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Traffic Accident Insurance Claims Article
By Dan Baldyga
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.
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.
THE FOLLOWING FOUR SPECIAL CATEGORIES ARE REFERRED
TO AND UTILIZED IN PERSONAL INJURY LITIGATION
(1) 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.
(2) 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.
(3) 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.
(4) 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!
>> Return
to traffic accident insurance claims articles
DISCLAIMER:
The purpose of this article "MEDICAL
BILLS - EVALUATING YOUR PERSONAL INJURY INSURANCE CLAIMS"
is for all readers to understand the motor vehicle accident
claim process. Neither Dan Baldyga, Scott Baker, I GOT HIT,
LLC, and/or the Accident Resource make any guarantee of any
kind whatsoever, NOR do they purport to engage in rendering
any professional or legal service; NOR to 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 said services.
Dan Baldyga’s third and latest book,
AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM (How To Evaluate
And Settle Your Loss) can be found on the internet at http://www.caraccidentclaims.com
or http://www.autoaccidentclaims.com.
This book reveals “How To” handle your property
damage claim so you won’t be taken advantage of. It
also goes into detail regarding BASE (The Baldyga Auto Accident
Settlement Evaluation Formula). THE BASE FORMULA explains
how to determine the value of the “Pain and Suffering”
you endured - - because of your personal injury !
Copyright (c) 2003 By Daniel G. Baldyga.
All Rights Reserved.
Dan Baldyga - Author
dbpaw@comcast.net
AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM
(How To Evaluate And Settle Your Loss)
http://www.autoaccidentclaims.com
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