Insurance companies are required to act in good faith when evaluating a personal injury claim. They should strive to pay personal injury claims rather than aggressively seek to deny or minimize claims. After all, an insured has paid premiums so that if a personal injury claim is brought against him or her, the insurance company should pay the claim rather than look for ways to avoid protecting the insured by not paying.
Let us look at a typical situation after a motor vehicle accident. You are the driver of a car and are legally stopped for a red traffic light. The insured driver is not paying attention, e.g., texting, talking on a cell phone, reaching down to pick something off the floor board, eating, distracted by music, and rear ends your car.
Due to the impact, you are injured. Your neck and back hurt. The police and emergency medical technicians arrive at the scene of the accident. The police officer tickets the insured driver who hit you for careless driving. You decide to go to the hospital by emergency vehicle. At the hospital, you wait for two hours before being seen. You are examined by an emergency room doctor and told to go home and rest. You are given samples of a potent pain killer and provided with the name of a doctor to follow up with taken from a rotation list.
You go home. You feel increasingly worse. You ask your friends who is a good doctor who specializes in neck and back pain. You get some names, call around and get an appointment with a neurologist or orthopedic doctor who accepts your no fault (Personal Injury Protection) motor vehicle coverage or your health insurance coverage.
Now, you are sitting in the lobby of a neurologist or orthopedic doctor. The medical assistant provides you with a patient information form. It is important that you write a detailed medical history although you do not feel well. The insurance company will carefully study this patient information form to try to find ways not to pay for the injuries you have sustained due to the negligence of its insured.
You must write about how you feel and where it hurts. A good way to think about this is what hurts due to the accident from the “top of your head to your toes?” Are you having neck and back pain? Did you lose consciousness or were you dazed at the scene, i.e., did you hit your head? Are you experiencing headaches and insomnia? Are you anxious and depressed? Are you having tingling and numbness in your arms, legs, hands, fingers, feet and toes? What is your pain on a scale of 1-10, with one being very little pain and 10 being extreme pain? If given a drawing of a human body to show where the pain is, make sure you show everywhere where it hurts.
You also should list injuries you may have had before this accident. This helps the doctor when analyzing your situation. If you do not disclose previous injuries, the insurance company will try to avoid paying you by saying you mislead the doctor although you may have simply forgotten to list such information.
Since you are hurting after the accident, you should consider having a friend accompany you to the doctor’s appointment. Your friend can make sure you do not leave anything out on the initial patient form and may have observed things about you that you have not noticed, e.g., memory loss, inability to do things around the house and in the yard, anxiety, depression, insomnia.
If you are missing work due to the accident, make sure you tell your doctor so that the doctor can determine whether a doctor’s note excusing you from work or limiting what you can do, e.g., lifting, hours worked, whether you need special accommodations at work, is appropriate.
Be sure and tell all your doctors, even your family doctor, about the personal injuries you are suffering from your accident. This will further document your injuries and show the insurance companies that you are fully disclosing your injuries so that you get the best medical treatment.
Taking these steps will protect you as you get medical treatment and will make it more difficult for insurance companies to deny your claim.