If you have filed a personal injury insurance claim, a Santa Fe injury attorney wants you to know what mistakes may invite adjuster scrutiny.
When your personal injury claim is filed, that claim will be assigned to an insurance adjuster. The first step the adjuster will take is see whether the policy even applies. If it does apply, then to what extent. After these questions have been addressed, then the financial amount is determined and considered.
Anything the adjuster cannot explain, doesn’t seem right. Or appears suspicious will cause questions. This is all highly objective and varies from adjuster to adjuster. Here are some red flags that may cause your case to be scrutinized, and parts or all of your claim to be rejected:
If certain attorneys always refer clients to the same doctors, and doctors referring clients to the same attorneys, then adjusters will think that they are working together. Adjusters will look more at attorney and doctor records and history rather than medical opinions and bills.
If you provide a detailed list of medical expenses, the adjuster may wonder if the treatment is supported by your medical reports. For example, if you are only treated by a chiropractor for your neurological or orthopedic ailments, then the adjuster will wonder why you did not see a specialized physician as well.
A Santa Fe injury lawyer cautions that the amount and frequency of treatment can be a red flag. If there is no improvement in your condition but the treatments stay the same, there will be concern.
If your injury is soft-tissue, and there are no other claims of pain or disability, then you might be flagged.
If your medical bills are excessive compared to similar ailments or conditions, you may be flagged.
If your type of treatment is not indicated by your specific injury, for example a psychiatric visit for a soft tissue injury, then you may be flagged.
For more information regarding how to avoid red flags in your claim, contact Santa Fe injury attorney Ryan McKelvey at (505)254-9090.