Accident Claim Value Workbook
Use this organizer to identify evidence, losses, insurance sources and unanswered questions. It does not calculate a settlement.
1. Incident and responsibility
2. Injury and medical status
| Condition / symptom | First reported | Provider | Current status | Future recommendation |
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3. Economic loss summary
| Category | Paid | Outstanding | Future estimate | Supporting record |
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| Medical / rehabilitation | | | | |
| Medication / equipment | | | | |
| Travel / parking | | | | |
| Past income | | | | |
| Future income capacity | | | | |
| Household / caregiving | | | | |
| Property loss | | | | |
| Other | | | | |
4. Daily function and quality of life
Activities affected
- Personal care
- Sleep
- Mobility
- Driving
- Work
- Household tasks
- Caregiving
- Recreation
Best specific examples
5. Insurance and recovery sources
| Insurer / party | Claim number | Coverage type | Limit / status | Adjuster / contact |
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6. Settlement readiness
- Responsibility investigation is reasonably complete.
- Medical diagnosis and prognosis are sufficiently understood.
- Future treatment and restrictions are documented.
- Past and future income issues are supported.
- Every expense is reconciled with benefits and insurance payments.
- All likely policies, parties and recovery sources are investigated.
- Liens, fees, expenses and expected net recovery are estimated.
- The full scope of the proposed release is understood.
- Local deadlines and required notices are confirmed.
- Professional advice has been obtained where stakes or uncertainty are significant.
7. Offer comparison
| Item | Offer 1 | Offer 2 | Expected alternative |
|---|
| Gross amount | | | |
| Fees and case costs | | | |
| Liens / repayments | | | |
| Other deductions | | | |
| Estimated net | | | |
| Payment timing | | | |
| Claims released | | | |
| Future loss unresolved | | | |
| Main risk | | | |
General educational tool only. Keep sensitive information secure. Confirm local law and obtain appropriate professional advice.