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Personal Injury Insurance Claim: Insurance Company Payment of Medical Expenses as Incurred



If you suffered personal injuries in an accident, you will likely require medical treatment or chiropractic care, and you need to figure out which insurance company is going to pay those bills. This section will present an outline of reasons for choosing wisely among available insurance companies. What follows is just an outline of the topic. Our members' section will of course have the complete coverage of this topic, but we wanted to alert our free visitors of some of the consequences of just letting the insurance adjusters take over the claim.

PAYMENT OF MEDICAL BILLS AS INCURRED



1. It is CRITICALLY IMPORTANT to Decide Which Insurance Company Will Pay Your Medical Bills from Your Personal Injury Accident

After you suffer personal injuries in an accident, it is imperative that you determine how your medical expenses will be paid. It is important to make a decision early on, based upon the considerations below, and tap into the insurance source of payment. Unpaid medical expenses will bear interest, and you have to pay the doctor back the interest. The tortfeasor is not responsible for interest on your unpaid medical bills. A little investigation before accepting payments from any of the potential insurance sources will yield dividends.

2. "Medical Bills" includes all types of treating professionals

Medical bills or costs or medical special damages all mean the same thing: the charges made by the emergency room, the MRI testing facility, the radiologist, the medical equipment or appliance store (crutches, neck brace, etc.), and your treating doctor, chiropractor, dentist, massage therapist, acupuncturist, homeopathic doctor, physical therapist, or other treating professional.

3. What are my choices in getting these bills paid in full and in a timely manner?
  • Third party carrier-the tortfeasor's insurer
  • Your own auto insurance PIP/MEDPAY
  • Your own health insurance or HMO (subject to some individual policy restrictions that prefer the insured to first use "available" auto insurance; TIP: if the tortfeasor does not admit liability there is no "available" coverage, hence you can use your medical insurance.
  • Tortfeasor's homeowner's Insurance for dog bite
  • Store insurance for premises liability
  • Self-insured tortfeasor (i.e. Wal-Mart)
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4. How Will My Choice of Insurance Company Sources Affect My Personal Injury Insurance Claim?
  • Control the Course of Treatment. If you let the tortfeasor's insurer start to pay your bills (and you can tell it is to her advantage to do so by the fact she offered right away), you run these risks on control of your claim:

    • Control starts with the price tag you will have to satisfy to gain access to interim tortfeasor payments: start with a full recorded statement and a blanket (that means open-ended or no-limit) medical authorization that allows her to go on a fishing expedition through your medical history;
    • She can control the course of your medical treatment;
    • She has virtual veto power over your choice of doctors and what type of treatment you will receive;
    • She can gain easier access to your doctor's staff, and perhaps other records;
    • She can control your personal injury insurance claim by terminating payment at any time or making you undergo a so-called "Independent" Medical Examination (IME);
    • Advantage: try your own PIP or medical insurance or HMO
  • Cut off your benefits. Some sources of payment are more likely than others to cut off benefits. Just keep in mind that the real goal of all insurers is to cut off your benefits as soon as they can while appearing fair about it. The auto insurers will employ two techniques discussed below. The goal here is to find the source least likely to interfere with your right to medical benefits. Advantage: try your health insurer or HMO.

  • Outside doctor's "records review". Some sources (mainly your own PIP) will sooner subject your medical records to what is known as a "records review". This is almost as undesirable as an actual IME, but at least one does not have the reviewing doctor making pronouncements on the claimant's character, and alleging exaggeration of your symptoms, as is the case often in IMEs. Advantage: try your health insurance or HMO or the tortfeasor's insurance.

  • Make you take an IME. Some sources (auto insurers, more likely tortfeasor's) are more likely to make you undergo an IME, which will (almost) ALWAYS inure to the detriment of your personal injury insurance claim. Advantage: try your PIP or your health insurer or HMO.

  • Cut you a break on subrogation. Some sources are more likely to compromise on the amount of subrogation that they will claim from your personal injury insurance claim settlement with the tortfeasor's insurer. Advantage: try your health insurer or HMO.
5. How much of your treatment costs will get paid?
  • "Reasonable and Necessary" medical costs. Insurance medical coverage is not a blank check for taking all kinds of tests and treatments. Both PIP and tortfeasor's auto insurers will be more restrictive in defining what is caused by the accident. Advantage: try your health insurance or HMO.
6. What Doctors Can I Treat With for My Personal Injuries?
  • Can you choose your own doctor? Your health insurer or HMO may have restrictions on which doctors you can select. Advantage: try your own PIP or tortfeasor's insurer.

ADDITIONAL VALUABLE INFORMATION ESSENTIAL TO SUCCESS: A PERSONAL INJURY INSURANCE CLAIM MAXIMUM SETTLEMENT


Here are some more free pages that are loaded with information and strategies to help you "do-it-yourself", all the way to a successful settlement of your personal injury insurance claim.

Accident Personal Injuries: Documenting and Learning Accident Medical Impacts will teach you the basic foundation to writing winning demand letters for your personal injury insurance claim settlement.

Statute of Limitations: Personal Injury Insurance Claims; Car Accidents, Dog Bites, Premises Liability will teach you the basic information on how to preserve your insurance injury claim.

Part 1 of our Directory of Car Accident Information and Insurance Injury Claim Settlement Procedures-1
discusses the first two aspects of Car Accidents: Handling the Accident Scene & Your Damaged Vehicle.

Part 2 of our Directory of Car Accident Information and Insurance Injury Claim Settlement Procedures-2
discusses the next two aspects of Car Accidents: Insurance Claims Adjuster; Correcting Officer's Report

Benefit much more by becoming a www.SettlementCentral.Com Member. Join Now! SettlementCentral.Com, Personal Injury Insurance Claim EXPERTS.


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