Car Accident Injuries & Medical Bills: What Insurance Will (and will not) Pay

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The range of injuries that result from car accidents varies greatly, from minor scuffs and bruises, to catastrophic injuries that require extensive hospitalization, surgery, and other intense medical treatment. If you were injured in a car accident in California, the laws essentially state that you are entitled to be made whole again, or to receive the medical care necessary to bring you back to the same state of health you were in prior to the car crash. The person who hit you is responsible for paying these medical bills, in general, but there are many "loopholes" that make getting full payment of your medical bills paid for difficult or impossible. 

How Does Insurance Evaluate Medical Care?

An injured person is expected to pursue reasonable medical treatment to care for their pains and ailments. What is reasonable? The answer to that question is, of course, subjective and it depends on who you ask. Generally speaking, medical care is considered reasonable by insurance adjusters if it happens at an appropriate time in relation to the car accident, the number of visits are within a normal range, and the cost of the care is within what insurance companies define as "industry standard." Some insurance companies are more strict than others when defining a price point for industry standard, which means they will not pay for treatment over a certain dollar point, regardless of where you live or how soon after your car accident you sought medical treatment. This situation leads many injured people to seek the advice of an injury attorney, even just to review their case and get advice on how to move forward.

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The Cost of Medical Treatment

Some insurance companies look to what Medicare accepts as "normal" pricing for a medical treatment or procedure. Obviously this is the lowest number possible for any given medical care, and the average car accident victim is unlikely to receive any medical treatment at the Medicare price. Does this mean you have to shop around endlessly to find the absolute cheapest medical care to treat your injuries? No. It may mean you'll benefit from the representation of a lawyer who practices car accident law, or an injury law firm that can assist you in finding access to medical care that will get you on your way towards full health. A good lawyer will fight to make sure you get your medical bills paid for and also compensation for pain and suffering.

Sequence Matters in Medical Treatment

Another way in which medical bills are slashed or denied by insurance companies is by the insurance adjuster claiming there was a "gap in treatment," or improper sequencing of care. This means that if you are hurt, you need to get help right away, and then follow the advice of your doctor. If you're injured, you need to first see a qualified doctor, and then follow the regimine the doctor prescribes you until you are better. If you take long breaks in-between treatment, you may find it difficult or impossible to get your bills paid for due to gaps in treatment. Similarly, if you know you require surgery, for example, you can't just delay getting the surgery for months and years. At some point, and it varies case by case, the insurance company will say the surgery is not related to the initial accident, and they will deny liability to pay for the operation. Sequence matters. This means you should seek the opinion of someone able to give an assessment of your injuries or ailments, like the kind of doctor visit you might get at an emergency room, at an urgent care, or through your primary care doctor. Then, you're expected to follow the advice of the doctor. For example, if the doctor says you need 25 visits of chiropractic care, you will be expected to go to a chiropractor and receive that amount of care.

Chiropractic care can be especially tricky when seeking payment for your medical bills from the insurance company of the individual liable for the accident and your injuries. Most insurance companies will balk at paying for more than 25 visits, unless specifically prescribed by a doctor not affiliated with the chiropractor's office. After 25 visits, if you are still injured, you'll be expected to seek additional treatment, something more advanced, such as an MRI, or a visit with a pain management office, or a specialist that deals with the body part(s) you've suffered injury in. 

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Don't Accept Pennies on the Dollar for your Bills

Some people injured in a car crash or other injury that was not their fault feel helpless when the insurance adjuster offers them a couple hundred dollars to pay for large bills. Feeling helpless, they don't know what to do and accept the money, thinking something is better than nothing. This plays perfectly into the insurance companies' strategy: if you offer ten people a very small settlement, at least seven or eight of those people will either go away, or eventually accept it. Dollar for dollar, this is their best bet, and they save the most money by doing this. What the seven or eight people who accept this offer do not know is that if they're offered $500, there is likely at least a couple thousand dollars available to pay for their bills, but they don't know how to get it.

Getting to a "Fair and Reasonable" Settlement for Your Injury

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If you weren't at fault, but you were injured, you deserve compensation to pay for your bills and for your pain and suffering. While the law says you deserve this, and there are tens of thousands of cases where this happens, most people don't know how to go about getting this money, and without the assistance of an experience and trusted injury law firm, you're very unlikely to get the money you deserve for your injury. Experience matters in injury law, and the representation of a good lawyer will, in almost every case, mean the injured person walks away with more money in their pocket and their medical bills paid for, than if they try to negotiate on their own. This has nothing to do with how smart the injured person is or how good a negotiator he or she is. If you don't know what your case is worth, or how the insurance company reviews your file and comes up with a price tag, you will not be able to get to their top offer. Of course, you can threaten to sue, but insurance companies are well represented by good defense law firms, so they are not intimidated by threats of lawsuits from individuals saying they'll go it alone and file the lawsuit. An injury law firm, on the other hand, will not only file a lawsuit on the injured person's behalf, but they'll go about it the right way and will very likely increase the cost of your claim by a lot of money: a lawsuit from a plaintiff represented by a good injury lawyer will get the attention of any insurance company or insurance adjuster.

The Lions Injury Lawyers, P.C. represents injured clients throughout California. Based in Orange County, CA, The Lions practice only injury law, meaning they focus 100% of their time, energy and effort on winning money for injured people throughout California. No matter if you live in San Diego County, Orange County, Los Angeles County - or somewhere else in California, The Lions will vigorously fight for you and your case. You won't talk to a salesman if you call for a free consultation - you'll discuss your case with an actual attorney, a lawyer who may eventually represent you and help you recover from your injury. Lawyers are ready to discuss your case today, or simply answer your questions.