Personal Injury & Insurance Glossary

Plain-English definitions for the terms used throughout our guides and calculators — 73 terms, linked to the guide that covers each one in depth where we have one.

A

Actual Cash Value (ACV): The value of damaged or totaled property accounting for depreciation — replacement cost minus wear and age — rather than what it would cost to buy new today. Insurers typically pay ACV, not replacement cost, for a totaled vehicle unless the policy specifically provides otherwise. Total loss and diminished value claims →
Adjuster (Claims Adjuster): The insurance company employee or contractor who investigates a claim, evaluates damages, and negotiates or denies payment on the insurer's behalf. An adjuster works for the insurance company, not for you, even when handling your own insurer's claim. Dealing with insurance adjusters →
Apparent Agency: A doctrine holding a principal liable for a technically independent contractor's conduct where the principal held that contractor out as its own and the injured party reasonably relied on that appearance. It is the most common route to hospital liability for a physician who is an independent contractor rather than a hospital employee, particularly in an emergency room where the patient had no real choice of provider. Can you sue the hospital for a doctor's malpractice? →
Appendix PP (State Operations Manual): The portion of the CMS State Operations Manual, titled Guidance to Surveyors for Long Term Care Facilities, that tells federal and state surveyors exactly what each F-tag requirement means in operational terms. Reading the Appendix PP entry behind a citation gives a far more specific and credible standard of care than a general claim that a facility should have been more careful. Nursing home inspection records as evidence →
Apportionment: The process of dividing responsibility for an injury among multiple at-fault parties, including the claimant, by percentage. Each party's share of fault typically determines their share of the damages owed, and it interacts directly with a state's comparative or contributory negligence rule. Comparative negligence by state →

B

Bad Faith (Insurance Bad Faith): An insurer's unreasonable refusal to pay a valid claim, unreasonable delay, or failure to properly investigate. Most states allow a policyholder — and in some circumstances a third-party claimant — to sue an insurer separately for bad faith, with damages that can exceed the original policy limits. Insurance bad faith claims →
Bellwether Trial: One of a small number of individual cases selected to go to trial first within a multidistrict litigation, while thousands of other similar claims remain on hold. The verdict does not legally bind the other claimants, but it gives both sides real evidence of how a jury values the claims — which is usually what actually pushes a mass settlement forward, more than the underlying legal arguments alone. What is a mass tort? MDL vs. class action →
Bodily Injury Liability (BI): The portion of an at-fault driver's auto insurance that pays for injuries to other people. State minimum BI limits are often written as two numbers, such as 25/50, meaning $25,000 per person and $50,000 per accident — figures that are frequently far lower than a serious claim's actual value.

C

Causation: The legal requirement that the defendant's conduct actually caused the claimed injury — not just that the defendant was negligent and the claimant was hurt, but that one led to the other. Causation disputes are the most common way insurers contest otherwise well-documented claims, especially around pre-existing conditions.
Certificate of Merit: A written statement, usually from a qualified medical expert, certifying that a reasonable basis exists to believe the standard of care was breached — required early in most states before a medical malpractice claim can proceed. Also called an affidavit of merit or expert report depending on the state. Missing the deadline, often measured in months rather than years, can end an otherwise strong case on procedure alone. Certificate of merit and expert report requirements →
Class Action: A single lawsuit brought by one or more representative plaintiffs on behalf of an entire group of people with essentially the same claim, resulting in one judgment or settlement that binds the whole group, apart from anyone who opts out where opting out is allowed. It differs from an MDL, where each claimant keeps an individual case that retains its own facts and, usually, its own damages decision. What is a mass tort? MDL vs. class action →
Collateral Source Rule: A rule, followed in most states in some form, that a defendant's liability is not reduced because the claimant had other sources of payment for their losses — health insurance, for example. Many states have modified this rule by statute, particularly for how medical bills are valued at trial.
Comparative Negligence: A system under which a claimant's own share of fault reduces, rather than automatically eliminates, their recovery. Most states use a modified version with a 50% or 51% bar above which recovery is cut off entirely; a smaller group use "pure" comparative negligence with no bar at any percentage. Comparative negligence by state →
Condition of Participation: A federal requirement a nursing home must meet to stay certified for Medicare and Medicaid reimbursement, set out in 42 CFR Part 483. The conditions create no private right to sue on their own, but a facility that violated one has, in most states, violated a recognized standard of care — a strong evidentiary argument in an ordinary negligence claim. How nursing home abuse and neglect claims work →
Contingency Fee: An attorney fee structure, standard in personal injury cases, where the attorney is paid a percentage of the recovery — commonly around a third — and nothing if the case recovers nothing. Case costs (filing fees, expert witnesses, records) are typically separate from the fee and owed regardless of outcome in most fee agreements. Lawyer fees and contingency agreements →
Contributory Negligence: The harsher predecessor to comparative negligence, still applied in a handful of jurisdictions: any fault at all on the claimant's part, even 1%, completely bars recovery. Courts in those jurisdictions generally still allow recovery if the defendant's conduct was grossly negligent or willful. Comparative negligence by state →

