med-bills

Medical Special Damages

Medical special damages are a key component of almost every personal injury claim. “Specials” as they are commonly called refers to the total expenses of diagnosis and medical treatment. Injury attorneys, judges, juries, arbitrators and insurance adjusters use medical specials to help determine total damages. The formula used by insurance companies depends on many factors, such as the type of medical treatment received, as well as who provided the medical care.

Different Types of Treatment

Insurance adjusters give less value to diagnoses and treatment provided by non-M.D.s. Adjusters also look at the duration and type of treatment.

Diagnosis and Treatment. We recently had a motorcycle accident client who had several MRI and CT Scans, which are very, very expensive. After these diagnostic tests, our client went through relatively minor treatment. He had massive specials because of the MRIs and Scans, but a small amount of treatment. To the insurance adjuster, this combination suggested minor pain and suffering. His pain was therefore worth less than many clients who have modest diagnostic costs and significant treatment expenses and duration. Longer treatment duration, as long as it’s reasonable, suggests greater pain and suffering, and greater damages. This means that the claim’s settlement value is greater than the first client’s.

Physicians and Doctors, Hospitals and Clinics

The insurance industry specifically favors Medical Doctors and mainstream medicine provided in hospitals and medical clinics. This means that chiropractic, physical therapy, and other “alternative” treatments, are viewed as less valuable by insurance adjusters. Medical expenses from treatment by physicians is more valuable at time of settlement that expenses for treatment provided by alternative health professionals.

Treatment Duration

Generally speaking, the more treatment a person requires following an accident, and the longer an injury takes to heal, the greater the pain and suffering value of a claim. Adjusters will view a reasonable amount of treatment over a long period of time as evidence of greater damages.

That being said, most insurance adjusters think that treatments provided by chiropractors or physical therapists are of little actual value to both the patient and the claim. They believe that chripractors and physical therapists are good for little more than taking their patients’ money, which is why extensive treatment history is not viewed as evidence of the injury’s seriousness.