Medical special damages are a key component of most personal injury claims. This refers to the amount that has been spent on medical bills while having injuries diagnosed and treated. Adjusters use medical specials as part of the personal injury damages formula to figure out total damages. This formula depends on many key factors, such as the type of medical treatment received, as well as who the medical care was received by.
Types of Medical Treatment
Not all medical services are considered equal, according to insurance adjusters. The duration and nature of medical service, as well as the type of facility or medical person providing the service can affect how insurance companies perceive it. Here are some variables that come into play:
- Diagnosis versus treatment Medical personnel have to diagnose an injury before they can treat it. In some cases, the diagnosis might not take time and its charge forms a very small part of the overall medical bill. This is why most insurance companies do not bother to distinguish between diagnosis and treatment, and consolidate all medical bills into a single medical specials amount. But at times, there might be several tests and medical examinations required to make a diagnosis. Some of these tests might be costly. There might also be a case wherein the person does not require too much treatment following a diagnosis. If this is the case, the total medical specials might not be viewed by the insurance adjuster, as accurately reflecting the injured person’s pain and suffering.
- Non M.Ds versus M.D.s and hospitals The insurance industry seems to have a longstanding prejudice in favor of mainstream western medicine and treatment that is provided by hospitals, physicians, and medical clinics. This bias extends and eliminates other non-mainstream activities such as chiropractic, physical therapy, and acupuncture. If a person has incurred a medical bill at the hands of a hospital, medical doctor or medical clinic, almost any insurance adjuster will consider it to be legitimate. Bills such as these are usually given a high multiplier in the damages formula. On the other hand, insurance adjusters tend to apply lower multipliers to treatments provided by non-mainstream medical providers.
Duration of Treatment
An injury might claim to have a high degree of pain and suffering if it receives a long period of medical treatment, and take a long time to heal. Therefore, a person who has been injured can use a prolonged medical treatment as evidence to prove the gravity and seriousness of the injury to an insurance adjuster. Having said that, most insurance adjusters are not really convinced by treatments provided by chiropractors or physical therapists. They believe that such treatments are extended to keep their money rolling in. That is why they are less likely to consider long periods of physical therapy or chiropractic treatments as concrete evidence of the seriousness of an injury than if a person had a more traditional, mainstream treatment program.
