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Vol. 50. Issue 2.
Pages 47-53 (April - June 2024)
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Vol. 50. Issue 2.
Pages 47-53 (April - June 2024)
Original Article
Study of the difference between the assessment of bodily injury by insurance entities and by extrajudicial experts advice in Valladolid during the years 2021 and 2022. Presentation of a comparison methodology
Estudio de la diferencia entre la valoración del daño corporal por las entidades aseguradoras y por las pericias extrajudiciales en Valladolid durante los años 2021 y 2022. Presentación de unametodología de comparación
Carmen Domínguez González
Corresponding author
carmen.dominguez@justicia.es

Corresponding author.
, José Domingo Sánchez Pérez
Instituto de Medicina Legal de Palencia, Salamanca y Valladolid, Valladolid, Spain
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Statistics
Figures (2)
Tables (6)
Table 1. Total sum of the days of personal injury in the medical reports and reasoned offers and their percentage of the total days.
Table 2. Percentage of consequences in reasoned offers and medical reports.
Table 3. Average compensation (in Euros) from medical reports and reasoned offers and the percentage of their differences.
Table 4. Difference between the medical report and reasoned offer.
Table 5. Differential medical report/ reasoned offer by insurance company.
Table 6. Average compensation (in Euros) from the medical report and reasoned offer by days of damage and sequelae and by insurers and their difference between the compensation from the medical report with respect to the reasoned offer in the overall cases of each entity.
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Abstract
Introduction

After the approval of Law 35/2015, the insurer is obliged to submit motivated offers in cases of traffic accidents and the possibility of requesting an extrajudicial expert advice from the Institutes of Legal Medicine in case of disagreement with the previous one.

Objective

The objective of this paper is to describe the differences between the motivated offers of insurers and the forensic reports of the 409 extrajudicial expert advice requested to the Institute of Legal Medicine in Valladolid from 2021–2022 and to propose a methodology for comparing.

Material and methods

All extrajudicial expert advice data from 2021 to 2022 was obtained, analysing the days of personal injury and sequelae and translating them into compensation variables.

Results

Forensic reports are more favourable for traffic injuries in about 81% of cases, granting on average an amount of almost €1400 more. This difference is mainly due to a greater consideration of sequelae, as well as a higher proportion of days of moderate particular damage in the forensic report. However, this difference is more or less accentuated, depending on the company that makes the motivated offer.

Conclusion

Translating the data from the forensic reports and motivated offers to compensation variables, allows us to make a comparison of the differences between both reports, observing that the forensic reports are more favourable than those issued by the insurers, at least in the province studied, and more studies are needed to have a more complete view.

Keywords:
Bodily damage assessment
Forensic medicine
Traffic accidents
Insurance claim review
Resumen
Introducción

Tras la aprobación de la Ley 35/2015, se obliga al asegurador a presentar una oferta motivada en casos de accidentes de tráfico y la posibilidad de solicitar una pericial extrajudicial a los Institutos de Medicina Legal y Ciencias Forenses en caso de disconformidad con la anterior.

Objetivo

El objetivo de este trabajo es describir las diferencias entre las ofertas motivadas de las aseguradoras y los informes forenses de las 409 Periciales Extrajudiciales solicitadas al Instituto de Medicina Legal de Valladolid entre los años 2021–2022 y proponer una metodología para compararlas.

Material y métodos

Se obtuvieron todos los datos de las Periciales Extrajudiciales de los años 2021–2022, analizando los días de perjuicio personal y las secuelas y traduciéndolos en variables de indemnización.

Resultados

Los informes forenses son más favorables para las lesiones de tráfico en aproximadamente el 81% de los casos, otorgando en promedio una cantidad de casi 1400 € más. Esta diferencia se debe principalmente a una mayor consideración de las secuelas, así como a una mayor proporción de días de daño particular moderado en el informe forense. Sin embargo, esta diferencia es más o menos acentuada, dependiendo de la aseguradora que realice la oferta motivada.

Conclusión

traducir los datos de las Periciales extrajudiciales y Ofertas Motivadas a variables de indemnización, nos permite hacer una comparativa de las diferencias entre ambos informes, observando que los informes forenses son más favorables que los emitidos por las aseguradoras en la provincia estudiada, siendo necesarios más estudios para tener una visión completa.

Palabras clave:
Valoración del daño corporal
Medicina Forense
Accidentes de circulación
Revisión de reclamaciones de seguros

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