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Insurance · Bodily Injury Claims

A claimant's medical treatment for a soft tissue injury lasted 3 months. They have $4,500 in medical bills and missed 2 weeks of work at $1,000/week. They also claim pain and suffering. How does a bodily injury adjuster approach a fair settlement value?

Reviewed by Jordan Morley, Editorial Lead at 247SimpleTests. Written by the 247SimpleTests Editorial Team from the official source material cited on every question.

Correct answer

Medical specials + wage loss + general damages (pain and suffering) — general damages are typically calculated as a multiplier of medical specials (1.5x-4x for soft tissue; higher for severe injuries), adjusted for liability (if any comparative fault) and specific case factors

  1. A Medical specials + wage loss + general damages (pain and suffering) — general damages are typically calculated as a multiplier of medical specials (1.5x-4x for soft tissue; higher for severe injuries), adjusted for liability (if any comparative fault) and specific case factors
  2. B Medical bills + wage loss only
  3. C Pay only the medical bills
  4. D Refuse all soft tissue claims

Why this is the answer

Bodily injury settlement calculation: SPECIAL DAMAGES (economic): Medical bills $4,500 + Lost wages $2,000 = $6,500; GENERAL DAMAGES (pain and suffering): Multiplier method: soft tissue, short duration (3 months), full recovery → 1.5x-2x special damages = $9,750-$13,000.

Total settlement value range: $6,500 + $9,750 = $16,250 to $6,500 + $13,000 = $19,500.

Adjustments: Liability (was insured 100% at fault?); pre-existing conditions; quality of medical treatment; gap in treatment; subjective complaints vs objective findings; Litigation exposure (is claimant represented? Venue?).

Settlement range: File a reserve that accounts for the full range of potential jury verdict plus litigation costs; offer settlement at the fair end of the evaluated range. Note: multiplier method is a heuristic — each case has unique facts.

Source: Insurance Adjuster — Bodily Injury, Settlement Valuation

Practice more questions

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About this topic: Bodily Injury Claims

Bodily injury claims turn on medical documentation, causation and the valuation of pain and suffering and lost wages — the areas adjusters are tested on most heavily because the dollar amounts and the litigation risk are highest. This is one of 3 Insurance Adjuster questions on bodily injury claims, each with a full explanation on a single study page.

New to this exam? Our Insurance exam guide explains the format, scoring, and how to prepare.

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