Personal Injury Claim Calculator
Give potential personal injury clients transparency into their potential claim value with an interactive calculator. This template helps law firms provide instant estimates based on medical expenses, lost income, property damage, and pain and suffering multipliers. Clients who understand their case value are more likely to pursue claims. Capture qualified leads from accident victims actively researching their options. Fully customizable to match your firm's practice areas and case evaluation criteria.
Try the Calculator
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export function personalInjuryClaimCalculator(form: FormTs) {
// Pain and suffering multipliers by injury severity
const severityMultipliers: Record<string, { min: number; max: number }> = {
'minor': { min: 1.5, max: 2 },
'moderate': { min: 2, max: 3 },
'serious': { min: 3, max: 4 },
'severe': { min: 4, max: 5 },
'catastrophic': { min: 5, max: 7 }
};
// Recovery time impacts
const recoveryMultipliers: Record<string, number> = {
'weeks': 1.0,
'months': 1.25,
'six-months': 1.5,
'year-plus': 1.75,
'permanent': 2.0
};
// Liability factors
const liabilityFactors: Record<string, number> = {
'clear': 1.0,
'mostly-clear': 0.85,
'shared': 0.6,
'disputed': 0.4
};
form.addRow(row => {
row.addTextPanel('header', {
computedValue: () => 'Personal Injury Claim Estimator',
customStyles: { 'font-size': '1.5rem', 'font-weight': '600', 'color': '#1e293b' }
});
});
form.addSpacer({ height: 20 });
// Accident Information Section
const accidentSection = form.addSubform('accidentInfo', { title: '🚗 Accident Information' });
accidentSection.addRow(row => {
row.addDropdown('accidentType', {
label: 'Type of Accident',
options: [
{ id: 'auto', name: 'Car/Auto Accident' },
{ id: 'motorcycle', name: 'Motorcycle Accident' },
{ id: 'truck', name: 'Truck Accident' },
{ id: 'pedestrian', name: 'Pedestrian Accident' },
{ id: 'bicycle', name: 'Bicycle Accident' },
{ id: 'slip-fall', name: 'Slip and Fall' },
{ id: 'workplace', name: 'Workplace Injury' },
{ id: 'medical', name: 'Medical Malpractice' },
{ id: 'product', name: 'Product Liability' },
{ id: 'other', name: 'Other Personal Injury' }
],
defaultValue: 'auto',
isRequired: true
}, '1fr');
row.addDropdown('liability', {
label: 'Liability Situation',
options: [
{ id: 'clear', name: 'Clear liability (other party at fault)' },
{ id: 'mostly-clear', name: 'Mostly clear (minor comparative fault)' },
{ id: 'shared', name: 'Shared fault (significant comparative)' },
{ id: 'disputed', name: 'Disputed liability' }
],
defaultValue: 'clear',
isRequired: true
}, '1fr');
});
// Injury Details Section
const injurySection = form.addSubform('injuryDetails', { title: '🏥 Injury Details' });
injurySection.addRow(row => {
row.addDropdown('injurySeverity', {
label: 'Injury Severity',
options: [
{ id: 'minor', name: 'Minor (sprains, strains, bruises)' },
{ id: 'moderate', name: 'Moderate (fractures, herniated discs)' },
{ id: 'serious', name: 'Serious (surgery required, long recovery)' },
{ id: 'severe', name: 'Severe (multiple surgeries, permanent impact)' },
{ id: 'catastrophic', name: 'Catastrophic (TBI, spinal cord, amputation)' }
],
defaultValue: 'moderate',
isRequired: true
}, '1fr');
row.addDropdown('recoveryTime', {
label: 'Expected Recovery Time',
options: [
{ id: 'weeks', name: 'A few weeks' },
{ id: 'months', name: '1-6 months' },
{ id: 'six-months', name: '6-12 months' },
{ id: 'year-plus', name: 'Over 1 year' },
{ id: 'permanent', name: 'Permanent injury' }
],
defaultValue: 'months',
isRequired: true
}, '1fr');
});
injurySection.addRow(row => {
row.addCheckbox('hospitalized', {
label: 'Required hospitalization',
defaultValue: false
}, '1fr');
row.addCheckbox('surgery', {
label: 'Required surgery',
defaultValue: false
}, '1fr');
});
injurySection.addRow(row => {
row.addCheckbox('ongoingTreatment', {
label: 'Ongoing medical treatment needed',
defaultValue: false
}, '1fr');
row.addCheckbox('permanentDisability', {
label: 'Permanent disability or impairment',
defaultValue: false
}, '1fr');
});
// Economic Damages Section
