By Serdar Arslan, editor · Last reviewed · 8 min read · How we research
An ER bill for a fractured wrist comes with a number on it. Six months of waking up at 3 a.m. because the wrist aches does not. For many people, that second part is the real cost of the crash: the missed games, the grandchild you can't lift, the drive to work you now dread. The law calls these losses "pain and suffering," one kind of non-economic damages, and below we cover what they include and how people put a dollar figure on them.
What "pain and suffering" means
Pain and suffering is a shorthand for harms that don't have a market price. California's civil jury instructions, which are written in plain language and are a useful reference, list examples such as:
- Past and future physical pain
- Mental suffering
- Loss of enjoyment of life
- Disfigurement
- Physical impairment
- Inconvenience
- Grief, anxiety, and humiliation
- Emotional distress
Other states use different wording, but the categories are broadly similar.
Economic vs. non-economic damages
| Economic damages | Non-economic damages |
|---|---|
| Medical bills | Physical pain |
| Future medical care | Emotional distress |
| Lost wages | Loss of enjoyment of life |
| Loss of earning capacity | Scarring and disfigurement |
| Property damage | Inconvenience and anxiety |
| Out-of-pocket expenses | Physical impairment |
Your total claim usually includes both. See how car accident settlements work for how they fit together.
There is no fixed formula
If you remember one thing from this page, make it this. The California jury instruction tells jurors there is no fixed standard for deciding these damages. They are asked to use judgment and common sense and land on a reasonable amount based on the evidence.
For future pain and suffering, the instruction says the injured person must show they are reasonably certain to experience that harm, and the jury decides an amount that fairly compensates them.
So during negotiation, insurers and lawyers fall back on rough methods.
Methods you'll hear about
The multiplier method
Some adjusters and lawyers start with economic damages (mostly medical bills) and multiply by a number chosen based on how serious the injury is. A minor sprain gets a low multiplier. A permanent injury gets a higher one.
Limits: This is a negotiation shortcut, not a legal rule. It can undervalue injuries with low bills but a big impact on your life, and overvalue injuries with high bills but quick recovery.
The per diem method
This assigns a daily amount for each day you live with the injury, from the crash until recovery. For example, a daily figure times the number of days in pain.
Limits: Choosing the daily rate is subjective, and the method works poorly for permanent injuries.
Insurance software
Many insurers use claims software that scores injuries based on diagnosis codes, treatment type, and duration. You usually can't see the inputs. That's another reason to make sure your medical records fully describe your symptoms and limits.
Comparable cases
Lawyers often look at verdicts and settlements in similar cases in the same area. This is one way attorneys add value, since that information isn't always easy to find.
Evidence that supports pain and suffering
With no receipt to point to, the claim lives or dies on documentation.
Medical records
- Consistent, timely treatment
- Notes describing pain levels, limits, and how long recovery will take
- Specialist referrals, imaging, and physical therapy notes
- Records of medications and side effects
A pain journal
Write a few lines each day:
- Pain level on a 1–10 scale
- What hurt and when
- Activities you skipped or couldn't finish
- Sleep quality
- Mood and anxiety
A journal made at the time is far more convincing than memories pieced together months later.
Photos and video
- Bruises, cuts, and casts over time
- Surgical scars
- Assistive devices like crutches or braces
Statements from people who know you
Family, friends, coworkers, and coaches can describe the change in your life: the runner who stopped running, the parent who couldn't carry groceries.
Mental health treatment
Anxiety, driving fear, and sleep problems are common after a crash. If you get counseling, the records help document that harm.
Our evidence checklist has a full list.
What can reduce pain and suffering
- Gaps in treatment. Insurers often argue that if you didn't need care for weeks, you weren't really hurting.
- Social media posts. A photo of you at a party may be used to argue you're fine, even if you were in pain that night. Consider staying off public posts while your claim is open.
- Inconsistent statements. Saying "I'm fine" at the scene and later describing severe pain can be explained, but it creates questions.
- Pre-existing conditions. The insurer may say your pain came from an old injury. Many states allow recovery for making a condition worse, but you'll need medical support.
- Your share of fault. Most states reduce all damages, including pain and suffering, by your percentage of fault. See comparative fault explained and try our comparative fault calculator.
No-fault states and injury thresholds
In no-fault states, your own personal injury protection (PIP) coverage pays medical bills and some lost wages regardless of fault. But PIP generally does not pay for pain and suffering. To claim pain and suffering against the at-fault driver in many no-fault states, your injury must meet a threshold, which may be a dollar amount of medical bills or a "serious injury" definition in state law. See no-fault vs. at-fault insurance and your state's page under car accident laws.
Caps on non-economic damages
Some states cap non-economic damages in certain types of cases, most often medical malpractice. Caps in ordinary car accident cases are less common, but rules differ. Claims against government agencies may also have special limits. Check your state's page or ask a licensed attorney.
Can you get pain and suffering from your own insurer?
Possibly. Uninsured and underinsured motorist coverage is designed to pay what the at-fault driver should have paid. The Texas Department of Insurance, for example, notes that UM/UIM coverage can pay for pain and suffering costs, along with repairs and medical bills. See uninsured and underinsured motorist claims.
Taxes
Under federal law, damages received on account of personal physical injuries or physical sickness, other than punitive damages, can generally be excluded from income. The IRS explains that emotional distress damages are excludable when they flow from a physical injury, but emotional distress damages without a physical injury are generally taxable (with a limited exception for medical expenses not previously deducted). Ask a tax professional about your situation.
Putting a number on it
Nobody hands you a chart. Multipliers and per diem figures are bargaining tools, not law, and the number that sticks is usually the one backed by steady medical care, a journal kept at the time, photos, and people who can say how your life changed. Treatment gaps, public posts, and your own share of fault pull the figure down. If you live in a no-fault state, check the injury threshold first, and if the other driver has little or no coverage, your UM/UIM policy may cover this part of the loss.