There are too many unique factors and nuances inherent in a given case to create a formula for accurately valuing tooth damage as part of an injury-related insurance claim or lawsuit. But in this article we'll discuss the main things to consider when attempting to value tooth damage in your claim.
To start, here are some examples of past verdicts and settlements where tooth damage was part of an injury case. As you can tell, the spread of damages is wide.
Valuing a case means coming up with a best guess at what a jury might award the person suing for tooth damage (the plaintiff), what the person being sued (the defendant) would be willing to pay in order to settle the case before trial, and finally, what the plaintiff would be willing to accept. That's a lot to consider. But the two big factors in valuing an injury case are the extent of the plaintiff's damages -- how bad the tooth damage is, in other words -- and how likely it is that the jury will find the defendant liable.
Estimating the potential recovery with any degree of accuracy is quite difficult for one main reason: at trial, it will most likely be a jury that ultimately decides just how much money the defendant must pay the injured plaintiff.
Some injury damages, like medical bills and lost wages, are easier to predict because these kinds of "concrete" damages will mostly be based on the amount the plaintiff demonstrates he or she has paid and/or will continue to pay. But for subjective, less concrete damages like "pain and suffering," predictions are at best an educated guess based on awards in similar tooth damage cases in the past. Because every case and every jury is different, even the best analysis will still only predict pain and suffering damages within a broad range.
What is also key in valuing damages is how the tooth damage affects a particular plaintiff. Depending on the damage and kind of dental repair possible, a plaintiff may have their eating abilities and habits permanently altered, or they may suffer a cosmetic issue that affects their well-being or livelihood. In other words, "pain and suffering" isn't just limited to the actual physical pain caused by the tooth damage, but all of the direct negative effects on the plaintiff's life.
Many insurance companies use some kind of formula to determine the appropriate payout. Many lawyers were also trained to use this approach. For more on that, see The Damages and Compensation Formula in an Injury Case, and see our settlement calculator to work your own numbers.
The nature of tooth damage is such that the plaintiff will not need to rely on his or her testimony alone -- damage to teeth can be directly observed by a jury, either by looking at the plaintiff, looking at photos or x-rays or hearing the testimony of a dentist, orthodontist, or other dental expert.
Because most plaintiffs will (and should) have their teeth repaired before trial, it is important to document the nature of the damage and request that the dentist or oral surgeon keep clear records of the course of the plaintiff's treatment. If the plaintiff has done a poor job documenting his or her tooth damage, the defendant could point that fact out to the jury and argue that the damage may not have been as extensive as the plaintiff wants them to believe.
Additionally, accidents that involve broken teeth usually also involve some kind of head injury, which may increase the "perceived" value of the claim. Adjusters will usually consider a "head injury" as more serious than a "tooth injury".
The other major factor in valuing a case is the likelihood a defendant will be found liable at trial. If the plaintiff has little or no evidence proving the defendant was at fault for the plaintiff's tooth damage, the value of the case goes down considerably.
Even if the potential damages are high, a defendant will be less willing to settle and more inclined to take her chances at trial if fault is clearly an unsettled issue. Similarly, the plaintiff will be more inclined to accept a low settlement because he runs the risk of getting nothing at trial. All these issues make it a fairly intricate negotiation "dance" to resolve a personal injury claim.