The Role of Medical Special Damages In Personal Injury Claim

The medical special damages represent the amount of money that the claimant has spent, by paying his or her medical bills. That amount plays a key part in determining the outcome for considerations of a given claim’s value.

If the claimant has health insurance, then the provider of that health insurance policy covers the cost of treatments.

Personal Injury Lawyer in St. Catharines knows that claimants with access to health insurance would enjoy the freedom to seek the best treatment. By the same token, each of them should find it easier to go after a second opinion.

If the insurance company has been provided with evidence that a given claimant has sought out the ideal treatment, then it should feel obligated to offer a larger compensation package.

Sometimes a series of diagnostic procedures has preceded the chosen treatment.

How extensive were the diagnostic procedures? Did a lengthy procedure match with the intensive treatment? If the answer were “yes,” then the adjuster would use a large multiplier in the formula that should indicate the claim’s value.

Suppose, though, that the answer was “no.” Suppose that a long series of diagnostic tests had resulted in discovery of a minor injury. In that case, the adjuster would use a small multiplier in the same formula.

Does a payout from the insurance company normally cover the cost of physical therapy?

Insurance companies usually cover the cost of prescribed therapy, unless it gets prolonged unexpectedly. Insurance companies also study the location at which the therapist has met with the claimant. Whenever such a meeting has taken place in a doctor’s office or in a rehabilitation facility, the insurer seldom questions the need to cover that particular expense.

Still not all meetings between a claimant and physical therapist take place in one of those 2 locations. Sometimes the therapist comes to the claimant’s home. Insurers hesitate to cover the cost of such visits, because therapists have a tendency to schedule unnecessary visits.

The unspoken question

While insurance adjusters do not hesitate to question the severity of a claimed injury, there is one question that goes unmentioned, especially when an insured vehicle has sustained a great deal of damage. That could concern the absence of any injury claim.

Sometimes, if a driver has gone unharmed, and if the other occupant of the front seat has seemingly escaped any injury, then the driver assumes that none of the occupants suffered any injuries. An adjuster would not question the absence of any reference to injuries.

Adjuster’s force insured drivers to face the consequences of their assumptions. Those that have assumed a lack of injuries could decide to accept a quick settlement, and then end up dealing with a slow-to-appear injury in a child or a teenager.

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