Sample Claim Review
Sample Claim Review: Post-Mediation Settlement
Hypothetical sample for demonstration purposes only. This is not legal advice, claim handling on behalf of an insurer, or a guarantee of outcome.
Executive Snapshot
- Review Type
- Complex Claim Review
- Claim Issue
- Commercial auto bodily injury claim in litigation
- Primary Concern
- Settlement range and exposure control
- Plaintiff Demand
- $220,000
- Recommended Settlement Range
- $95,000–$125,000
- Potential Demand Reduction
- Approximately $95,000–$125,000 below demand
- Policy Limit
- $1,000,000
- Key Review Areas
- Coverage, liability, damages, exposure, litigation strategy
- Recommended Direction
- Resolve within a documented settlement range if possible to avoid added trial risk and defense cost
Executive Summary
A commercial delivery truck was involved in a collision with a motorcycle at a signalized intersection. The injured rider filed suit and demanded $220,000.
After mediation, the mediator recommended a settlement range of $95,000 to $125,000, suggesting shared liability and meaningful trial risk for both sides.
Based on the sample facts, the file appears positioned for resolution inside the $95,000 to $125,000 range, which would resolve the matter approximately $95,000 to $125,000 below the plaintiff's demand while avoiding additional defense cost and trial uncertainty.
Estimated Settlement Position
What RoadClaims Advisor Identified
- The mediator's range suggests shared-fault exposure rather than clear liability.
- The $220,000 demand appears negotiable based on comparative fault and disputed damages.
- A $95,000 to $125,000 settlement range may reduce defense cost and trial uncertainty.
- The file should preserve the liability defense while documenting the business reason for settlement.
- Settlement within the recommended range would keep the resolution comfortably within the $1,000,000 policy limit.
Documents That Support the Claim
- Police report
- Scene photographs
- Driver statement
- Witness statements
- Medical records and bills
- Demand package
- Mediation statement
- Defense evaluation
- Prior settlement offers
- Policy declarations page
Coverage Analysis
The commercial auto policy appears to have been active on the date of loss, and the involved vehicle appears to qualify as a covered auto. The policy carries a $1,000,000 bodily injury limit, which is sufficient for the proposed $95,000 to $125,000 settlement range. No obvious exclusion is identified based on the sample facts.
Liability / Responsibility Analysis
Liability remains disputed. The plaintiff alleges the commercial vehicle caused the collision, while the defense evidence suggests the motorcycle may have entered the intersection without adequate clearance.
The mediator's recommended range reflects risk on both sides and supports a shared-fault evaluation.
Damages
The plaintiff alleges $220,000 in damages, including medical expenses, pain and suffering, and lost wages. The injury claim includes lower-back and shoulder complaints, imaging, and follow-up care, with no surgery reported.
The mediator's range suggests the damages have value but should be discounted for liability risk, causation issues, and trial uncertainty.
Exposure
The realistic settlement exposure appears to fall between $95,000 and $125,000, subject to final negotiation and documentation. This range is well within the $1,000,000 policy limit and may avoid additional litigation cost.
Compared to the $220,000 demand, the recommended range represents a potential demand reduction of approximately $95,000 to $125,000.
Claim Strategy
Attempt to resolve within the mediator's recommended range. Document the shared-fault basis, damages concerns, and avoided trial costs.
If the plaintiff rejects a reasonable offer, preserve the defense position and continue preparing for trial.
Recommended Action
Recommend settlement authority within the $95,000 to $125,000 range to resolve below the $220,000 demand and avoid the cost and uncertainty of trial. Maintain documentation explaining why the range is reasonable based on liability, damages, and litigation risk.
Settlement within this range would keep the file well below the $1,000,000 policy limit and create a clear business reason for resolution.
Consultant Letter
To: Apex Cargo Transport, LLC
Re: Post-Mediation Settlement — 2023 Loss
Subject: Settlement Position & Strategy Guidance
Apex Cargo Transport,
Based on the current information, this claim appears to involve disputed liability and a realistic opportunity to resolve the matter below the plaintiff's $220,000 demand. The mediator's $95,000 to $125,000 recommendation suggests both sides carry risk and that a settlement inside that range may be reasonable.
The available policy limit is $1,000,000. A settlement within the recommended range would resolve the claim well within the available limit and approximately $95,000 to $125,000 below the plaintiff's current demand, depending on the final negotiated amount.
The recommended approach is to prepare a documented settlement offer within the mediator's range, explain the shared-fault basis, and preserve the defense position if the offer is rejected.
If accepted, resolution would avoid additional defense cost and trial uncertainty while keeping the settlement well within the available policy limit.
Final Disclaimer
This review is a professional claim-handling opinion based on hypothetical facts. It is not legal advice, legal representation, claim handling on behalf of an insurer, or a guarantee of any claim outcome. For legal advice, consult an attorney licensed in your state.