People who are injured due to the fault of someone else should continuously provide their medical bills, records and diagnostic studies (e.g. MRI cd, CT scan, etc.) to the at fault person’s/company’s insurance company. The reasons for this are as follows:
1. Liability insurer needs documentation to make a fair offer.
If you want a chance at settling your personal injury case before filing a lawsuit, you should give the insurance adjuster your medical bills, medical records and any diagnostic studies as soon as you have them. This is true regardless of whether you are dealing with an auto insurance bodily injury liability adjuster, or a liability adjuster from a business or a home where you were injured.
If you are seriously injured, you should request your medical records and bills after every major medical visit with a doctor that you have. If your injuries are soft tissue (neck and back pain treated with physical therapy and no additional treatment), you may want to wait to request your therapy records until after you are done with your medical treatment. It is always a good idea to request your medical bills and records from the hospital as soon as you are discharged (leave) the hospital.
The claims adjuster will hire a doctor and give him/her your medical records and diagnostic studies (MRI, CT scan, etc.) and ask him/her to do a “peer review” or “independent” review.
They hire a doctor to give his opinion as to whether your injuries were caused or aggravated by the incident and the extent of injury.
If you don’t give the at fault person’s insurance company all of your medical records and bills, you may not get offered as much money as possible.
The exception to this is if the limited medical records and bills that you provide to the insurance adjuster(s) justify the adjuster paying the limited policy limits that are available to cover your damages.
2. Get bills paid under MedPay.
If you were injured on the property of business, and the liability adjuster needs your medical bills and records so that they can pay your medical expenses under the Medical Payments portion of the commercial general liability (CGL) insurance policy.
This assumes that the business has Medical Payments, which is optional, under its commercial general liability insurance policy.
Larger commercial establishments such as Publix and Walmart do not have Medical payments coverage. They self-insure above a certain amount. Walmart self-insures up to $4 Million dollars.
3. The insurance company needs to set a reserve so that they have money set aside to pay to your claim.
The sooner you provide the insurance adjuster with your medical bills and records, the sooner they can set (or increase) the reserve. Generally speaking, this will result in the injured victim receiving an offer sooner.
Also, insurance adjusters have supervisors that may need to approve the settlement.
The sooner the adjuster that you are dealing with has your medical bills and records, the sooner they can ask their supervisor for permission to settle the claim. In bigger claims, the supervisor may need to request permission from their supervisor (or the home office).
If you want to get paid for the money that you were not paid because you missed work because of an accident, you should give the liability insurance adjuster this information as soon as possible.
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Editor’s Note: This post was originally published in June 2011 and has been completely revamped and updated.
Chris Pederson says
Thanks for explaining how the reserve can get set faster if you give the adjuster your bills and records as soon as possible. I have never had to work with an adjuster before.
If I ever need to, I’ll be sure to get all my bills as quickly as possible and give them to all the respective parties that need them.