const economicSection = form.addSubform('economicDamages', { title: '💵 Economic Damages' });
economicSection.addRow(row => {
row.addMoney('medicalExpenses', {
label: 'Medical Expenses (to date)',
min: 0,
max: 10000000,
defaultValue: 5000,
isRequired: true,
tooltip: 'Include all medical bills: ER, doctors, specialists, physical therapy, medications, medical equipment'
}, '1fr');
row.addMoney('futureMedical', {
label: 'Estimated Future Medical Costs',
min: 0,
max: 10000000,
defaultValue: 0,
tooltip: 'Projected future treatment, surgeries, therapy, medications'
}, '1fr');
});
economicSection.addRow(row => {
row.addMoney('lostWages', {
label: 'Lost Wages (to date)',
min: 0,
max: 5000000,
defaultValue: 0,
tooltip: 'Income lost due to inability to work'
}, '1fr');
row.addMoney('futureLostIncome', {
label: 'Future Lost Earning Capacity',
min: 0,
max: 10000000,
defaultValue: 0,
tooltip: 'Projected future income loss due to disability or reduced capacity'
}, '1fr');
});
economicSection.addRow(row => {
row.addMoney('propertyDamage', {
label: 'Property Damage',
min: 0,
max: 500000,
defaultValue: 0,
tooltip: 'Vehicle damage, personal property, etc.'
}, '1fr');
row.addMoney('outOfPocket', {
label: 'Other Out-of-Pocket Expenses',
min: 0,
max: 100000,
defaultValue: 0,
tooltip: 'Transportation to appointments, home modifications, etc.'
}, '1fr');
});
// Non-Economic Damages Section
const nonEconomicSection = form.addSubform('nonEconomicDamages', { title: '💔 Non-Economic Damages' });
nonEconomicSection.addRow(row => {
row.addDropdown('painLevel', {
label: 'Pain and Suffering Level',
options: [
{ id: 'mild', name: 'Mild - temporary discomfort' },
{ id: 'moderate', name: 'Moderate - significant pain during recovery' },
{ id: 'severe', name: 'Severe - intense ongoing pain' },
{ id: 'extreme', name: 'Extreme - chronic debilitating pain' }
],
defaultValue: 'moderate'
}, '1fr');
row.addDropdown('emotionalDistress', {
label: 'Emotional/Mental Impact',
options: [
{ id: 'minimal', name: 'Minimal impact' },
{ id: 'moderate', name: 'Moderate (anxiety, sleep issues)' },
{ id: 'significant', name: 'Significant (PTSD, depression)' },
{ id: 'severe', name: 'Severe (major psychological trauma)' }
],
defaultValue: 'moderate'
}, '1fr');
});
nonEconomicSection.addRow(row => {
row.addCheckbox('lossOfEnjoyment', {
label: 'Loss of enjoyment of life',
defaultValue: false
}, '1fr');
row.addCheckbox('lossOfConsortium', {
label: 'Loss of consortium (impact on relationships)',
defaultValue: false
}, '1fr');
});
form.addSpacer({ height: 20, showLine: true, lineStyle: 'dashed' });
// Estimate Summary Section
const summarySection = form.addSubform('summary', { title: '📊 Claim Estimate Summary', isCollapsible: false });
summarySection.addRow(row => {
row.addPriceDisplay('totalEconomic', {
label: 'Total Economic Damages',
computedValue: () => {
const medical = economicSection.money('medicalExpenses')?.value() || 0;
const futureMedical = economicSection.money('futureMedical')?.value() || 0;
const lostWages = economicSection.money('lostWages')?.value() || 0;
const futureLost = economicSection.money('futureLostIncome')?.value() || 0;
const property = economicSection.money('propertyDamage')?.value() || 0;
const outOfPocket = economicSection.money('outOfPocket')?.value() || 0;
return medical + futureMedical + lostWages + futureLost + property + outOfPocket;
},
variant: 'default'
}, '1fr');
row.addTextPanel('multiplierUsed', {
computedValue: () => {
const severity = injurySection.dropdown('injurySeverity')?.value() || 'moderate';
const mult = severityMultipliers[severity];
return `Pain & Suffering Multiplier: ${mult?.min || 2}x - ${mult?.max || 3}x`;
},
customStyles: { 'font-size': '0.9rem', 'color': '#64748b', 'text-align': 'center', 'padding-top': '8px' }
}, '1fr');
});
summarySection.addRow(row => {
row.addPriceDisplay('painSufferingLow', {
label: 'Pain & Suffering (Low Est.)',
computedValue: () => {
const severity = injurySection.dropdown('injurySeverity')?.value() || 'moderate';
const recovery = injurySection.dropdown('recoveryTime')?.value() || 'months';
const painLevel = nonEconomicSection.dropdown('painLevel')?.value() || 'moderate';
