Proper medical treatment is one of the most important aspects of a personal injury claim. Without the right doctors providing their professional medical opinions, you will not have an insurance claim to help pay for your injuries.
With that being said, it is vitally important that clients understand that thorough, properly documented medical care is essential. A good personal injury attorney will monitor closely a client’s medical care to ensure it will be sufficiently documented for an insurance adjuster, or the jury if we take that route.
In every personal injury case, you must show that the car collision caused your injuries. Sometimes proving causation is easy, i.e., your leg was immediately severed. Sometimes it is more difficult to prove that the collision caused your injuries, like in an older person whose back was already significantly deteriorated from old age.
Good medical treatment and experts are needed to prove causation. Knowing who these experts are, working with these experts and having the financial ability to hire these experts are important in selecting the right personal injury attorney.
Multi-Disciplinary Medical Approach
Further, obtaining a multi-disciplinary medical approach to your injuries is better for your care and helps the insurance company understand your claim. Examples of a multi-disciplinary approach is where the emergency room doctors diagnose a back strain. Thereafter you follow-up with your family doctor who also confirms a back strain. Then your family doctor refers you to physical therapy or chiropractic care, where a third confirming medical determination is made. It is hard for insurance adjuster to argue with three different treating medical providers that an injury did not occur.
Medical Over Treatment
Poorly monitored medical treatment can cause your insurance claim to have problems. The first place we see this is over treatment. This can occur with physical therapists, chiropractic physicians, or any medical provider. Over treatment occurs when the treating providers continues to treat the patient’s injuries without seeing real medical progress. Or treating past the point of maximum medical improvement. Maximum medical improvement is where there is nothing else the medical provider can do to provide medical relief to the patient’s injuries. If the client understands this is occurring, but still sees value in the medical treatment, that is fine, but the client must understand the significant ramifications on their insurance claim. It is a balancing act.
Over treating can, but not always, occur when medical providers provide medical treatment on a lien. The below examples demonstrate how over treating impacts the bottom line compensation to a client at the end of the day, when settlement or a verdict occurs.
FACTS: A rear-end car collision and you are hurt.
|COURSE OF MEDICAL CARE INCURRED|
|Type of Medical Care||Costs|
|Emergency room visit.||$1,100.|
|Total Medical Bills||$8,050|
|Best Settlement Offer, or Trial Verdict Result||$10,000|
In this example above the best offer from the insurance adjuster was $10,000 because the insurance adjuster discounted around $3,000 of the chiropractor’s bills and medical treatment, calling them palliative (relieving pain without dealing with the underlying cause), and not medically necessary. In fact, an in-house paper review by the insurance adjuster’s medical doctor (M.D.) reported that the injured party already reached maximum medical records when the bills reached $3,300.
|Attorney Fees:||$3,300 (1/3 contingency fees)|
|Costs Reimbursement||$110 (Costs fronted by the attorney)|
|Total Fees to Attorney:||$3,410|
|Total Settlement to Client:||$6,590|
|LESS Unpaid Medical Bills:
1. $5,050 unpaid lien to Chiropractor.
2. PIP benefits paid the first $3,000 in medical bills, covering your ambulance ride, ER visit and some of the chiropractor’s bills, leaving $5,050 of unpaid chiropractic bills.
|Total Settlement to Client after Unpaid Bills and Liens are Paid:||$1,540|
As you can see, because of over treatment with the chiropractor, it makes the case hard to settle because the insurance adjuster refuses to count all the chiropractor’s bills. This can also happen with physical therapist, or really any medical providers who over treats. Cases can even get upside down, meaning the client is actually owes money at the end of the day. What happens in these “tight cases” is the attorney asks the various unpaid medical providers to reduce their bills to allow for a settlement to occur. A good personal injury is always watching out for over treatment, or at least educating the client on how the movie will end if they choose to continue the care.
In the case example above, had the chiropractor, the personal injury attorney and the client had this conversation when the bills hit $3,500, the situation could have been avoided, or at least known so there are no surprises when the cases settles.
Utah Car accident injury cases can take four months on the short end and years on the long side to resolve. Ensure that you hire a personal injury attorney who knows how to keep your case viable and well documents so that the insurance companies understands your injuries.
Call personal injury attorney Jacob S. Gunter at (801) 373-6345 for a free consultation today.