Wednesday 23 November 2011

Role of Medical Treatment in a Car Accident Claim


The role of medical treatment in a car accident claim is best illuminated by way of example. A potential client scheduled a consultation in our law office. "John" had been in a car accident six months prior in which the other driver was at-fault. John was seeking compensation for his bodily injuries and felt that third party insurance (the at-fault driver's insurer) was treating him unfairly. The property damage was quite substantial and his movements were cautious and guarded, consistent with ongoing pain. John confirmed that he was injured in the car accident and was still struggling with daily discomfort and physical restrictions. As an articulate historian, John detailed the sources of his pain and the ongoing havoc in his life as a result of his injuries from this collision. When asked to detail his course of treatment, however, John revealed that he had not been to see any medical providers, traditional homeopathic, chiropractic or otherwise. We informed John that the absence of treatment was going to have a negative effect on the third party's valuation of his claim. John was appalled. His stressed the mere fact that he had not gone to the doctor did not mean that he was not in significant pain and in no way diminished his inconvenience and suffering.

The problems with John's claim highlight the crucial role of medical treatment in every personal injury case where the claimant is seeking monetary damages for bodily injury. This article will address only the typical insurance claim for bodily injury following an unintentional car accident where no permanent disability or disfigurement was suffered.

We must begin with an important premise that the typical injured person often does not know or is manipulated into forgetting: Insurance adjusters are not your friend; the insurance adjuster does not have your best interest at heart; and the insurance adjuster will put forth substantial effort to pay as little for your claim as possible. Their job is not to accept your assessment of damages at face value. Their job is instead to investigate your claim and limit compensation for your injuries when said injuries are at all unsubstantiated and possibly unrelated.

That said, if you are injured in a car or motor vehicle accident it is critical that you seek medical treatment. Primarily it is important simply because if you are in pain and suffering, a professional should evaluate the extent of your injuries and ensure that you receive the necessary attention and care. Depending on your current state of health, the extent of the impact, the crash-worthiness of the vehicle, injuries can vary widely. In addition, adrenaline can mask serious injuries and pain symptoms can therefore be delayed. Pain and discomfort associated with soft tissue injuries typically escalates over a forty-eight hour period. Moreover, it is also important to protect your rights and seek a personal injury attorney.

Aside from the obvious - your health and well-being - medical treatment and oversight also greatly affects the value of your personal injury claim. There are a number of reasons for this, the first being that your doctor acts as an autonomous source of corroboration. If a person is evaluated by an independent medical professional who via their experience and expertise substantiates the presence of impairment, contusions, abrasions and injury, insurance is provided with evidence of injury independent of the claimant. The extent and course of treatment and concomitant medical records substantiates ongoing injuries and the need for continued treatment. The necessity of such treatment is able to be assessed, and the progress made toward recovery and resolution of symptoms is able to be tracked.

Secondly, as an injured person making a claim for damages, you the claimant have an affirmative obligation to mitigate your damages. It is known as the doctrine of avoidable consequences and obligates a victim to take reasonable steps to lessen their harm. The rule as stated in C. McCormick, Damages 33, at 128 (1935) is that where one person has committed an unintentional tort, or legal wrong, against another, it is incumbent upon the latter to use such means as are reasonable under the circumstances to avoid or minimize the damages. The person wronged cannot recover for any item of damage which could thus have been avoided. See Labriola v. Pollard Group, Inc., 152 Wn.2d 828, 840, 100 P.3d 791 (2004)( The doctrine of avoidable consequences, or mitigation of damages, prevents an injured party from recovering damages that the party could have avoided through reasonable efforts); 16 David K. DeWolf and Keller W. Allen, Washington Practice: Tort Law & Practice 8.9, at 261 (3d ed. 2006). John will thus have difficulty recovering money for six months of pain in the absence of any treatment. Third party insurance will argue that crawling around his house in pain was simply unreasonable, and that had he pursued some form of medical/rehabilitative/therapeutic treatment, his injuries would have likely resolved in a shorter time and his suffering been minimized substantially. A claimant should also remember that consistent treatment, showing up for appointments and following provider directives are similarly important.

Third, medical treatment and the cost of those services also serves as an imperfect, yet objective, quantifiable measure of damages associated with your care. Imperfect because the cost of medical care can in no way encapsulate the fear, frustration, inconvenience, and physical pain that an injured party experiences on a daily basis. It is difficult to place a dollar value on the extent of a person's suffering. But that is exactly the calculation a claimant is asking an insurance adjuster to perform. The cost of relieving those symptoms, therefore, serves as a tool for the adjuster, a measurement of value for the period of time the claimant is undergoing treatment. The cost of the actual medical care received, therefore, plays a role in the final settlement offer extended by third party insurance.

The moral of the story is: If you are injured in a car accident, seek medical treatment from your family physician or chiropractor. Don't wait.




Federal Way attorney Angel Chenaur has handled thousands of personal injury cases, ranging from minor to catastrophic injuries. Angel also graduated from the University of Washington in 1994 with a B.S. in Political Science. After graduating, she went on to law school and graduated from Seattle University School of Law in 1998.





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