const medical = economicSection.money('medicalExpenses')?.value() || 0;
const futureMedical = economicSection.money('futureMedical')?.value() || 0;
const totalMedical = medical + futureMedical;
const baseMult = severityMultipliers[severity]?.min || 2;
const recoveryMult = recoveryMultipliers[recovery] || 1;
let painAdjust = 1.0;
if (painLevel === 'severe') painAdjust = 1.2;
if (painLevel === 'extreme') painAdjust = 1.4;
let additionalFactors = 0;
if (injurySection.checkbox('surgery')?.value()) additionalFactors += 0.2;
if (injurySection.checkbox('permanentDisability')?.value()) additionalFactors += 0.5;
if (nonEconomicSection.checkbox('lossOfEnjoyment')?.value()) additionalFactors += 0.15;
if (nonEconomicSection.checkbox('lossOfConsortium')?.value()) additionalFactors += 0.15;
return totalMedical * baseMult * recoveryMult * painAdjust * (1 + additionalFactors);
},
variant: 'default'
}, '1fr');
row.addPriceDisplay('painSufferingHigh', {
label: 'Pain & Suffering (High Est.)',
computedValue: () => {
const severity = injurySection.dropdown('injurySeverity')?.value() || 'moderate';
const recovery = injurySection.dropdown('recoveryTime')?.value() || 'months';
const painLevel = nonEconomicSection.dropdown('painLevel')?.value() || 'moderate';
const medical = economicSection.money('medicalExpenses')?.value() || 0;
const futureMedical = economicSection.money('futureMedical')?.value() || 0;
const totalMedical = medical + futureMedical;
const baseMult = severityMultipliers[severity]?.max || 3;
const recoveryMult = recoveryMultipliers[recovery] || 1;
let painAdjust = 1.0;
if (painLevel === 'severe') painAdjust = 1.2;
if (painLevel === 'extreme') painAdjust = 1.4;
let additionalFactors = 0;
if (injurySection.checkbox('surgery')?.value()) additionalFactors += 0.2;
if (injurySection.checkbox('permanentDisability')?.value()) additionalFactors += 0.5;
if (nonEconomicSection.checkbox('lossOfEnjoyment')?.value()) additionalFactors += 0.15;
if (nonEconomicSection.checkbox('lossOfConsortium')?.value()) additionalFactors += 0.15;
return totalMedical * baseMult * recoveryMult * painAdjust * (1 + additionalFactors);
},
variant: 'default'
}, '1fr');
});
const finalSection = form.addSubform('final', {
title: '💰 Estimated Claim Value Range',
isCollapsible: false,
sticky: 'bottom'
});
finalSection.addRow(row => {
row.addPriceDisplay('lowEstimate', {
label: 'Low Estimate',
computedValue: () => {
const liability = accidentSection.dropdown('liability')?.value() || 'clear';
const liabilityFactor = liabilityFactors[liability] || 1;
// Economic damages
const medical = economicSection.money('medicalExpenses')?.value() || 0;
const futureMedical = economicSection.money('futureMedical')?.value() || 0;
const lostWages = economicSection.money('lostWages')?.value() || 0;
const futureLost = economicSection.money('futureLostIncome')?.value() || 0;
const property = economicSection.money('propertyDamage')?.value() || 0;
const outOfPocket = economicSection.money('outOfPocket')?.value() || 0;
const totalEconomic = medical + futureMedical + lostWages + futureLost + property + outOfPocket;
// Pain and suffering (low)
const severity = injurySection.dropdown('injurySeverity')?.value() || 'moderate';
const recovery = injurySection.dropdown('recoveryTime')?.value() || 'months';
const painLevel = nonEconomicSection.dropdown('painLevel')?.value() || 'moderate';
const totalMedical = medical + futureMedical;
const baseMult = severityMultipliers[severity]?.min || 2;
const recoveryMult = recoveryMultipliers[recovery] || 1;
let painAdjust = 1.0;
if (painLevel === 'severe') painAdjust = 1.2;
if (painLevel === 'extreme') painAdjust = 1.4;
let additionalFactors = 0;
if (injurySection.checkbox('surgery')?.value()) additionalFactors += 0.2;
if (injurySection.checkbox('permanentDisability')?.value()) additionalFactors += 0.5;
if (nonEconomicSection.checkbox('lossOfEnjoyment')?.value()) additionalFactors += 0.15;
if (nonEconomicSection.checkbox('lossOfConsortium')?.value()) additionalFactors += 0.15;
const painSuffering = totalMedical * baseMult * recoveryMult * painAdjust * (1 + additionalFactors);
