YOUR CLIENTS PERSONAL INJURY INSURANCE CLAIM
~ DOCUMENTING THEIR DISABILITY ~
PLUS SOME INSIGHTS INTO MEDICAL REIMBURSEMENTS
By: Dan Baldyga
The best judge of Total Disability and/or Partial Disability is “Ole” Doc Comfort your clients attending physician. The Medical Report he executes for the insurance company you’re battling with, Rock Solid Insurance Corporation, should always contain his comments regarding the nature of their disability. His diagnosis will be crucial to I. M. Smart, the adjuster assigned to handle the claim, because it will detail the duration of their “Pain and Suffering“. In addition it will also prove the time they lost from work as being legitimate.
When settlement time arrives, Smart will form a healthy portion of his evaluation based on the documented proof of the length of time of each of the following two elements: “Total” and “Partial” disability – - the both of which will indicate how much they restricted their inability to work and also their social activities.
YOU MUST CONSIDER ALL THE POSSIBLE OPTIONS FOR MEDICAL REIMBURSEMENTS: Be aware you may be able to collect from their own motor vehicle insurance carrier (via “Medical Payments” coverage) plus you may also be able to collect from your clients health insurance policy or plan.
Yes, Rock Solid Insurance, in a clear case of liability (and as part of its settlement) will pay your clients medical bills. BUT HOW ABOUT THEIR OWN MOTOR VEHICLE POLICY’S MEDICAL PAYMENTS COVERAGE? You must ask your client to read their motor vehicle accident policy carefully. It may provide them with coverage up to certain limits (one or two thousand dollars – - some are often a lot higher) for all the medical bills they had as a result of the accident – - regardless of who was at fault!
“Med Pay” is a separate part of their policy, which they pay extra for, but it’s definitely worth it. Since they’re shelling out money for this extra coverage they should consider taking advantage of what it offers.
The following people are usually covered under the Med-Pay provisions: Your client or any relative who lives with them (when driving or riding in the vehicle) plus anybody else who is driving with their permission (and also their invited “guests”) who happen to be riding along with them in the car.
It may state in their policy that their insurance company has a right to recover the amount of the Medical Payments made to them should they (later-on-down-that-often-very-loooong-rocky-road) get paid for their loss by Rock Solid. But, even if they don’t, they’ll still be paid for their medical bills under the Medical Payments (Med-Pay) Coverage of their motor vehicle insurance policy without having to pay their insurance company back.
It’s usually a practical move, to elect to file a claim with their own auto insurance company (under the Med-Pay Coverage) so your client will be confident all their medical bills are paid in time.
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THEIR OWN HEALTH INSURANCE POLICY/PLAN: There’s another possible medical bill coverage for the accident – - and that’s their Health Insurance policy or whatever Health Plan they may have. If the Med-Pay provisions of their motor vehicle policy state that they must be paid back, should you collect from Rock Solid, you may find it more advantageous to file a claim under their Health Insurance policy or some other Health Plan.
HOWEVER: You or they should check the wording in those policies very closely because they may NOT require you to pay them back for the medical payments they’ve made to your client- – even if you collect for their loss from The Rock Solid Insurance Corporation !
There’s nothing wrong or immoral about collecting money from more than one source for the same medical bills. Tell your client to think of it like a Life Insurance Policy. If an individual is paying premiums for three $10.000 Life Insurance Policies and they pass away, is the love-of-their-life (as the named beneficiary) entitled to $10,000 or $30,000? Indeed, because the premiums were paid on all three, that individual is entitled to a payment of $10,000 times three, or $30,000.
BY THE WAY: If Adjuster Smart happens to ask you if your client may have any such options, don’t tell him. Whatever other insurance coverage’s they have is their own business! It has absolutely nothing to do with the value of their claim, how much money they should be paid for their “Pain and Suffering”, nor (ever) – - any other portion of their loss.
NEVER FORGET: Your client has already paid for these types of coverage and they’re entitled to be paid under all their options for reimbursements – - even if that means they’re paid by multiple sources for the same bills !
