If you got injured in an accident, what should you exactly do? This question is a crucial one and a lot of people have no idea of what to do.. The first thing you will take care of is, of course, your health and injuries. In other words, you need to find a doctor that treats auto injuries. But what after that? Because what you do after that decides if you will have to spend money from your pocket or have the auto insurance company pay for your doctors visits.
How to get the auto insurance company to pay for your doctor visits
The first thing you do is contact the police after the auto accident. You must get an accident report or case number. Then, you can go pick up the police report when it is ready. The at fault insurance company will not pay for anything without an accident report. A police report is the most critical piece of information you can get. It will tell everyone a lot of important information and include the at fault party’s insurance information.
See a Doctor that treats auto accident cases
Bring your report number, case number, or police report to the doctor’s office with you. If the doctor treats auto accident cases he will know what to do with it. If you have Med pay or live in a pip state, then the doctor will bill that as first party. Then, they may try and bill the at fault auto insurance for your medical bills.
If you wish to be compensated for all medical expenses and wages you lost, this is what you should do: For all the damages that took place because of the accident, you need to make the claim. It would be the first step to get the insurance company to reimburse you when you see a doctor.
Do you need to see a doctor for making the claim? Yes, and there are more internal factors to consider for the same. This article covers all the basics you need to know for receiving an insurance injury claim after an accident. It includes the following topics:
- The difference between first party and third party claim
- The process of insurance claims
- Claim denial and the process of appeal
- Evaluating the total value of an insurance claim
Claims Made by First Party vs Third Party
The auto insurance claims are mainly of two types. The first one is named as first-party claims and the second one is called third party claims. The claim you file with your own insurance company is called a first-party claim. On contrary, the claim you file with the other party’s insurance provider is known as third party claim. The other party can be the other person or business involved in the accident.
Most of the insurances provide coverage for the third parties when they get injured because of the insurance holders’ actions. Which claim you will file depends on who was at fault for the car accident.
In simple words, it all comes down to three factors.
- First, who caused the accident and is at fault.
- Second, what kind of accident has occurred?
- Lastly, what your insurance covers and to what extent.
For instance, what if you have caused an automobile accident with your car? In such a case, you probably need to contact your auto insurance provider for a first-party claim. What if you got hit by a vehicle when you were crossing the street? Or what if you got into an accident when you were a passenger in a car? Then, you should contact the other party’s auto insurance provider for a third party claim.
What if you get injured when you are shopping or eating in a store or a restaurant? Then you should contact the business’ insurer or insurance company and file a third-party personal claim for injury. These claims can be applied for property damage as well as bodily injury caused in the accident.
The Process of Auto Insurance Claims
What to do if you were in an automobile accident and got injured? What if you were at some other building or your home? What if the incident happened when you were visiting a business? In all cases, you need to typically report the accident to the insurance company within the next 24 hours.
How would you file a claim if you were not at fault for the accident or incident? Reach the insurance provider of the party who is at fault. The at-fault business, driver, or building owner would most likely cooperate with you. You will probably be required to provide details of the accident and the extent of your injuries.
Only then, the insurance company would open an investigation for your claim. You might get asked to submit pictures of the incident or accident scene and the full names of the witnesses. You may need to provide some more details about the car accident.
After evaluating the value of the claim made, the insurance company may provide a settlement check. In case the claim gets denied or you think the settlement amount is insufficient, you may appeal to the insurance company. For the appeal, you will probably need to submit more evidence. For example, you can submit additional examinations or further information about the accident. Or, you may need to consult a personal injury attorney.
Claim Denial and the Process of Appeal
There can be various reasons why your claim may get denied. For instance, you may have taken too long to file your claim after an accident. Or you may fail to provide a statement or proof, such as an accident report. Or simply, the kind of car accident that took place may not have coverage under your insurance plan.
Whatever is the reason, you will ultimately receive notification in case your claim gets denied by the adjuster. It then depends on you if you would like to appeal against the denial of your claim. The procedures of appealing can vary from insurance company to insurance company. Therefore, you should study the policies in question for learning about the next steps.
What to do if you have any questions about the appealing process or your appeal gets denied? In such a case it is best to contact and consult with an attorney.
Evaluating the Value of Insurance Claim
The amount of medical expenses and lost wages is generally how a claim is valued. However, it is complex to put a dollar amount for the suffering and pain a person experiences after getting hurt. Insurance companies have come up with damages formulas for this calculation. Based on this, they decide how much to compensate the injured for such types of losses that are non-monetary.
The analysts for insurance claims first add up all of the medical expenses of the patient. If the injuries are not extreme, this amount is multiplied by 1.5 or 2 to get the “special damages” amount. On contrary, if severe injuries are there, they may multiply the total by 5. In case the injuries are too enervating, they can multiply the numbers by up to 10.
Once the amount for special damages is determined, the analysts add the lost wages to it. This is how they come up with your settlement amount. If you wish, you can negotiate and discuss with the insurance company to receive a higher settlement amount. However, that is just a guide. Every case and every insurance company is different. When in doubt, consult with a personal injury lawyer.
Beware if the auto insurance company to write you a check on the spot
Why do we say this. I have personally seen patients/clients who said the insurance company sent them a check for there trouble. This check was a settlement for lost wages and medical expenses disguised. If you read the fine print on the check and documentation it will say something like this is full and final settlement payment. That means if you deposit that check or cash it, you just settled your personal injury case. The adjuster is trying to quickly settle the claim, so you won’t have time to think about your future medical expenses or lost work. It’s no illegal to do this, but i think for people who don’t understand what they are doing, it’s certainly wrong. The adjuster should explain the check and exactly what its for.
This is a common practice with some insurance companies. They will throw some money out there, hoping you will bite. And, in some cases, it’s fine to do that. In others, it’s completely unacceptable. If you are hurt, don’t settle your claim until you see a doctor.
Will the Auto Insurance Company Reimburse me if I See a Doctor
It can be a pain in the butt to deal with the aftermath of a car accident. And, it can also be frustrating dealing with the insurance company. Though it is your body and health that matters the most after an accident happens, we cannot overlook the finances. Being involved in an accident can be a heavy hit on your pocket.
However, if you are quick enough to contact the insurance company, you can get the insurance claim on file. Visiting a doctor is required in most cases for getting a medical claim paid. After all, if you don’t see a doctor, you really don’t have any medical expenses. You need to follow the required legal procedures as mentioned above so that your claim does not get denied. IF you have questions about the process or need the services of an attorney, make sure you take advantage of a free attorney consult.
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