6 Ways to Ensure your Car Insurance Covers your Accident.
Worried about being in a car accident? Be prepared before the accident and follow this how-to guide to ensure you have the right details and the right care. Here are 6 things you can do to ensure that your healthcare needs are covered by your health insurance...
Ok, this is a brief tutorial on car accident insurance and coverage by your insurance company. Don't get to freaked out, it is OUR job to deal with your lawyer and your insurance companies for you and to ensure all the T's are crossed and I's are dotted.
Your job is to heal and try to ignore the sometimes constant pestering of the opposing insurance company. With this said, sit back and relax as we take care of this for you. OUR job is documentation, ensuring all the info backs up your claims, and to provide clear and guided goals and homework for you to ensure your are making progress in your healing process. You just focus on healing, make your visits on time (and don't forget to book out). For those worry-warts, we've made a list of 6 things you can do to ensure your care gets paid for.
If at anytime you are fearful or afraid, don't hesitate to reach out. Your job is to heal, you can't do that if you are afraid. Just to make you a little LESS fearful, we've only had ONE case NOT pay us in the past decade. We have it down. Come in, relax, and heal. Leave the rest to us. We'll elt you know when you are good to go without our care. You will feel it too!!
1.Book a visit right away!
Seems like a no-brainer but you'd be surprised how many patients wait a few months. The longer you wait, the more diminished the possibility that your insurance will cover it.
You’ve just been in an accident and you have minor whiplash... Visit a doctor? Absolutely
Please don’t hit up the local ER unless you feel that it is truly an emergency!!
A sore neck or back is something you can book a visit to see your practitioner for (in most cases) and even get a quick check-up at the local non-hospital urgent care centers. Almost all accidents, are covered by your car insurance if you have coverage (an exception would be an uninsured motorist collision, in which if you don't have it, you pay out of pocket). You are covered regardless if you have MedPay on your plan. Most plans cover 5,000 immediately without the need for a lawyer, so book in and don't be shy about coming in twice a week until your symptoms decrease. The better and more complete a file we have, the better your chances of winning any future lawsuits. Copious notes, specific questions, and rated pain scales for each painful region might be the reason you win your pain and suffering case, if you choose to persue one.
The research shows that the amount of damage done to your car does
NOT match the amount of injury sustained by your body.
Some injuries, such as ligamentous damage or vertebral misalignment, may not show up directly after the accident. Swelling and inflammation might cover-up hyper mobility or joint damage that a trained doc will keep an eye out for. It is not unheard of to heal from the soft tissue aches and pains of the initial trauma but to begin feeling symptoms weeks after the accident as your inflammation settles. This is especially common in nearby regions which might not be as painful immediately following the accident, but once the inflammation decreases in your 'main' zone, you might notice your shoulder, hip or (insert region here) might still be bothering you. We see a lot of neurological damage after accidents in which pain and tingling of an arm, buttock, or foot shows up weeks or months after an accident. This is why proper documentation and care is necessary to maintain a timeline in your medical file.
Personally, I myself was in a head on collision in my youth, impacting the steering wheel on my sternum, I had general bruised pain but I wrote it off as just tenderness. I began having heart issues a few weeks later (more like 6-8 weeks later) and upon re-exam, I had partially fractured my sternum and irritated my heart. I was in care for years after this for the trauma that occurred to my thoracic spine and today still suffer the late effects of scar tissue, hypomobility, and muscle guarding. I wish I had received care immediately (instead of waiting a year). Insurance did not cover it!
2. Get Documentation to back up your claim.
As mentioned earlier in this post, it is REALLY important for you to document your symptoms, your response to care, and your aches and pains in each region of impact. Its ok to have 8 regions immediately following an accident, which dwindles down to 2-3 within a month, and then 1 or 2 for a few months thereafter for those in truly aggressive accidents.
Think ahead and try to round up any photos of your car (call the collision shop and/or cops if you didn't take them yourself) and a detailed description of repairs needed for your records. Often the speed of collision is incorrectly recorded and these notes will come in helpful.
If you have any bruising, swelling or visible abnormalities to your own body, get photos of these and try to compare left to right in the photos. (So if your left hand was injured, get a photo of it next to the right hand, in mirror image of each other if possible).
Also get the name of the person who examined your car and keep full detailed records (I'd draw them out) of the location, impact angle and what position your head and body were upon impact. We will add this to your file for submittal to your insurance agent.
Again, if it's not documented, it can be viewed as 'suspect' in court later on and not covered as it could be.
Information is power
Get additional documentation of your injuries by seeing us as well as your general practitioner. We will refer you out for any advanced imaging or testing that might be needed to support your care (and more importantly, allow you to heal). If you are slow to resolve, we will create a network of other providers to support your healing and to ensure we haven't missed anything. At the end of your care, if you have any lingering effects, this is where a medical examiner comes into play to evaluate your level of disability. Only needed for car accident cases in which you have sustained permanent damage (rare), your lawyer will take this into account when building your case. We have only had 1 client in our history that needed this, all the others we healed back to 100%.
