VIDEO TRANSCRIPT: Hello everybody! This is Robert Mansour. I wanted to make a brief video today to address something called the gap. The gap is the gap between the date of the accident and the date that you start actively getting medical treatment for your injuries from that accident. If the gap is too long, say, 2, 3 weeks, the insurance adjuster and the insurance company is going to use that against you.
They're going to say, "You weren't hurt all that bad. If you were hurt that bad, you would've gone to the doctor, you would've gotten care, et cetera." The fact that you waited 2 or 3 weeks, or in some cases, I have cases where the clients don't go for months, and then they call and it's too late at that point, it looks really, really bad. They might be hurt for sure, but their behavior was not congruent with their allegation of injury. The other gap that is sometimes used against you is if you miss treatment sessions. Let's say you're getting physical therapy for your car accident case and it's helping, but you cancel some appointment, you reschedule them, you don't show up, you're a no-show, then your treatment looks very sporadic and there are tremendous gaps between the treatment sessions or between evaluations from a doctor. Those gaps will also be used against you. Please understand, it is not only in the best interest of your personal injury matter, but it's also in the best interest of your health to make sure that you get appropriate treatment for your injuries, and that you're proactive about it. I hope this has been helpful. My name is Robert Mansour. Please visit my website ValenciaLawyer.com for lots more educational material about personal injury cases. Thank you. VIDEO TRANSCRIPT: Hello everyone this is Robert Mansour, and today I wanted to make a brief video about what happens after you have finished treating for your personal injury accident. I get this call all the time, my client's finished treating at their doctor, or they finished their physical therapy, and they call me basically the next day, and they're like, "What next? What's going to happen now?" I try to explain to them that it's going to be a few more weeks before anything really happens, because here's what needs to occur. I need to assemble all the medical records and all the bills from all the different health care providers that they've been to.
Also, if they just finished going to the doctor, and they've just finished going with a physical therapist, those people need some time to generate all the bills, and to generate all the reports that are needed to help present the personal injury claim. It doesn't happen overnight, it takes some time. Then after I get everything I have to review everything. I have to dissect it, I have to see what it all ... How it all comes together, and how it all fits together. Then I have to present the case to the insurance company, and that requires, generally speaking, what's called a demand letter. The demand letter is basically where I present our demand to the insurance company, that we demand to settle the case. Sometimes you put a number in there, sometimes you don't put a number in there, and then the dialog begins between the insurance company and the attorney's office. Now, keep in mind just because I send a letter to the insurance company doesn't mean the very next day I get a call. Most insurance adjusters have about two hundred files sitting on their desk at any given time. My letter comes in, along with the supporting documents for your case, and it just sits on their desk probably for a good thirty days before they can do anything with it. I tell clients that after they're finished with the doctor and everything, about thirty days later I'm in a position, provided I have everything I need, to present their case. Then about thirty to forty-five days after that we hear from the insurance company. For the most part, you can count on about sixty days after you're finished treating before you hear anything. Now, invariably I run into some problems, especially if there's a client who has been to a dozen different health care providers. Each of those health care providers has their own billing department, they have their own records department, in some cases there is a collection agency, in some cases some of these departments are out of state, and so they close and open at different times of day than California. In some cases we make phone calls to these places, and they never return our calls. In some cases we're promised records, and I paid for them and I never get them. Just because that's the way that's supposed to go, things don't always unfold as smoothly as I would like. That gives you a little bit of an idea of what happens after you're finished treating. I present the claim once I have everything that I need to have, the insurance company responds, the negotiations begin. Now, as part of the negotiations I need to make sure that all of your health care providers have been paid. Some of them have not been paid, and we need to make sure that they are. If anything has gone to collections we need to make sure we work with the collection agency. If Medicare is involved or Medi-Cal, or your health care insurance is involved, we need to make sure we keep them in the loop. As you can see there's many different variables that go into settling a case, and it's not just a matter of finishing your treatment and then you get a settlement the next day. I hope this helps you understand a little bit about what the mechanics are, and if you have any questions you could please call my office or send me an email. Thank you very much. VIDEO TRANSCRIPT:
Dave: And I am assuming too, because points two and three are very similar. They don't want you to go to call an ambulance. They don't want you to go see a doctor. Robert: An ambulance is a perfect example of injury. I mean, if you were taken away by ambulance, it's hard for them to argue that you weren't injured, because the ambulance guys are not going to take you to the hospital unless they feel that there's something to do. If you're just sitting there, and they take you to the hospital, that's further evidence that you were injured. And so they will say, they'll often tell me over the phone, "Well your client wasn't taken away by ambulance." So they will use the lack of an ambulance as evidence that you were not injured. And the same thing, what was the last one you talked about? Dave: Don't go to a doctor. Robert: Yeah. If you wait too long to go to a doctor after an accident, and too long, I would say anything beyond a week or two, they will poo-poo your injury. And a lot of clients, especially guys, try to man-up. They're like, "I'll be fine. This shoulder, it hurts, but I'll be fine." Two weeks go by, they're like, "It's not fine. I can't lift my shoulder." They go to the doctor. The insurance company will say, "You waited too long. You didn't go to the doctor soon enough, so it must be something else that caused your shoulder injury." Tami: That's right. And you'll hear people all the time saying, "I don't need an ambulance. My son can take me. My wife can take me. My husband can take me to the hospital." Robert: It is an expense. I mean, you have to be aware of that. So yeah, sometimes people forego an ambulance because it's expensive. Dave: Right. Tami: So I would think the suggestion there would be if you're not going to take an ambulance and you are injured, go straight to the hospital. Robert: Or Urgent Care. Do something that shows that you were injured ... Tami: Right. Robert: ... because if you don't, they will use it against you. If you need help with your accident case or simply want to run it by an attorney, feel free to call our office at (661) 414-7100. We will let you know if we can help. I got a call from a prospective client a couple of days ago. He explained that he got into a serious car accident earlier that day. He was experiencing a great deal of back and neck pain. He called my office and asked, "Should I go to Urgent Care, or will that screw up my case?" Part of me was happy that the client was being careful about his case. After all, there are many things clients do to "screw up" their personal injury case. However, I explained to him, "Look, your health is more important than any personal injury case. If you got hurt and you don't feel right, you should go to Urgent Care and get checked out. Nevermind your case....go get some healthcare because that's much more important."
