and after” witnesses can testify to the day-to-day life of the plaintiff before the wreck, and after the wreck.