It is not uncommon to
have an entire health care team
working for you...
At our office, depending on your needs, we might recommend you seeing our in-house physical therapist for your 're-training' exercises, Dr. Karen for massage and chiropractic adjustments to support the connective tissue healing and bony alignment, and give you supportive home-care to ensure you unload the region while it heals and to teach your body not to guard it for years to come after it is healed to optimal. Trauma is multifaceted. We merely give you your options, make recommendations as if you were a family member, and let you choose accordingly.
The magical trick, if there is one, for proper insurance coverage is to receive structured patterned care and to document your symptoms and your progress until the end of your healing process. Once you hit maximal improvement and stay there for a period of time while you learn to support and protect your injury, your insurance coverage is complete. Maintenance care thereafter is often at your own expense unless grouped into your auto accident claim with your lawyer.
Usually no lawyer is needed and we get paid in full unless you take a turn for the worse or your healing process is complicated by prior conditions or injuries. This is rare. With this said, a good provider who is familiar with the auto-insurance industry, will continually ask you to fill out pain diagrams and questionnaires to evaluate your progress.
3. Don’t let any gaps occur in your care.
If you do get injured in an accident and you head right in to see the doctor, make sure you keep going back until your symptoms resolve.
The doctor will make recommendations as for the duration of care and you should go in at least weekly for the first few weeks before you decide that you are ready to close your claim.
Q. If your job gets too busy to come in for care?
A. Call your doctor and put it on record or swap to another assisting clinic who has later hours.
Q. Moving or going on a trip?
A. Set up supporting care on your trip to ensure that you continue to heal while away from our office.
4. Don’t close your case early
Once you are pain free, you can close your case… But take your time!
The golden rule is that when the insurance companies speed up (asking for you to fill out forms), you slow down to fully read those forms and to ensure that you aren’t rushing the process. .
Q. Do they want your case closed immediately?
A. This could be a red flag that they assume you have returned to your health prior to the accident.
The insurance company might also think that you have hitting the end of your care. The key takeaway is that Insurance companies do not cover care once a claim is closed. It is in their best interests to close your case as soon as possible so they do not incur any more costs.
5. Communicate with your Claims Agent
It is ok to talk to your insurance agent and to tell them the specifics about how you are feeling.
Don’t sugar coat your symptoms or tell your claims agent
that your pain is worse than it is...
If you're not sure how you are feeling, tell them when you felt your worst over the past week and what it felt like, you can also tell them how you feel at your best (and how long that lasts for). When in doubt, tell them that LifeSport will send over your forms/notes for review. Answering with "I feel great" when you do not may skew their perception of your injury and do remember they are taking notes to add to your file for any court proceedings. Be clear, consistent and concise.
Choose to use examples to describe the continuation of your symptoms:
When discussing your current condition, I might make the recommendation to skip the basic descriptors such as ‘fine’ ‘ok’, ‘bad’ or ‘good’, and would recommend you mentioning how your injuries affect your daily activities.
Are there things you are still unable to do due to pain?
Are there things you are able to do but not at 100%? Make sure to tell your claims adjustor this as well when they call. Basically, they will write it down and if it is the opposing insurance company, they will use it to calculate how much care they think you still have left at our clinic.
Are you having trouble putting on your shoes or sitting on the toilet for too long? How about washing dishes, backing up your car from a parking spot? They would better benefit from these tidbits of daily life. You can also tell them how long the symptoms are lasting (and if it has changed from right after the accident) as well as if the severity of symptoms has decreased (you used to experience ‘stabbing’ pain with putting on your shoes, now you feel a mild ache that is momentary. Telling them you ‘feel fine’ when you are having trouble sitting for more than 30 minutes or standing for longer than 1 hour.
Don’t be afraid of relying where you are in your care. Kindly tell them how you are feeling to your truest ability and tell them you are waiting to close your case just to make sure you don’t have a relapse.
I’d recommend waiting a full month without symptoms before you close your case. Also, take the time to use your expected future medical treatments to ensure that they are covered, many insurance companies (AllState as a example), do not cover future medical and want you to finish care before your case is closed.
6. Only ask for care that is related to the injury
Your car accident insurance will only pay for care that is related to the accident.
Often clients come in with pre-existing injuries, or those that were there prior to the car accident. If this is you, make sure that your massage therapist and/or doctor stays on track to treat the region that is affected in your accident.
The reasoning is this, if they put in their notes that they were working on your left ankle (from your ankle sprain last summer), and your car accident exam notes do not say in there anywhere that your left ankle was affected, your insurance isn’t going to cover it.
