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Red Flags in Medical Treatment


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3/20/2014
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When filing an insurance claim, you never want to be overly scrutinized by the claims representative. A Baltimore accident injury lawyer knows the red flags that could bring on unwanted scrutiny.Baltimore accident injury lawyer

Before claims adjusters question anything specific in your claim, first they will consider if the policy even applies. If your policy does apply, then the adjuster will figure out to what extent. After this is determined, then the adjuster will begin to scrutinize the claim, questioning anything that doesn’t appear right based on the circumstances and facts presented. If anything seems suspicious, then further investigation is warranted. If this happens, it becomes harder for your attorney to get an acceptable resolution in your case.

A Baltimore Personal Injury Attorney Describes Some of the Red Flags
When your medical expenses are presented, even if they are detailed, and they should be, the adjuster will check with current medical reports to see if your treatment is supported.

The doctor may then come under scrutiny. If you were treated by a chiropractor, for example, the adjuster will look at the report more carefully than by a neurosurgeon. The more doctors consulted, the less likely the scrutiny.

The amount of treatment you receive, as well as the frequency, will be considered. If you have received treatment frequently with no noticeable improvement, then this is considered a red flag.

If your medical bills are disproportionate to your injury, like excessive physical therapy charges, then a red flag will be raised.

Disability claims are subjective if you have only soft-tissue injuries, like chronic pain, especially those with little or no objective medical findings to support your symptoms.

Receiving treatment for something other than the injury your are claiming, for example, seeing a chiropractor for a broken bone, will raise a red flag.

If there is a cluster of patients in common between doctors and certain attorneys, it appears to the adjusters that the two have a working relationship. Similarly, if a certain attorney exclusively uses one doctor, it appears if they have a working relationship.

For more information on the red flags insurance adjusters look for when reviewing a claim, contact Baltimore accident injury lawyer at the Law Offices of James Lee Katz, P.A. at 443-394-0900 or 800-564-7808.

 



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