You’ve been injured through no fault of your own and need medical treatment. What do you do when somebody else is responsible for your injuries but their insurance company will not pay up front for your medical care? Instead they will offer you payment all in one lump sum upon you reaching maximum medical improvement. How do you get from where you are to where you need to be?
- Don’t sign anything from the at fault party’s insurance company or do a recorded statement until you are in a the right state of mind to do so. That does not mean in the hospital bed with a morphine drip hours after the traumatic incident. Regardless of what the insurance adjuster says, it can wait and it will not expedite anything. It could only complicate things. (It’s never a good idea to sign anything from an insurance company without at least talking to an attorney-most times without any costs to you);
- Seek treatment from an emergency room or minor care facility where there is no appointment or prior consultation necessary. Only you can judge the need for emergent medical care based on your injuries and pain level, no one else;
- If you have health insurance, Medicare, and/or Medicaid file all medical care you seek with those providers. Yes, someone else caused your injuries. Yes, you will have to reimburse them for expenses paid. HOWEVER, those expenses will be less than had you not filed through the benefits mentioned above because of the reduced, contracted rates they have with medical providers. (Darren Tobin wrote a great article on this reimbursement process, known as subrogation, entitled "Understanding Subrogation-Why You May Not Be Keeping It All".);
- If you have no means of health insurance you can still be seen at the emergent facilities in your area or free clinics. Make sure you have a copy of the form filled out by the trooper if you were injured in an automobile accident. If from other negligence, be sure to indicate to the doctor how you ended up being injured and in need of medical care. Details are important, both in the doctor’s understanding to provide efficient & effective care and in determining the proximate cause of your injuries;
- If you have a primary care physician you have previously visited and sought care from make an appointment with them and explain how you ended up being injured and be detailed with your specific complaints;
- If you are a doctor, nurse, and/or otherwise medically trained & educated do not seek gratis, undocumented care because you know what your injuries are or what to do to make them better without anyone but you knowing. That is the worse thing you could do. As a well known Greenville attorney told me, "Insurance companies are like the Russians during the Cold War…." What does that mean? Don’t confuse them. By not having documentation from a third party about your injuries, it confuses them. They don’t know how to value that so they don’t; and
- If you are hard headed or adverse to medical treatment, okay. Just don’t expect the insurance company to put a value on your "pain and suffering" sitting at home without anyone knowing what you have endured but your loved ones. If it is not documented, you are not injured in the mind of the insurance company. If you wait weeks after the incident that injured you, insurance companies call that a "gap in treatment". Essentially giving them more reason to low ball you or make excuses on how you were injured other than reality.
I know you don’t know what to do. I realize you think the insurance company will take care of you because you didn’t ask to be put in this situation. Plus, it was the person, company, and/or entity they insure that put you in this condition. I understand you have values and morals where you would treat others as you would want to be treated.
However, my job is not to help you strengthen misplaced beliefs in how the world SHOULD work. My goals and objectives with every client interaction are three part:
- Educate you on the law, specific to your situation;
- Help you get compensated for what you have had to endure at no fault of your own; and
- Make sure you are satisfied with our attorney/client relationship so you brag about me to your friends, family, and others you know that may need me to fight the faceless insurance companies on their behalf.