An angry client once proclaimed that the insurance industry only has two planks in its business platform: Take in a premium and never pay a claim. “That’s why they have all the money.”
Well, yes and no. Start with the basic premise that everyone works for someone. While an insurance adjuster may be highly motivated to pay the minimum compensation in the range of fair value on a personal injury claim, the adjuster handling your claim is limited in making the decision on value based on what is presented on your behalf for consideration.
The adjuster assigned to handle your claim answers to a supervisor or a claims committee every month or so to give a report of how much money has been set aside, or placed in reserve, to conclude your personal injury claim. The insurance company knows the value of its assets, but accounting principles and sound business practice require that the insurer set reserves on what it is going to pay out in claims.
The primary and overriding factor in setting the pay out reserve is the nature and extent of the medical record. If you are injured and you expect to be well compensated for your injuries, don’t sit at home and suffer in silence. Treat with competent health care providers and generate a medical record that will provide an objective third party narrative of your injuries that will serve to document them.
We live in a fast paced, complex world. Everyone is busy. It takes time to go to the doctor. It can consume valuable time that detracts from pressing personal matters. But unless you obtain correlation of your injuries through the medical record, little credence is going to be given to the assertion that “I am hurt; I am injured”.
Pictures say a thousand words. Imaging studies can go a long way in validating your subjective complaints of pain. Although a plain series X-ray may be limited to isolating fractures or misalignment of the skeletal structures, CT scans, MRIs and nerve conduction studies can be invaluable in the confirmation of soft tissue lesions, ruptured discs, nerve root compression and many of the common presentations that cause pain, impairment and disability.
If you stay at home and suffer in silence, your claim adjuster will not have any narrative in the form of a third party record to defend the amount of money placed in reserve to conclude your claim for injury when he or she is called upon by a superior to defend the reserve set to resolve your assigned case file.
People work hurt every day. Although lost wages and diminution of earning capacity are valid and compelling elements of recoverable damages in a personal injury claim, if you must work to put food on the table while you are injured, by all means continue to treat for your injuries as long as you have symptoms and the treatment plan is giving you relief and improvement from your condition. Most physical therapy and other treatment facilities have evening hours to accommodate those patients who work day time hours.
Your claim file should contain medical clinical notes on your interaction with your doctor that tell the history of how you were injured, assessment of those injuries, the treatment plan and your ultimate prognosis upon release from treatment. The medical record is the story of your personal injuries and it should read as a straight forward, persuasive documentary as to the nature and extent of your injuries and why you deserve substantial compensation.
Go write it.