D

Damages Cap: A statutory limit on the amount recoverable for a specific category of damages, most commonly non-economic damages (pain and suffering) in medical malpractice cases, or damages against a government entity. Caps vary enormously by state and claim type, and some have been struck down by state courts as unconstitutional.
Daubert Standard: The federal test for whether an expert's scientific testimony is reliable enough to be presented to a jury at all, from Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993). A judge acts as a gatekeeper, screening the expert's qualifications and methodology before the jury ever hears the substance of the opinion. Many states apply their own version of this standard, or the older Frye standard, instead — which one applies can determine whether an expert's causation or damages testimony is heard at all. Life care plans and future medical costs →
Declarations Page: The summary page at the front of an insurance policy listing the named insureds, coverage types, policy limits and deductibles. It is the fastest way to check what coverage — including UM/UIM — actually applies before assuming a policy does or doesn't cover something.
Demand Letter: A formal written statement of a claim sent to the at-fault party or their insurer, laying out liability, injuries, treatment and damages, and requesting a specific settlement amount. It is typically the opening move of a negotiation, not a final offer. How to write a demand letter →
Deposition: Sworn, recorded testimony given outside of court during the discovery phase of a lawsuit, typically with attorneys for both sides present and a court reporter transcribing every word. What a witness or party says in a deposition can be used to challenge their testimony later at trial.
Discovery Rule: An exception that starts the statute of limitations clock when an injury was discovered or reasonably should have been discovered, rather than on the date it actually occurred. It typically applies to latent injuries — toxic exposure or a retained surgical instrument — not to accidents where the harm is obvious immediately. Statute of limitations by state →
Dram Shop Liability: Laws in many states holding a bar, restaurant or other alcohol server liable for injuries caused by a visibly intoxicated patron they continued to serve, or a minor they served at all. Not every state recognizes dram shop liability, and those that do vary widely in what they require to prove it. Dram shop wrongful death claims →

E

Economic Damages: Damages with a specific, documentable dollar figure — medical bills, lost income, property damage, future medical care. They are contrasted with non-economic damages (pain and suffering), which have no receipt or paystub behind them.
Eggshell Plaintiff Rule: The principle that a defendant is liable for the full extent of an injury even if the claimant had a pre-existing condition that made them unusually vulnerable to harm — "you take your plaintiff as you find them." It does not erase a genuine pre-existing-condition dispute, but it does mean aggravation of an existing condition is compensable. Pre-existing conditions and injury claims →

F

F-Tag: The code identifying which specific federal nursing home requirement a facility was cited for violating — F689 for accident hazards and inadequate supervision, F686 for pressure ulcers, F600 for abuse and neglect, F725 for insufficient staffing, among others. Each F-tag maps to a section of 42 CFR Part 483 and to interpretive guidance in Appendix PP of the CMS State Operations Manual. Nursing home inspection records as evidence →
Fairness Hearing: The court hearing at which a judge decides whether to give final approval to a proposed class action settlement, based on whether it is fair, reasonable and adequate to the class — including how many class members object or opt out. A settlement described as "reached" or "announced" is not the same as one that has survived its fairness hearing and become final. Roundup lawsuit status: SCOTUS ruling & settlement →
Five-Star Quality Rating System: CMS's public rating of each nursing home on Medicare Care Compare, from one to five stars overall plus three separate domain ratings: health inspections, staffing, and quality measures. The domain ratings matter more than the blended overall number for a claim — a facility can carry a decent overall rating while its staffing domain, the mechanism behind most neglect, is poor. Nursing home inspection records as evidence →
Form CMS-2567 (Statement of Deficiencies): The document a state survey agency uses to record every deficiency found during a nursing home inspection, along with the facility's required plan of correction. Redacted copies have been public since 2012 through Medicare Care Compare or a state survey agency; a citation is a regulatory finding, not proof of negligence in a specific case, but it is strong evidence of notice and of the standard of care. Nursing home inspection records as evidence →

