January 29, 2010, Newsletter Issue #116: Finishing Medical Treatment Prior to Settlement

Tip of the Week

Depending on the type of personal injury you have, you may have to finish treatment for your injury prior to settlement, if the company is going to settle on behalf of their insured. Coverage for injuries may fall under different types of policies, and some benefit types may be first party, meaning you are entitled to those benefits, after a review of the reasonableness of your treatment. Policies cover injuries where, when, and how they happen, and sometimes why they happen. You may also file claims under your health carrier. However, health insurers, some carriers have subrogation clauses stating if you collect a monetary settlement from another carrier, you must re-pay the health insurer. As to personal injury third party liability claims, you usually must finish treating for your injury prior to any liability settlement, and a release signed prior to any payout. If it is an auto accident and you are a passenger, you may collect benefits under either first party Medical Payments (MP) coverage for your medical expenses from the driver's policy, or become a claimant against the driver if the driver is at fault. On a premises claim, if there is no liability found on the part of an insured, a company may cover bills up to a certain amount under the same type of first-party MP coverage some companies carry for incidents occurring on their premises. The adjuster may pay your bills as expenses incur, but, do not expect a "general damages" (otherwise known as pain and suffering) settlement in addition.

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