Medical Bills, Examinations and Reports


By: Dan Baldyga

It’s an indispensable necessity that you see a doctor to get medical attention as quickly as possible (the sooner the better!) after an accident. This decision spells the crucial difference between being handed a fistful of hundred dollar bills for your loss or a paltry “nuisance value” settlement, made to just simply close the case. It’s a fact of life that your claim for bodily injuries have no credibility with the insurance adjuster unless those injuries were verified by the final report of your attending physician.

THE HIGHER THE MEDICAL BILLS THE HIGHER THE SETTLEMENT VALUE OF YOUR CLAIM: The value of a claim has a direct relationship to the amount of your medical bills. Why? Because with medical bills of say, $500.00 to $700.00, the typical bodily injury claim is worth three to five times more than a claim with bills of $100.00 or less. The adjuster will reason if you were hurt badly enough to run up $500.00 to $700.00 worth of medical expenses, than your injuries must be fairly substantial. But, if you see a doctor once or twice, and your bills are $100.00, or less, the adjuster will assume you weren’t hurt too seriously. That’s why you should go for medical treatment as often as possible. It’s an absolute fact of insurance claim settlement’s that the more you see your doctor the higher the medical bills will be and therefore the greater the value of your claim.

REQUESTING A MEDICAL REPORT: After your treatment is over you must obtain a written Medical Report from your doctor because it’s crucial to the successful settlement of your bodily injury claim. Explain to your attending physician what you would like to have the Medical Report cover: Length of total disability, length of partial disability, inability to perform certain functions, and the existence or probability of permanent or disabling effects.

Most doctors are familiar with the accident claim process and will understand. The report should be addressed “To Whom It May Concern”. It should be given only to you and not sent to the insurance company. That way you can make sure it says something worth sending, and doesn’t state anything that minimizes your injuries, before you make it a part of the negotiating process.

GUARD YOUR MEDICAL RECORDS: Never sign any authorization for, or otherwise agree to, your attending physician releasing your medical records to the insurance adjuster. Tell the adjuster you’ll secure a copy and send it to him.

EXAMINATION BY THE INSURANCE COMPANY’S DOCTOR: The adjuster may tell you he wants you to be examined by a doctor of the insurance company’s choice. Beware of such a request. Doctor’s selected by the insurance company are notorious for finding nothing wrong with the claimant, or for finding “no objective basis” for your complaints i.e., “failure to find any symptoms”, they could physically see or specifically measure. This may be because they didn’t have the benefit of seeing you often, or over an extended period of time, as your attending physician had. Being agents or affiliates of the insurance company, who pays them big bucks for what they do, it’s only natural for such doctors to lean in the direction of the insurance company, especially in circumstances where there’s some element of doubt or if there’s no clear-cut answer concerning your condition.

You don’t have to agree to be examined by the insurance company doctor. You’re entitled to see only the doctor of your choice. The insurance company has no right to make you submit to their doctor – – unless your claim actually becomes a formal court case involving a lawsuit. By that time it will be too late for you to be caught in the crossfire of a medical “hustle” the insurance company may attempt to pull on you. The adjuster knows all this, so stall him. Hold your ground until your attending physician has released you. By then it’s okay to submit to an examination because so much time will have passed it will be impossible for them to minimize the pain, discomfort and suffering your injury has caused you. _______________________________________________________________

This article was authored by Daniel Baldyga. Copyright © 2003, by Daniel G. Baldyga. All Rights Reserved.

Reprinted with permission of the Daniel G. Baldyga.

DISCLAIMER: This article is intended for background information. Its purpose is to help people understand the motor vehicle accident claim process. Neither Dan Baldyga nor Free makes any guarantee of any kind whatsoever, NOR purports to engage in rendering any professional legal service, substitute for a lawyer, an insurance adjuster or claims consultant, or the like. Where such professional help is desired, IT IS THE INDIVIDUAL’S RESPONSIBILITY TO OBTAIN IT.

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