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Proving Past Medical Expenses for Your Car Accident Claim

When you have a personal injury claim from a car accident, there are steps you must take to successfully gain compensation for past medical expenses for your injury from the accident. It is critical that the insurance adjuster is satisfied by:

  • Medical necessity of your treatment
  • Charges for the medical care were reasonable

Most injury victims struggle with proving these two facts of received care. This is because they do not understand how the adjuster is looking at the claim and the criteria they use to evaluate whether your medical care was both needed and reasonably priced. This is why it is important to gain the help of an experienced personal injury and car accident attorney. Such a lawyer will prove the value of your claim for you, using the documentation you provide from past medical expenses.

Medical Treatment Expense after an Auto Accident

You should receive a medical evaluation, after an auto accident, to determine if you have any injuries. Some injuries may need further treatment. When appointments, diagnostic studies, prescriptions and other treatments are required, it is the accident victim who must first take responsibility for the charges.

When a negligent driver is proven to have caused the accident that caused your injuries, past medical expenses can be compensated for when you sue the defendant, their insurance company or both. During these actions, the injured victim submits copies of medical bills to the defendant’s insurance adjuster. The adjuster evaluates them for reimbursement. There are a wide variety of medical expenses that can be recovered by someone injured in an auto accident, particularly with the help of an experienced car accident lawyer.

Criteria Insurance Adjusters Look for in Payment of Past Medical Expenses

Many people believe that getting your past auto accident medical expenses paid is just a matter of submitting the bills. But there is very specific criteria that adjusters seek for satisfaction that treatments received were medically necessary due to the injuries of the accident. It is helpful for plaintiffs to know what will be reimbursed and the type of proof required to gain compensation.

Helpful points for providing documentation of medical expenses to insurance adjusters include:

  • Doctor’s documentation of the injury and how it was caused
  • Nature, source and supplier of provided medical reports and treatments
  • Substantiating evidence showing the care was provided
  • Verification that the received care was necessary in order to determine the diagnosis, provide treatment or cure injuries caused by the defendant
  • Reasonably valued cost of all of the provided treatments and services

The defendant’s insurance carrier will examine all of the claimed medical expenses and accompanying documentation. This is why it is so important that the expenses were specified as necessary with their cost being appropriate. The insurance adjuster, defendant and the defendant’s attorney can contest claims for reimbursement.

Reasons why they may contest your reimbursements include:

  • Documentation does not show that the defendant’s negligence was the cause of the claimed medical condition
  • Evidence disproves one of the essential elements of submitted claims or proves that:
    • The plaintiff did not receive treatment claimed
    • Medical necessity did not exist for listed treatments or prescriptions
    • Provided treatment or prescriptions was part of a litigation consultation and not actual medical care
    • Claims exceed the amount of actual bills
    • Injuries were falsified, fabricated, exaggerated or over-treated

Most auto accident victims struggle to prove their claim to the insurance adjuster. Adjusters are trained to focus on certain aspects that laypeople do not examine. This is why it is so important to have the help of an experienced personal injury attorney after your auto accident.

What a Personal Injury Attorney Does for Auto Accident Victims

With a personal injury attorney on your side, he or she will guide you through the specifics of proving your claims and will negotiate with the insurance company with you. Additionally, an experienced and established personal injury attorney in your area is likely to have a reputation with insurance companies, having handled claims for other clients against those same companies in the past. This means that the insurance adjusters and their employers are aware that the attorney will fight, how long they will work to ensure you are successful in your case and that the lawyer is knowledgeable in how they work.

If a difficult dispute arises with the adjuster, the personal injury and auto accident attorney will use his or her skill to ensure the dispute is resolved through the court system.

When you are in an auto accident, you and your family members are also affected by the wreck will likely incur high medical expenses. These will include copays, deductibles and out-of-pocket expenses. But you have a right to pursue reimbursement from the negligent or at-fault driver in the accident.

When you have been in an auto accident, you should contact a personal injury lawyer as soon as possible. Having an established auto accident attorney on your side will help you avoid much of the stress associated with dealing with insurance companies and their adjusters. You will also be able to gain more compensation with an experienced attorney representing your case, than insurance companies will pay you if you do not have a lawyer.

Call the auto accident attorneys of Hirsch & Lyon Accident Law Accident Law now at (602) 691-7278 for a free, no-obligation consultation about your personal injury claim.


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