Reviewed By: Pramod Kerkar, MD, FFARCSI

Car accident can happen at any time of the day and any place in the world. Most car accidents do not cause life threatening injuries and may not need any treatment. Some car accident may cause multiple severe injuries that may need several months of hospitalization and treatment during recovery. The question asked is “I was hurt in a car accident, do I need a lawyer?” The published study suggests cost of treatment depends on severity of injuries, number of days of hospital admission and expenses for advanced treatment like ICU, artificial ventilation therapy or surgery.1 Prolonged recovery period following serious injury may be followed with severe disability because of impaired functions of the body part. The loss of job and income can cause severe financial burden. In most countries, you do not need lawyer when all medical treatments and disability benefits are paid by your auto insurance or personal insurance provider. In country like USA, you may need legal advisor because of dispute and refusal of payment for treatment and disability income loss.

The laws regarding payment and liability of auto insurance provider following car accident differs in different states in USA. Most states in USA have a limited maximum payment for treatment and disability benefits. All auto insurance providers are for profit companies and often struggle to show a higher profit at the end of year. Profit depends on spending, thus most auto insurance prefer to defer payment to following years that results in delay of payment.

There are studies published and discussed suggesting Chiropractors, Physicians and Physical Therapists have conflict of interest that results in prolonged treatment for financial gain.2 Auto insurance providers have tried to defer the payment as well as involve other insurance provider for payment of treatment as well as disability benefits. In such cases one may raise a question “Do I need a Lawyer”. One of the reports published in 1983 indicates, the insurance payment was disputed between worker’s comp and auto accident insurance provider when a nurse was injured while on duty.3 In several cases auto insurance provider tries to find the reason to deny claim on technical or contractual ground. In most cases auto insurance provider try to shift the burden of payment to alternative auto insurance provider covering victim of second car involved in same accident.

The legal terminologies and obligations included in agreement that you have signed are often overwhelming for a common person to understand. In general, the most auto insurance providers prefer victims to consult a lawyer after initial delay of payment for various reasons. The dispute and litigation follows and prolongs the case evaluation and thus payment is delayed. At the end, the payment of treatment and disability of victim often remains the same with or without involving attorneys.

In same token one has to consider the reports published in local and national news papers as well as discussion in television about several fraudulent claims of auto accident. These reports are documented and published. Several individuals are punished through legal dispute. But, it is often mind boggling when a normal person becomes permanently disabled following accident and yet has to struggle to get paid as well as go through complicated and time consuming legal proceedings. The law suits against a wealthy auto companies can emotionally and financially drain out most victims and families.

I Was Hurt in a Car Accident, Do I Need a Lawyer?

I Was Hurt in a Car Accident, Do I Need a Lawyer?

So, to answer the question “I was hurt in a car accident, do I need a Lawyer”? In most cases you may not need a lawyer if you are not held responsible for payment of medical treatment and your disability benefits are paid as per the agreement.

If you are hurt in a car accident, you may need car accident lawyer in the following circumstances:-

  • Your Private Medical Insurance provider like Blue Cross Blue Shield, Manage Care or HMO are refusing payment for medical treatment and physician services following auto accident related injuries.
  • The private personal health insurance provider, Medicare (Federal Government Medical Insurance Provider) or Medicaid (State Medical Insurance Provider) are asking you to contact auto insurance provider and refusing to give preauthorization for investigational procedure and treatment. You are unable to get any favorable response from auto insurance adjuster.
  • You had contacted auto insurance provider and established your claim. But auto insurance adjuster has not contacted hospital and refuses to pay until accident investigational procedures are completed.
  • The payment for investigation and treatment is denied because of accident report suggesting car accident fraudulent.
  • You or your private insurance has paid the hospital and service provider, but unable to get the reimbursement from auto insurance, in such instance, you should contact car accident lawyer near you.
  • The payment is denied because the expert physician hired by auto insurance provider reports that your symptoms and signs are related to past illnesses and not auto accident.
  • You may need an accident lawyer to make sure fees for all treatments are paid even though some treatment was not necessary because only lawyer can prove that you were innocent and unaware of all wrong doing.
  • You for sure may need a car accident lawyer or attorney if you may have sustained severe injuries as a pedestrian involved in automobile accident.4 Most auto insurances will refuse to pay as you were not driver or passenger in a moving motor vehicle at the time of accident.
  • You are a victim in car accident which was stolen and driver is not carrying any valid auto insurance policy.5 Your car insurance refused to pay on the ground that the insurance of the driver who caused accident should pay. You need an attorney to present your case otherwise all the payments will be blocked.

It is sad and difficult to understand why all such accident and injury disputes can be resolved only through lawyer or legal experts or trial attorneys. The auto insurance on the contrary in some cases often pay lot more than disputed amount to medical expert and defending lawyer to defend their role of refusing to pay or delay the payment. The delay or refusing of payment is as good as withholding the amount for several months.

References

  1. Cost-driven injury prevention: creating an innovative plan to save lives with limited resources.

    J Trauma. 2011 Apr;70(4):985-90. , Dicker RA1, Lopez DS, Pepper MB, Crane I, Max W.

  2. Conflict of interest, physicians and physiotherapy.

    Waldman M1., CMAJ. 1996 Jun 1;154(11):1737-9.

  3. Law and the ED nurse: auto accident injuries: who is responsible?

    George JE., J Emerg Nurs. 1983 Nov-Dec;9(6):354-5., J Emerg Nurs. 1983 Nov-Dec;9(6):354-5.

  4. Pedestrians injured by automobiles: relationship of age to injury type and severity.

    Demetriades D1, Murray J, Martin M, Velmahos G, Salim A, Alo K, Rhee P., J Am Coll Surg. 2004 Sep;199(3):382-7.

  5. Auto theft-related trauma.

    Livingston DH1, Merritt S, Callori S, Vanek S., J Trauma. 1998 Oct;45(4):780-3; discussion 783-4.

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 30, 2018

This article does not provide medical advice. See disclaimer

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