I told him to get checked out and then consult with an experienced lawyer about his case. However, I reminded him to get his records and billing from the Urgent Care facility because most healthcare facilities that don't work on personal injury matters can give you (and your lawyer) a really hard time when it comes to obtaining the paperwork necessary to present your case. Therefore, the answer to the question is this: "Go to urgent care or any where else if you need treatment right away. Just remember to ask for your records AND bills when you are done with the facility. Then provide the bills and records to your lawyer." Robert Mansour is a personal injury lawyer handling serious accident cases in Santa Clarita, Valencia, Saugus, Canyon Country, Castaic, Newhall, Stevenson Ranch, Palmdale, Lancaster, and beyond. Call (661) 414-7100. You should mention all of your injuries to every single doctor you visit after a car accident. The reason is that you want to be consistent with your complaints from the very first visit to the very first doctor. Insurance companies are using software more and more to analyze personal injury cases. If you do not complain about certain injuries to the doctors, it's almost like the injury never occurred. The insurance adjuster simply will not consider the injury if it's not listed. Also if there are inconsistencies, they will be used against you. For example if you complain of neck pain to one doctor then fail to complain of neck pain to another doctor, it may not even be considered - even if you weren't seeing the second doctor for neck pain. You have to be exhaustive in your complaints.
Also, do not simply mention the injuries the currently bother you, but make sure to mention the injuries that bothered you shortly after the accident as well. After all, those injuries resulted from the accident and should not be overlooked. Remember, insurance companies are using software, and if they don't input the correct information, your case may be undervalued. You have to make sure your doctors have your complaints properly documented, not only within the handwritten records generated by the doctor and the doctor's support staff, but it also helps if those complaints are contained in the narrative typed reports. If you have suffered a serious car accident and need help with your personal injury case, please call (661) 414-7100 and ask for a free consultation with attorney Robert Mansour. Robert serves Santa Clarita and its communities of Valencia, Saugus, Canyon Country, Newhall, Castaic and Stevenson Ranch. In some cases, significant car accidents, especially side-impact auto accidents can cause hip injuries or aggravation of a pre-existing hip problem. Trauma from a car accident to the hip can lead to very severe fractures.
The treatment of these injuries can require the use of plates and rods or the revision of the hip replacement entirely with placement of a new, long femoral component to span the fracture. The key in these kinds of injury cases is causation. Was there is “mechanism of injury?” The main question is whether or not the accident actually caused the hip injury. Just because you have a hip problem doesn’t mean you get to blame a car accident. If you had a pre-existing problem in your hip, the accident may have “aggravated” the condition but not necessarily made it worse. Close consultation with a hip replacement surgeon is critical when it comes to hip injury and car accident personal injury cases. Answer: Right away. Don’t delay. After nearly 2 decades of practicing law, I have found that clients who wait more than 10 days to seek medical attention have done themselves a disservice. The insurance company will view this delay as an indication that the injuries weren’t all that bad. If you waited so long, how bad could it be? Of course, there are many reasons why you may not be able to seek medical attention right away, but the insurance company for the party at fault won’t be quite that understanding. If you are claiming injury from an accident, your actions (i.e., seeking medical help) need to be consistent with that claim.
Many people are surprised to learn that the insurance company for the party at fault does not pay their medical bills as they become due. In other words, they won’t pay your medical bills until you are finished with your treatment in most cases. This can prove to be an unpleasant surprise for many people. Also, the treating doctors aren’t terribly happy about it because they want to get paid.
Keep in mind the insurance company for the party at fault doesn’t really have any obligation to you. First, they have to “investigate” and “determine” whether or not the accident was your fault or not. After that, don’t expect them to pay your medical bills whenever you present them. First, they will have to “determine” whether or not your treatment was reasonable in THEIR opinion. In some cases, they use databases or other computer software to make that determination. Then, they will look at every single charge you incurred to see whether or not they agree with the charge by the doctor. If they don’t agree, they will slash the doctor’s bills – in many cases dramatically, leaving you with a big hole to fill. So all the assurances of the world from the other party’s insurance company should mean nothing to you at the end of the day because there is no guarantee they’re going to pay your medical bills. |
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November 2023
by Robert MansourRobert Mansour is a personal injury lawyer serving Santa Clarita, Valencia, |