Medical Bills - Evaluating Your Personal Injury
Insurance Claim
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The value
of a personal
injury claim
has a direct
relationship
to the amount
of your
medical
bills. Why?
Because
a claim
with medical
bills of
$500.00
is worth
three to
five times
more than
a claim
with $100.00,
or less.
And that's
a fact of
life in
the world
of insurance
claims.
The adjuster
will reason
if you were
hurt badly
enough to
run up $500.00
in medical
expenses
than it's
correct
to assume
that your
injuries
must be
substantial.
But, if
you see
your chiropractor
or physician
only once
or twice,
and your
final bills
are in the
vicinity
of $100.00,
that adjuster
will assume
you weren't
hurt too
seriously.
DEMAND
THAT ALL
YOUR MEDICAL
BILLS BE
PAID: The
adjuster
may try
to disallow
a substantial
part of
your total
medical
expenses
which he
contends
doesn't
qualify
as "medical"
in character.
He'll often
attempt
to divide
your medical
costs into
two arbitrary
parts -
- "Diagnostic"
and "Treatment".
In the "Diagnostic"
category
he'll include
items such
as ambulance
and emergency
room costs,
costs of
X-rays,
and other
diagnostic
procedures,
plus visits
to specialists.
And the
rest (principally
costs of
the hospital
and regular
office visits
to doctors,
physical
therapy
and medication)
will be
termed "Treatment".
The items
that are
categorized
as "Diagnostic"
expenses
are the
bills the
adjuster
would like
to disallow
as not being
"Medical"
types of
activities.
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He may try
to do this
because
with a differentiation
(between
what is
"Diagnostic"
and what
is supposedly
true medical
"Treatment")
the basic
worth of
your claim
will have
been drastically
reduced,
as the amount
of your
"Special
Damages"
and thus
drastically
reduce the
true value
of your
claim. At
that point
the adjuster
will argue
that the
"Treatment"
portion
of your
medical
bills that's
"directly
related"
to the severity
of your
injury,
therefore
it's what
truly reflects
(and measures)
your "Pain
and Suffering".
Don't let
him get
away with
that! If
he should
attempt
to pull
this on
you tell
him, "It's
absurd and
illogical
to separate
medical
expenses
into two
arbitrary
categories
and designate
one as "Diagnostic"
and the
other as
"Treatment".
Each area
works hand-in-hand
with the
other in
medical
practice.
I can't
get properly
treated
without
being diagnosed!
He'll
gulp, because
he knows
what you
say is true
and that
will usually
be the end
of such
nonsense
on his part.
"PERMANENT"
AND/OR "TEMPORARY"
DISABILITY:
In discussing
"Disability".
it's important
to develop
a working
knowledge
of these
two legitimate
concepts.
Commonly,
personal
injuries
are classified
as either
"Permanent"
or "Temporary".
These two
terms are
used basically
to describe
the anticipated
duration
of an injury,
and not
its degree
of severity!
Thus, if
an injury
is conceived
as one which
would continue
throughout
the remainder
of an individuals
lifetime,
it's said
to be "Permanent"
in nature.
Conversely,
if it's
a reasonable
probably
that the
claimant
will attain
a full or
complete
recovery
(within
some future
period)
the injury
is classified
as "Temporary"
- - regardless
of how severe
or extensive
the injury
might otherwise
appear.
TOTAL
AND/OR PARTIAL
DISABILITY:
Another
common classification
of "Disabilities"
will relate
to whether
they are
considered
to be "Total"
or "Partial".
These terms
refer to
the actual
extent of
the claimant's
injuries,
regardless
of whether
they're
permanent
or temporary
in duration.
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THE FOLLOWING
FOUR SPECIAL
CATEGORIES
ARE REFERRED
TO AND UTILIZED
IN PERSONAL
INJURY LITIGATION
TEMPORARY
TOTAL DISABILITY:
This is
symbolized
by a seriously
injured
person who
is temporarily
hospitalized
or otherwise
completely
impaired,
although
expected
to eventually
regain full
function.
TEMPORARY
PARTIAL
DISABILITY:
This is
that period
when, following
the initial
period of
complete
impairment
of the seriously
injured
party (that
period of
"Temporary
Total Disability"),
the party
recovers
and is able
to resume
some (but
not all)
formal activities.
PERMANENT
TOTAL DISABILITY:
This describes
a condition
(usually
applicable
in the most
sever cases,
in which
the injury
produces
a nearly
total impairment
to the body
as a whole)
- - again
placing
the emphasis
both on
the extent
of the functional
impairment
and its
duration.
PERMANENT
PARTIAL
DISABILITY:
This describes
a condition
where the
injured
party, (even
after sustaining
a permanent
injury)
still retains
some substantial
body function
or earning
capacity,
with the
emphasis
centered
on the extent
of the functional
impairment
itself.
MEDICAL
BILL COVERAGE'S:
Read your
Motor Vehicle
Policy to
discover
if you have
"Medical
Payments
Coverage".
Also check
all your
non-automobile
insurance
policies.
You may
have coverage(s)
to pay your
medical
bills regardless
of who was
at fault.
If you have
a Health
Insurance
Policy and/or
Health Plan
of some
sort, read
the fine
print. Your
policy may
not require
you to pay
back the
medical
bill payments
made in
your behalf
- - even
if you collect
from the
person who
struck you!
DISCLAIMER:
This article
~Medical
Bills ~
Evaluating
Your Insurance
Claim, is
intended
for background
information.
Its only
purpose
is to help
people understand
the motor
vehicle
accident
claim process.
Where such
professional
help is
desired
IT IS THE
INDIVIDUALS
RESPONSIBILITY
to obtain
it!
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