It is our experience that utilizing an Attorney is a wise choice because most accident victims don’t know all of their legal rights and can become very distressed dealing with insurance companies. Once an Attorney is retained, you are free from having to speak to insurance companies or other parties. All questions and inquires will be handled by your Attorney and Doctor.
Lawyers can help protect your rights and help you get all the money you are entitled to for your health care coverage, damage to your vehicle, and any awards for lost wages resulting from your accident. The decision whether or not to attain an Attorney is best determined after the Doctor examines the extent of your injuries and your related conditions. (If your case warrants having an Attorney represent you, we can supply you with a list of competent Attorneys if you do not already have one.)
Many patients are under the false assumption that if they retain an Attorney, the Attorney’s fees will take away from the full settlement awards that they may otherwise have been entitled to receiving. Actually, Attorneys know how to handle insurance claims appropriately and will acquire the maximum awards that you may be entitled to receive. The settlements reached include the Attorney’s fees and are almost always greater than the amount that an individual can negotiate on their own. The insurance companies’ own research shows that car accident victims receive more money when represented by an Attorney.
Insurance companies usually try to discourage patients from retaining an Attorney. Most insurance companies contact accident victims immediately after an accident. The companies tell victims they want to help. The truth is, insurance companies do not necessarily care to “help” you. Their primary motive is to deny care as much as possible. The reason is cost containment. That is ALL that they care about. They often assert to patients, “You should not be as injured as you are claiming based on the damage to the vehicles, nature of the accident, etc.”
Ask yourself, who is the insurance company really trying to help by having you quickly settle your case?
The primary reason they want you to settle your case ASAP is because they are well aware that personal injuries, such as whiplashes, require on average at least six months to one year of treatment in order to restore the damaged structures to their pre-injury status.
The cost for proper care, plus other potential awards, exceeds the amount the insurance companies offer in initial settlements. If this was not statistically correct insurance companies would not be eager to quickly settle cases and would elect to have injured patients complete their course of care and then settle all payments. Remember, insurance companies are in the business to make as much profit as possible, and they do this by taking the least expensive route. They care about profits, not people. Make no mistake about this!
Many patients are eager to settle as soon as they are “out of pain.” The problem that all too often occurs with this strategy is that the pain will return again if the underlying damaged structures are not fully rehabilitated to their maximum correction.
Many patients experience headaches, muscle spasming, pain, and other problems weeks or even months after they elect to discontinue care. When any of these symptoms return, and they realize that more care is required, they are left paying for this care out of pocket.
Most people are unaware that the effects of uncorrected whiplash injuries lead to Osteoarthritis, degeneration of Spinal Discs, diminished Ranges of Motion, and can ultimately cause Nerve Dysfunction. The facts substantiating these post injury residual conditions resulting from improper or limited care is well documented Medically and Chiropractically.
All too often, we see patients coming in for more care several months or even years after having settled their cases by stopping care prematurely, only to find out that their uncorrected spinal instabilities have arthritically degenerated. At this stage, it is difficult to correct these previously preventable conditions.
It is standard in the insurance industry that they like to “close cases” ideally within six months, or within a year maximum.
Many insurance companies call patients and make them feel guilty if they require care beyond six months. They will tell the patient that according to statistics, they “Should be better by now.” Or they may tell the patient, “Based on the limited damage to your car, you should not be this injured and be requiring such prolonged care.”
They may accuse the patient and the doctor both of embellishing care. They may threaten to not reimburse for any care if the patient does not end care after a certain time period (usually six months). Often times, the insurance carrier will “bribe” a patient into terminating care by offering to pay all medical expenses without further hassle, and they may even offer to reward the patient with a small settlement for ending care.
The reason why the insurance companies want to “close your file” as quickly as possible is because once your case has closed, you cannot reopen it in the event that you find yourself needing further care or care in the future for residual problems that stem from your initial injuries. The insurance companies know that a fair percentage of people who experience whiplash type injuries unfortunately end up with some degree of permanent residual effects. Such residual effects usually require future supportive care periodically to treat the effects of flareups that occur as a result of the long standing destabilizing effects caused by their injury. The insurance company fears such permanent results that require future supportive care, thus they have a strong desire to convince or financially coerce patients into settling and closing their cases after about six months. They know, statistically, that cases that require more than eight or twelve months of care, will often result in some degree of permanent instability.
Most injuries do reach full improvement, even if treatment pursues for one to two years, but the insurance companies do not want to take the chance that it will not reach full recovery. That is why they want to end care as soon as possible. Once care is ended, the patient has no recourse for any reimbursement should there be a need for further or future care.
FACTORS AFFECTING REIMBURSEMENTS
• Severity of Injuries Sustained
• Intensity and Duration of Treatment
•Lost Wages from Work
•Extent of Disability
•Difficulties in Performing Activities of Daily Living due to Injury
•Patient Keeping Consistent Appointments and Following the Doctor’s Recommended
•Program of Care
• Proper Case Management & Documentation
Please be aware that insurance companies rarely provide additional settlement payments for non-economic losses. In other words, while they typically reimburse for vehicle damage, doctors’ fees and lost wages, rarely do they provide additional money for “pain and suffering.”