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Ask a Car Accident Lawyer – 3
- How do the different insurances work?
Your car accident lawyer will mail a notice of representation to the other driver’s insurance company. This will trigger them to set up a bodily injury (BI) claim. The BI claim is different than the property damage claim. The BI is not responsible for paying for your medical expenses until it is time to settle.
Your health insurance carrier covers your medical expenses. They will also assert a lien on your case. If you have Medpay (in NH) or PIP (in MA), these must be exhausted before your health insurance kicks in. Medpay and PIP is through your insurance company.
In NH, Medpay is typically $5,000. The BI is responsible for covering your medical expenses regardless if Medpay covers a portion of your bills. Medpay does not get reimbursed.
In MA, PIP is $2,000 if you have private health insurance. PIP is $8,000 if you have public health insurance (such as Masshealth of Medicare). Unfortunately, the BI will reduce the settlement amount by how much they have to reimburse PIP. The exception is if you max out the BI policy, in which case, they cannot take a deduction.
- What should I do after my claim is set up?
You should follow your doctor’s medical advice. Your car accident lawyer is never going to encourage you to seek medical care that’s unnecessary. With that said, the squeaky wheel gets the grease. The claimants who do not pursue treatment are not going to have a compelling paper trail when it comes time to negotiate their claim.
Typically, the patient will present to their PCP after being discharged from the ER. The PCP will act as the gate keeper and funnel the patient to a specialist if they deem fit. If the PCP suspects that the injured are soft tissue, they will refer you to a course of physical therapy.
But what if the injuries persist after PT is completed? There are certain medical complaints that will trigger the PCP to order the necessary diagnostic testing. For example, if the patient can’t raise his arm over his head, that is an indication of a SLAP tear. This can only be diagnosed with an MRI. If the patient experiences numbness (radiculopathy) in his arms, that it is an indication of a cervical (neck) disc herniation. If the patient experiences radiculopathy in his legs, that is typically an indication of a lumbar (lower back) disc herniation. These too, can only be diagnosed with an MRI.
If the MRI is positive, the PCP will refer the patient to an orthopedist or a neurosurgeon.
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