The section of an insurance policy that concerns personal injury claims should guarantee coverage of the policyholder’s medical expenses. Suppose though, that an insured patient has developed a back or neck injury, and has chosen to seek chiropractic treatment. Would the purchased policy cover that sort of treatment?
Presentation of certain documents helps to guarantee the policyholder’s ability to enjoy such coverage.
• The records provided by the treating chiropractor
• Details on the insured patient’s specific symptoms
• Papers that explain the nature of the treatment that was given to the injured policyholder
• Papers that document the cost of each treatment
• None of the above should be vague or inconclusive.
What would be done with the documents that have been listed above?
If the case were to go to trial, then those listed documents would get shown to members of the jury. The jurors would then decide on the extent to which each administered treatment could qualify as something that was reasonably necessary. The defendant’s insurance company should cover any treatment that has appeared reasonably necessary, in the eyes of the jurors.
Still, that does not mean that the jury’s decision is final. The judge could choose to modify the jury’s decision. According to the law, judges have the final say, regarding how much of the covered costs would apply to any one patient’s treatment. In other words, the judge presiding over the trial decides whether or not a given treatment was reasonable.
How the system could affect a lawyer’s choice, regarding when to settle a case?
Personal Injury Lawyer in Waterdown that are representing a plaintiff have no ability to predict what a jury might decide, if the plaintiff’s case were to go to trial. Normally, an attorney does not like to reach a settlement with the opposing party until the same attorney’s client has reached the point of maximum medical improvement.
Still, if that same client had suffered a back or neck injury, and was seeing a chiropractor, the attorney would not know how many of the chiropractor’s bills might be deemed reasonable by a jury. In light of that level of uncertainty, the attorney’s normal view about the proper time for a settlement could get altered.
In other words, if a lawyer’s client had been seeing a chiropractor, then that same lawyer might not want to wait until the client’s recovery had reached the point of maximum medical improvement. Instead, the wisdom gained through experience could push that member of the legal community to make a most unusual decision. In that case, he or she might decide to accept a settlement offer, despite the fact that the plaintiff’s injury could get worse, or could trigger the development of some sort of complication.