If you have been involved in a personal injury accident, you may be in the process of trying to get an insurance company to pay out its policy for bodily injury. An Irvine personal injury attorney may be able to help you make the strongest case to your insurer, and tell you what your insurance company is looking out for when deciding how much to pay. Here are some of the factors insurers evaluate when looking at claims.
In the course of filing your claim, you must submit medical records regarding the treatment you received and the corresponding medical bills. Insurers are on the lookout for medical bills that do not have matching medical reports to confirm why that particular treatment was used. They will look at the diagnosis made and treatment administered, and if your Irvine personal injury attorney has not provided a medical report describing those factors, the insurer may not include those charges in the payment.
Insurers will closely scrutinize any records and claims submitted for discrepancies and questionable charges. Their job is to question everything and treat your case skeptically, so if they see charges in the settlement demand for which no supporting records or documentation has been provided, the claims adjuster may wonder if your claim has been padded or exaggerated at all.
Your Irvine personal injury attorney will probably provide an itemized list of medical expenses to the insurer; it is important that a copy of the bill be included as well so that the claims adjuster is able to reconcile and verify it. If they find a reference to a bill but not the bill itself, they will not give that bill much credence.
Claims adjusters are also skeptical toward medical reports that seem to be copy-and-pasted from the same root document, with only the patient’s name changed. Because adjusters come across so many claims forms, they often develop a sense of which health care providers and doctors submit which types of reports and how thoroughly, and “fill in the blank” forms from certain physicians often set off their radar.
If you have more questions about what insurance adjusters look for, contact Irvine personal injury attorney Samer Habbas for a free evaluation of your case.