Insurance claims adjusters and your medical bills

VIDEO TRANSCRIPT:  Hello everybody, this is Robert Mansour broadcasting from my home office here in Los Angeles, California. One of my areas of practice is personal injury, and there is an issue that sometimes comes up that I think we should address in this short video segment, and that is the issue of whether or not your bills are actually going to be paid by the insurance adjuster or not. Sometimes, clients come to my office and they say, “Yeah, I spoke with Larry. He's the insurance adjuster for the other side, and he assured me that he's going to go ahead and take care of all of my medical bills.”

To which I usually chuckle because in my over 20 years of practice now I don't think I've ever seen an insurance adjuster just go ahead and pay all of the medical bills without any question. I suppose it has happened, but most of the time the insurance adjusters do not pay your medical bills as you present them to them. Usually, what they do is they "review" them.

You see, an insurance adjuster's job is to "adjust." Their job description is in the name of their job. They're "adjusters."  They are adjusting, so you give them some numbers and even property damage, even medical bills, any kinds of physical therapy bills. In most cases, the insurance adjuster is not just going to swallow these bills and say, “Well alright, here's a check.” No, they need to adjust and that's what their job is.

Generally speaking, which direction do you think they're going to adjust? Upward or downward?  You guessed it. Downward! I don't think I've ever had a case where the insurance adjuster calls me and says, “You know what, Rob? I know the bills are only $5,000, but we're going to give you $10,000.” No, usually what happens is they try to slice every single bill, every single thing that you were charged. They'll tell you it was unreasonable, it was too high. This doctor doesn't know what they're doing.

Keep in mind none of these adjusters, I shouldn't say none, but I venture to guess that most of them do not have medical degrees. Most of them do not practice medicine. Most of them are not chiropractors or physical therapists. However, they have training to look at your bills and slice them.

Oftentimes what they'll do is they'll put all the information into a computer software program and that computer software program basically spits out some numbers for them, and they're generally stuck with those numbers with a little bit for leeway, depending on which insurance company you're dealing with.

So once again do not be surprised that the insurance adjuster isn't just going to pay all of your bills. That's not what they do. They adjust because they are adjusters. Once again, which direction? Usually down. If you have any questions, feel free to contact my office. Again, my name is Robert Mansour, and thanks for spending this short time with me.

For more information about personal injury, please visit other sections of our website.  You can also call for a free consultation if yours is the type of case we handle.  Call (661) 414-7100 to schedule your consultation today if you've been the victim of a serious car accident.