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DISCLAIMER: The only purpose of this article “YOUR CLIENTS PERSONAL INJURY INSURANCE CLAIM ~ DOCUMENTING THEIR DISABILITY ~ PLUS SOME INSIGHTS INTO MEDICAL REIMBURSEMENTS” is intended for information only. Neither Dan Baldyga nor LAWGURU.COM make any guarantee of any kind whatsoever; NOR to they purport to engage in rendering ay professional or legal service; NOR to substitute for a lawyer, an insurance adjuster, or claims consultant, or the like. Wherever such professional help is desired it is THE INDIVIDUALS RESPONSIBILITY to obtain said services.
Dan Baldyga’s third and latest book AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM (How To Evaluate And Settle Your Loss) can be found on the internet at http://www.caraccidentclaims.com or http://www.autoaccidentclaims.com. This book explains, in simple language, “How To” handle a motor vehicle accident claim so they won’t be taken advantage of. It also contains BASE (The Baldyga Auto Accident Settlement Evaluation Formula). THE BASE FORMULA will explain how to determine the value of the “Pain and Suffering” you endured – - because of your motor vehicle accident injury!
Copyright (c) 2004 By Daniel G. Baldyga. All Rights Reserved
Dan Baldyga has a lifetime of experience in the field of motor vehicle accidents, personal injury and compensation. From 1951 thru 1955 he worked his way through college employed by a Springfield, Massachusetts detective agency, where his assignments included insurance fraud, missing persons, financial and background investigations and undercover operations. He specialized in representing major New England insurance companies, for whom he collected evidence in the inquiry of automobile accidents.
Upon graduation from American International College in 1955, where he had a scholarship and played varsity football quarterback for 4 years, Baldyga was drafted into the United States Navy where he was assigned to a “Special Unit” in Criminal Investigations. His primary duty was to travel throughout the Midwest, determining negligence and bringing to a conclusion those accident cases involving government motor vehicles. After a year he was transferred to the Orient where he worked on serious and highly complicated criminal cases.
In 1958 after serving in the Navy, he entered the world of insurance claims, where he began as an Adjuster, was promoted to Supervisor, and then to Claims Manager for 35 years. He then spent another five years of his career assisting company attorneys at court trials.
In 1968, Baldyga wrote the ground-breaking HOW TO SETTLE YOUR OWN INSURANCE CLAIM, published by Macmillan. This revolutionary concept created a heated debate within both the insurance and legal industries — because it revealed, the deep secrets surrounding the settlement of motor vehicle accident claims. This had never been done before!
Baldyga appeared on over 100 regional and national television and radio talk shows throughout the United States including the Mike Douglas Show where he made the observation, “Insurance is an ultra-conservative industry that breeds unimaginative, narrow minded men”. It took a wealth of twisting and turning to dodge the bullets fired at him from both the insurance industry and his Home Office. His innovative book sold over 200,000 copies.
His later publications also include the 1983 novel A SAILOR REMEMBERS and his second “How To” insurance claim book, SECRETS NEVER TOLD was released in 1998. Over the past decade his insurance claim articles have been published in dozens of national magazines, newsletters and e-zines reaching millions of readers.
Upon his retirement, Baldyga decided that it was time to publish the definitive guide concerning motor vehicle accident personal injury claims.
After examining mountains of statistics and confidential reports, he has created BASE (The Baldyga Auto Accident Settlement Evaluation Formula). Experts have called this personal injury evaluation method “Amazing” and “Revolutionary.” THE BASE FORMULA is ingenious, yet matter-of-fact, simple, yet accurate, and eliminates the mystery of how to place a monetary value on “Pain and Suffering” !
His new book, which goes into specific detail regarding The BASE Formula, AUTO ACCIDENT PERSONAL INJURY INSURANCE CLAIM (How To Evaluate And Settle Your Loss) can be found on the internet at either of his 2 his web sites: http://www.caraccidentclaims.com OR http://www.autoaccidentclaims.com
Once again Dan Baldyga has broken new ground in the normally dormant, unchanging landscape of motor vehicle accident insurance claims!