Albany, CA (Law Firm Newswire) May 19, 2018 - Doctors and insurance companies provide valuable services – that is why we pay them. But if there has been a car accident, there is no guarantee they will not cut corners. An experienced personal injury lawyer – someone who knows the ins and outs of how accident victims can get taken advantage of – is the most important ally. Here’s why.
If someone has been hurt in a car accident, a complete and accurate diagnosis from a doctor is needed to get the full settlement deserved. An incomplete diagnosis will just hurt recovery – it could drastically increase medical costs.
Let’s say there has been an accident. A driver was hit from behind, briefly lost consciousness, and was taken to the hospital by ambulance. The injured victim is feeling neck pain radiating down into the shoulder, arm and hand. The victim also has headaches, dizziness, blurred vision and loss of concentration. This information is relayed to the doctor.
What does a complete diagnosis look like? A full orthopedic, physical and neurological exam looks at all injured body parts, whether or not they ultimately get treated. A complete diagnosis might look something like this:
1. S06.DX1A Concussion, brief loss of consciousness
2. R42 Vertigo, dizziness and giddiness
3. M54.12 Cervical radiculitis
4. G44.89 Headache
5. S16.1XXA Cervical strain
6. S13.4XXA Cervical sprain
7. M99.01 Cervical segmental dysfunction
8. M48.32 Cervical traumatic spondylopathy
9. S43.401A Right shoulder sprain
10. M77.01 Right medial epicondylitis
11. G56.01 Right carpal tunnel
By contrast, an incomplete diagnosis might only say this:
1. S16.1XXA Cervical strain
2. S13.4XXA Cervical sprain
A medical degree is not required to see that there is a huge difference between the two.
Why is this important? It is important because the diagnoses are used by the insurance companies to establish the maximum settlement that may be received for a victim's injuries.
Look at the diagnoses above. See the codes on the left of the symptoms? They are all the auto insurance company has to go on to determine the value of a case. An incomplete diagnosis cuts this down considerably. As the saying goes: garbage in, garbage out.
When someone is in a car accident, the insurance company enters a doctor’s diagnostic codes into a software program (named, ominously enough, “Colossus” in some cases) and then the program spits out a decision about the case.
Insurers take this opportunity to provide a low-ball estimate. Colossus and similar programs reduce the value of a claim by diminishing the compensation attributed to certain common injuries (e.g., whiplash).
Unfortunately, that’s just the beginning of the tactics insurers use to avoid paying on claims. Here are some others:
* Claiming that the victim, the doctor, or both are lying
* Forcing claims all the way to trial by making only low-ball settlement offers (thereby increasing the costs and time required to prosecute a case against the at-fault driver)
* Convincing at-fault clients to not disclose policy limits
* Refusing to accept service of the court documents when a lawsuit is filed
* Demanding a lien whenever the victim receives medical treatment
* Limiting reimbursement to 6-8 weeks of medical care following damage to the victim's car
* Placing claims in the “minor impact, soft tissue” category based on property damage amounts regardless of how badly a victim was hurt.
The goal here is two-fold: in the short term, insurers hope to convince unknowing victims to settle for less money. In the long term, they try to discourage victims from bringing lawsuits. Both goals have insurer's profits – not a victim's recovery – in mind.
Insurers like to paint lawyers with a broad brush, claiming that frivolous personal injury lawsuits are clogging up the court system. (In fact, personal injury cases account for only about 1 percent of the cases filed in California.)
Accusations like this try to obscure an important truth: if someone has been hurt in an accident, the insurance company’s interests do not align with the victim. An injured driver wants the full settlement that he or she is entitled to, and insurance companies want to keep it as low as possible.
A Good Lawyer Can Help
The one person whose interests do align with the victim's is his or her lawyer.
But choosing the right lawyer – someone who knows how insurers avoid paying victims and will not let them get away with it, for example – is important.
When a victim hires an experienced personal injury lawyer, the lawyer’s sole purpose is to make sure that no one cuts corners on any settlement.
A person cannot always control getting into a car accident. But with the help of a smart, capable attorney, they can control how the plaintiff gets out of one.
Do not let insurance companies, uninformed doctors, or the wrong lawyer interfere with getting the full settlement that is deserved. For those that have been in a car accident, call an experienced personal injury lawyer today.