The amount of a personal injury claim is always calculated on the amount specified on the medical bills submitted. Your initial claim application is usually followed by a string of inquiries by the insurer. The insurer tries to determine the kind of injury suffered and the treatment involved, on the basis of the evidence put together by a team of efficient personnel. Then, the claim is assessed and accordingly you would receive the reimbursement calculated.
You need to be very particular and preserve all the medical bills, as proof of the treatment. They should be credible enough for the insurer to proceed with the claim. Many a times, people tend to overrate their medical expenses. In such cases, the insurer is likely to reject a substantial part of the gross medical expenses that he disqualifies as ‘medical’ in nature.
The medical claim amounts are usually categorized as ‘diagnostic’ and ‘treatment’ expenses. The ‘diagnostic’ part of the claim includes expenses on the ambulance, medical wards, X-rays, visits to the specialists and other diagnostic procedures that may be advised. The ‘treatment’ part of the claim includes hospital fees and periodical visits to the clinic, physiotherapy and pharmacy bills. Generally, the expenses incurred on the list included under the ‘diagnostic’ category would be disqualified as medical bills. This would lead to a major reduction in the basic value of the personal injury claim.
It is necessary to back your claims with sufficient proof. It is essential to establish the connection between the diagnostic claims and the treatment expenses. This will help in your endeavor to prove to the insurer that the expenses incurred are co-related and no treatment would be complete without a thorough diagnosis.
Personal injury claims are generally classified as ‘permanent’ or ‘temporary’. The classification suggests the duration of an injury and not the degree of its severity. An injury is considered to be permanent in nature if the treatment is likely to continue for a lifetime. A temporary personal injury claim covers the expenses borne on account of an injury that would involve a short-term treatment.
It is necessary to choose an insurance company wisely for your personal injury insurance claim. The choice of an insurance company affects the personal injury insurance claim in the following manner:
— It controls the course of your medical treatment.
— It is authorized to select the doctors and the kind of treatment you need to avail of.
— It has access to your medical history.
— It could terminate payment at any point of time and put you through a second medical examination.
You need to be careful while applying for your personal injury insurance claim. The process is not an easy one and involves a lot of patience, before the amount of claim is finally reimbursed. All the bills produced should be authenticated with a stamp and the signature of the issuing authority. The documents required to be filed with the insurer should be photocopied and a set of the same should be maintained with you. The choice of insurer should be settled on only after conducting a thorough research on the reputation and depending on the amount of the claim.