G

Government Contractor Defense: A defense shielding a manufacturer from liability where it built a product to the government's own reasonably precise specifications, the product conformed to those specifications, and the manufacturer warned the government of any dangers known to it but not to the government — the three-part test from Boyle v. United Technologies Corp., 487 U.S. 500 (1988). It fails where a manufacturer withheld known risks from the government, which is exactly what defeated it in the AFFF firefighting foam litigation. AFFF firefighting foam lawsuit status →
Gross Negligence: Conduct far more careless than ordinary negligence — a reckless or conscious disregard for the safety of others, not just a mistake. It matters most in contributory-negligence states, where a defendant's gross negligence can defeat the harsh bar that would otherwise apply to a partially at-fault claimant.

I

Independent Medical Examination (IME): A medical exam by a physician selected and paid for by the insurer, not the claimant's own treating doctor — despite the name, rarely neutral in practice. Most states allow an insurer to require one as a condition of continued benefits, and the resulting report is frequently used to argue treatment should stop.
Informed Consent: A physician's duty to disclose the material risks, reasonable alternatives, and consequences of declining treatment before a patient agrees to it. It is a duty independent of performing the treatment competently — a flawlessly executed procedure can still be malpractice if a material risk was never disclosed and it later materialized. Informed consent: when not warning you is malpractice →

J

Joint and Several Liability: A rule under which any one of several defendants found liable can be required to pay the entire judgment, regardless of their individual share of fault, leaving that defendant to seek reimbursement from the others. Many states have limited or abolished pure joint and several liability by statute, particularly for non-economic damages.

L

Last Clear Chance: A doctrine allowing recovery despite a claimant's own negligence if the defendant had a final, clear opportunity to avoid the harm and failed to take it. It is recognized narrowly in some contributory-negligence jurisdictions as one of the few ways to overcome that rule's harsh effect. Comparative negligence by state →
Lien (Medical Lien / Subrogation Lien): A legal claim against settlement proceeds, asserted by a health insurer, hospital, Medicare, Medicaid or a workers' comp carrier, to be repaid for medical costs it already covered. Liens are resolved before you receive your net settlement, and can be negotiated down, but must be addressed — ignoring one does not make it go away. Medical liens and subrogation in a settlement →
Life Care Plan: A detailed, itemized projection of the future medical care, equipment, home modifications and support services a catastrophically injured person will need for the rest of their life, typically prepared by a Certified Life Care Planner working from treating physicians' recommendations and standardized cost data. It is usually the single largest driver of the total damages figure in a catastrophic injury claim, and its methodology can face a Daubert challenge just like any other expert testimony. Life care plans and future medical costs →
Long-Term Care Ombudsman: A federally mandated advocate, created under the Older Americans Act, who investigates and helps resolve complaints made by or on behalf of nursing home residents, independent of both the facility and its state regulator. Federal rules bar a facility from restricting a resident's access to the ombudsman or discouraging contact with one — including inside an arbitration agreement — so a clause attempting that is independently improper. Nursing home arbitration agreements →
Loss of Chance: A doctrine, recognized in some states and rejected in others, allowing recovery where negligence reduced an already less-than-even chance of a better outcome — a delayed cancer diagnosis, for instance — even though the patient likely would have suffered a similar result regardless. Whether a state recognizes it can decide whether a diagnostic-delay malpractice claim survives causation scrutiny at all. The four elements of a medical malpractice claim →