return Math.round((totalEconomic + painSuffering) * liabilityFactor);
},
variant: 'large'
}, '1fr');
row.addPriceDisplay('highEstimate', {
label: 'High Estimate',
computedValue: () => {
const liability = accidentSection.dropdown('liability')?.value() || 'clear';
const liabilityFactor = liabilityFactors[liability] || 1;
// Economic damages
const medical = economicSection.money('medicalExpenses')?.value() || 0;
const futureMedical = economicSection.money('futureMedical')?.value() || 0;
const lostWages = economicSection.money('lostWages')?.value() || 0;
const futureLost = economicSection.money('futureLostIncome')?.value() || 0;
const property = economicSection.money('propertyDamage')?.value() || 0;
const outOfPocket = economicSection.money('outOfPocket')?.value() || 0;
const totalEconomic = medical + futureMedical + lostWages + futureLost + property + outOfPocket;
// Pain and suffering (high)
const severity = injurySection.dropdown('injurySeverity')?.value() || 'moderate';
const recovery = injurySection.dropdown('recoveryTime')?.value() || 'months';
const painLevel = nonEconomicSection.dropdown('painLevel')?.value() || 'moderate';
const totalMedical = medical + futureMedical;
const baseMult = severityMultipliers[severity]?.max || 3;
const recoveryMult = recoveryMultipliers[recovery] || 1;
let painAdjust = 1.0;
if (painLevel === 'severe') painAdjust = 1.2;
if (painLevel === 'extreme') painAdjust = 1.4;
let additionalFactors = 0;
if (injurySection.checkbox('surgery')?.value()) additionalFactors += 0.2;
if (injurySection.checkbox('permanentDisability')?.value()) additionalFactors += 0.5;
if (nonEconomicSection.checkbox('lossOfEnjoyment')?.value()) additionalFactors += 0.15;
if (nonEconomicSection.checkbox('lossOfConsortium')?.value()) additionalFactors += 0.15;
const painSuffering = totalMedical * baseMult * recoveryMult * painAdjust * (1 + additionalFactors);
return Math.round((totalEconomic + painSuffering) * liabilityFactor);
},
variant: 'large'
}, '1fr');
});
finalSection.addRow(row => {
row.addTextPanel('liabilityNote', {
computedValue: () => {
const liability = accidentSection.dropdown('liability')?.value() || 'clear';
const factor = liabilityFactors[liability] || 1;
if (factor < 1) {
return `Note: Estimates adjusted for comparative fault (${Math.round(factor * 100)}% recovery potential)`;
}
return '';
},
customStyles: { 'font-size': '0.85rem', 'color': '#f59e0b', 'text-align': 'center', 'font-style': 'italic' }
});
});
finalSection.addRow(row => {
row.addTextPanel('disclaimer', {
computedValue: () => 'This calculator provides general estimates only. Actual case values depend on many factors including specific facts, evidence, insurance coverage, jurisdiction, and legal strategy. No attorney-client relationship is formed. Consult with a personal injury attorney for accurate case evaluation.',
customStyles: { 'font-size': '0.8rem', 'color': '#64748b', 'font-style': 'italic' }
});
});
form.configureSubmitButton({
label: 'Get Free Case Evaluation'
});
}
Frequently Asked Questions
How accurate are these estimates?
The calculator provides general estimates based on typical case factors. Actual settlement values depend on many variables including liability, insurance coverage, jurisdiction, and case specifics. Include disclaimers that only a consultation can provide accurate case evaluation.
Can I customize the multipliers?
Yes. The pain and suffering multipliers, damage categories, and all calculation factors are fully customizable to reflect your jurisdiction and case experience.
Does this create attorney-client privilege?
No. Include appropriate disclaimers that using the calculator does not create an attorney-client relationship. The tool provides general information only.
What types of injuries can this cover?
The calculator supports various injury types from minor soft tissue injuries to catastrophic cases. You can configure severity levels and corresponding multipliers for your practice areas.
Can I capture lead information?
Yes. The submit button collects contact information and case details for follow-up consultations with qualified leads.