I HAVE A QUESTION ABOUT INJURIES AND TREATMENT.©
Prepared by: Mark Wolfe, Attorney at Law. The following information is provided as general advice and without charge. Some of the information and material contained herein is reprinted, with permission, from the Spring 2005 edition of Legally Speaking. Questions about specific issues or situations should be directed to an experienced motor vehicle accident attorney. NOTE: The following material is protected by all applicable State and Federal Copyright laws. Published May, 2005.
FREQUENTLY ASKED QUESTIONS ABOUT INJURIES AND TREATMENT
The accident wasn’t my fault, should I use my Health Insurance to cover the cost of my medical bills? Generally the answer is yes. While the medical bills related to treatment of injuries suffered in an accident are an element of recoverable damages, most auto-insurance companies do not allow or authorize partial payments related to a liability claim. (Please read What Should I Know About Insurance Claims and Coverage for more information on the types of insurance claims arising from a car accident.) This means they will not reimburse these bills until the claimant is ready to settle all aspects of the bodily injury claim and sign a release. If care and treatment is going to take several weeks and/or months, it is better to use your health insurance to cover the medical bills so as to insure continued care and treatment. Also, remember under Alabama law, your health insurance carrier is entitled to be reimbursed for any bills it paid that are also part of your liability claim. This right is called Subrogation but the amount and extent of a subrogation claim can vary depending on the policy language and applicable law. I have a liability claim for injuries against the at-fault driver’s auto-insurance carrier but I do not have Health Insurance, will my hospital and/or doctor bill the at-fault driver’s carrier? No. Most healthcare providers are not set-up to delay billing for the care and treatment they provide and most auto-insurance carriers will not make partial payments for healthcare bills related to a liability claim. Some healthcare providers will accept an Attorney Protection Agreement (APA) on behalf of a patient who does not have health insurance. An APA is a binding agreement wherein the client/patient authorizes his or her attorney to pay any outstanding medical bills from the client’s anticipated liability settlement. An experienced motor vehicle accident attorney can usually provide clients with the names of doctors and hospitals that will accept an APA. I went to the hospital after the accident and I just received a notice that the hospital is filing some sort of legal proceeding against me. What should I do? The hospital has probably sent you a notice, and maybe a copy of, the Hospital Lien it has filed, or intends to file, with the local Probate Court. This is not necessarily a legal proceeding against you but it serves as legal notice of an amount due to the hospital from any settlement or other insurance, such as med-pay, paid to you as a result of the accident. Generally, insurance companies are bound to satisfy the Hospital Lien if it is not satisfied or withdrawn. Under Alabama law, only hospitals can file a lien. There is no statutory provision to allow doctors to file a lien with the local Probate Court. This lack of financial protection is why many doctors will not treat accident victims who do not have health insurance. At the hospital I was told that I had “whiplash” or “soft-tissue injuries” from the accident. What type of doctor should I use for my follow-up care? Generally, soft-tissue injuries from a trauma such as a car accident are treated by three types of doctors: General Practitioners (Family doctors), Orthopaedic doctors and Chiropractors. In Alabama, Chiropractors do not prescribe medication and they rely on adjustments and physical therapy to treat soft-tissue injuries. Family and Orthopaedic doctors can prescribe medication and they will often prescribe physical therapy in conjunction with their treatment. Having represented a large number of clients who have suffered soft-tissue injuries in car accidents, we must defer to our client’s personal preference regarding the selection of a healthcare provider. Simply put, we do not try to suggest or recommend one type of doctor over another. The most important thing we tell our clients about healthcare is to follow their doctor’s instructions and complete the healthcare plan suggested by the doctor. Remember, the doctor’s goal is to get you better and to help you make a full and complete physical recovery from your injuries.
GENERAL INFORMATION ABOUT AUTO-ACCIDENT INJURIES
IRC Study Reports That Injuries Occurred in 26.4% of 2003 Car Accidents. STUDY ALSO SHOWS THAT SERIOUS INJURIES FROM CAR ACCIDENTS ON THE DECLINE. The Insurance Research Council (IRC) recently concluded and published its study, Trends in Auto Injury Claims, 2004 Edition. The study of 2003 auto accident claims revealed that about one in four auto accidents resulted in a personal injury claim. The research also suggests that the seriousness of these personal injury claims has decreased in recent years. “Indicators such as extent of disability, days of restricted activity, and time lost from work tell us that auto accidents are producing fewer serious injuries”, said Elizabeth A. Sprinkel, senior vice president of the IRC. She attributes the decline in serious injuries to the manufacture of safer cars and auto safety campaigns. According to past IRC studies the “one-in-four” injury to accident ratio has remained about the same since 1980. A review of similar reports from 1980 and 1995, and the current report, shows injuries occurring in an average of 24.6 % of all auto accidents. To learn more about medical care and treatment after an accident please read, Care and Treatment After the Accident. Neck Injuries Common in Rear-End Accidents. According to the American Academy of Orthopaedic Surgeons®, 20% of all people involved in a rear-end accident will suffer a cervical sprain/strain injury (commonly called Whiplash) which will require medical care and treatment. The majority of these people will make a good recovery from their injuries after 4 to 12 weeks of care but for a small percentage the problems could become chronic. (See links below related to Whiplash.)
THE FOLLOWING LINKS MAY PROVIDE MORE INFORMATION ABOUT INJURIES AND TREATMENT WebMD. A good general information web site for a variety of medical questions and conditions: http://www.webmd.com/
The Merck Manual of Diagnosis and Therapy. A searchable data base for information about healthcare and treatment: http://www.merck.com/mrkshared/mmanual/home.jsp PDR.Health. This on-line health information site is sponsored by the publishers of the Physician’s Desk Reference. The web site contains information about prescription medications and Over-the-Counter medications: http://www.pdrhealth.com/
The Association for the Advancement of Automotive Medicine. A multi-disciplinary organization that seeks to improve care and treatment for accident victims and to help prevent injuries in motor vehicle accidents. This site has very good informational links for both areas: http://www.carcrash.org/index.html
The Orthopaedic Connection – Whiplash. Provides a brief overview of the mechanism and treatment for a whiplash injury. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=232&topcategory=Neck
eMedicine – Whiplash. Another site providing information about whiplash injuries: http://www.emedicinehealth.com/articles/5844-1.asp