M

Maximum Medical Improvement (MMI): The point at which a treating physician determines an injury has stabilized and is not expected to improve further with additional treatment, even if it has not fully healed. Most attorneys wait until MMI to send a demand letter, since a claim's value cannot be reliably calculated until the final medical picture is known. How to write a demand letter →
MDS Assessment: A Minimum Data Set assessment — the standardized, federally required evaluation of a nursing home resident's physical, cognitive and functional condition, completed on a regular schedule and after any significant change. A documented change in a resident's assessed condition is dated evidence of when a facility knew, or should have known, something was wrong. Nursing home inspection records as evidence →
Med Pay (Medical Payments Coverage): Optional auto insurance coverage that pays medical bills for you and your passengers regardless of who caused the accident, up to a modest limit. Unlike PIP, it typically does not cover lost income, and unlike a liability claim, it does not require proving fault.
Mediation: A settlement process where a neutral third party facilitates negotiation between the claimant and the defendant or insurer, without the power to force a resolution. It is faster and less expensive than trial, and many courts require it be attempted before a case can proceed further.
Multidistrict Litigation (MDL): A federal procedure that consolidates similar lawsuits filed in different courts nationwide — typically product liability or drug injury claims — before a single judge for coordinated pretrial proceedings, discovery and bellwether trials. Unlike a class action, each plaintiff in an MDL keeps an individual case; the consolidation ends and cases return to their home courts, or settle, once shared pretrial issues are resolved. What is a mass tort? MDL vs. class action →
Multiplier Method: A common approach to estimating pain and suffering by multiplying economic damages (typically medical expenses) by a factor — often 1.5 to 5 depending on injury severity — then adding that to the economic damages themselves. It is a starting point for negotiation, not a formula either side is bound by. Injury settlement calculator →

N

Never Event: A patient-safety term for a serious, largely preventable medical error that established protocols should essentially eliminate — wrong-site surgery and a surgical item left inside a patient are the standard examples. The term doesn't create its own legal claim, but it reflects how strongly the failure is viewed as a protocol lapse rather than a difficult clinical judgment call. Surgical errors: wrong-site surgery and retained objects →
No-Fault Insurance: A system, used in a minority of states, where your own insurer pays your medical bills and lost income through PIP coverage regardless of who caused the accident. In exchange, the right to sue for pain and suffering is typically restricted unless the injury meets a specific statutory threshold. Florida car accident settlements & PIP →
Non-Economic Damages: Damages without a specific bill or receipt behind them — pain and suffering, emotional distress, loss of enjoyment of life, loss of consortium. They are real, compensable damages, just harder to quantify than economic damages, which is why methods like the multiplier method exist.
Notice of Claim: A formal, often short-deadline requirement to notify a government entity of an intent to sue before filing, separate from and usually far shorter than the general statute of limitations. Missing this notice deadline typically bars the claim entirely even when the general limitations period has years left. Statute of limitations by state →

P

Pain and Suffering: The most common shorthand for non-economic damages: physical pain, emotional distress, and the general impact an injury has on daily life. Its value is estimated rather than calculated from a bill, most often via the multiplier method. Injury settlement calculator →
Personal Injury Protection (PIP): No-fault auto insurance coverage, required in some states, that pays a portion of your medical expenses and lost income after an accident regardless of fault, up to a policy limit. It pays first and fast, but the limit is often modest and exhausted quickly in a serious injury. Florida car accident settlements & PIP →
Plan of Correction: A nursing home's own required written response to a deficiency on Form CMS-2567, describing what it will do to fix the problem. Because it is the facility's own admission in writing, a later and similar failure is much harder for the facility to characterize as an isolated accident. Nursing home inspection records as evidence →
Policy Limits: The maximum amount an insurance policy will pay for a covered claim, regardless of how much the actual damages exceed that figure. In practice, policy limits — not the severity of the injury — are frequently the real ceiling on what a claimant can recover from the at-fault party.
Premises Liability: The area of law governing injuries that occur on someone else's property, most commonly slip-and-fall claims. Liability generally turns on whether the property owner knew or should have known about a hazardous condition and failed to fix or warn about it within a reasonable time. Slip and fall settlements against a business →
Proximate Cause: A legal limit on causation: even where a defendant's conduct technically contributed to an injury, they are only liable if the harm was a reasonably foreseeable result of that conduct. It is the doctrine insurers invoke when arguing an injury was too remote or unexpected a consequence to hold them responsible for.
Punitive Damages: Damages awarded not to compensate the claimant but to punish especially egregious conduct — gross negligence, recklessness or intentional wrongdoing — and deter similar conduct in the future. They are awarded far less often than compensatory damages and are capped or barred entirely in some states. Punitive damages in personal injury claims →

R

Release (Settlement Release): The legal document signed to finalize a settlement, in which the claimant agrees to give up any further claim against the released party in exchange for the settlement payment. Once signed, a release is generally final — additional injuries or complications discovered afterward are typically not recoverable, which is why settling before maximum medical improvement is risky. How to write a demand letter →
Res Ipsa Loquitur: Latin for "the thing speaks for itself" — a doctrine allowing a claimant to argue negligence occurred based on the nature of the accident alone (a surgical instrument left inside a patient, for example), without direct proof of exactly what the defendant did wrong. Surgical errors: wrong-site surgery and retained objects →
Respondeat Superior: Latin for "let the master answer" — the doctrine holding an employer liable for an employee's negligent acts committed within the scope of their employment. It is why a trucking company, not just the driver, is typically a defendant in a commercial vehicle accident case. Suing a trucking company →

S

Scope-and-Severity Grid: The A-through-L letter scale CMS surveyors use to grade each deficiency on Form CMS-2567, combining how widespread a problem was with how much harm it caused or risked. A citation at G or above means actual harm occurred rather than merely the potential for it, and a pattern of G-and-above findings in the same area across successive surveys is a materially stronger document than one isolated low-severity citation. Nursing home inspection records as evidence →
Settlement: An agreement to resolve a claim for a specific payment, without a trial. The large majority of personal injury claims settle rather than go to verdict; a settlement is typically final once the release is signed.
Special Master: A neutral person appointed by the court in complex litigation — often in an MDL — to handle a task the judge doesn't have time to manage directly: facilitating settlement negotiations between the parties, resolving discovery disputes, or administering a claims process once a settlement exists. Appointing one is often a sign that structured settlement talks have begun, but it does not guarantee a settlement will actually result. Hair relaxer lawsuit: where the MDL stands →
Standard of Care: What a reasonably prudent provider in the same specialty would have done under similar circumstances — the benchmark a medical malpractice claim measures the defendant's conduct against. Historically judged by a strict local standard, most states have shifted toward a national or similar-communities standard, particularly for board-certified specialists. The four elements of a medical malpractice claim →
Statute of Limitations: The deadline for filing a lawsuit, after which the claim is permanently barred regardless of its merits. It varies by state and claim type, can be extended by tolling or the discovery rule, and is not paused by ongoing settlement negotiations with an insurer. Statute of limitations by state →
Statute of Repose: An absolute outer deadline measured from a fixed event — such as a product's first sale or a building's completion — rather than from the date of injury or its discovery. Unlike a statute of limitations, a statute of repose can bar a claim before the injury even occurs. Statute of limitations by state →
Subrogation: An insurer's right to recover what it paid out from the party actually at fault (or their insurer), stepping into the shoes of the party it paid. It is the mechanism behind most medical and property-damage liens asserted against a settlement. Medical liens and subrogation in a settlement →
Survival Action: A claim for the damages a person who died would have been entitled to had they survived — their own pain and suffering and medical bills before death — brought by their estate. It is legally distinct from a wrongful death claim, which compensates surviving family members for their own losses, and the two can run on different deadlines. Wrongful death settlement amounts →

T

Third-Party Claim: A claim brought against someone else's insurance — the at-fault party's — as opposed to a first-party claim against your own policy. Workers' compensation cases frequently involve both: a no-fault first-party claim against an employer's coverage, and a separate third-party claim against a negligent non-employer if one contributed to the injury. Workers' comp settlement amounts by injury →
Tolling: A pause in the statute of limitations clock, commonly applied while a claimant is a minor or mentally incapacitated, or where a defendant concealed their identity or the wrongdoing itself. Tolling rules vary significantly by state and often carry exceptions for claims against government entities. Statute of limitations by state →
Tort: A civil wrong — as opposed to a crime — that causes harm to another person, giving rise to a legal claim for damages. Nearly every claim discussed on this site, from a car accident to a dog bite, is a tort claim, most commonly grounded in negligence.

U

Uninsured/Underinsured Motorist Coverage (UM/UIM): Coverage on your own auto policy that pays when the at-fault driver has no insurance (uninsured) or not enough insurance to cover your damages (underinsured). It frequently becomes the real source of recovery in a serious injury claim, since at-fault drivers with minimum coverage are common. Uninsured/underinsured motorist claims →

V

Vicarious Liability: Liability imposed on one party for the wrongful acts of another, based on their relationship — an employer for an employee, for example — rather than on the first party's own direct fault. Respondeat superior is the most common form of vicarious liability in personal injury cases. Vicarious liability and negligent entrustment →

W

Wrongful Death: A civil claim brought by surviving family members (or an estate on their behalf) when a death was caused by another's negligence or wrongdoing. It is a separate cause of action from a survival action, usually runs from the date of death rather than the date of injury, and its value is driven largely by the decedent's age, earnings and dependents. Wrongful death settlement amounts →