Navigating Auto Insurance Healthcare Coverage when in a Motor Vehicle Accident

According to the US Census, there are about 10.5 million motor vehicle accidents (MVA) every year in the United States since 2000.  Besides scary, getting into an auto accident is extremely stressful.  While most of us pay for auto insurance, we don’t really know the details of our coverage especially as it relates to healthcare.  

Auto insurance is designed to not only repair our vehicles but also our bodies.  The best way to educate yourself about your insurance coverage is to understand your Personal Injury Protection (PIP) coverage amounts and how to maximize them.  What most people don’t realize is that by law, insurance companies have a minimum set amount that is guaranteed (usually $15,000 per person) in every accident, without having to do complicated settlements.

 

Dr. Brenda Ku, chiropractic physician at Root Whole Body Health offers a 10-step checklist for navigating the complex process of how to take care of yourself if you’ve been in an auto accident:

 

1.  Exchange insurance information with the other driver and ideally take photos.

Immediately after an accident, and assuming you are able to move, swap insurance and personal information.  Taking photographs is also recommended.

 

2.  Call the police to report the accident, but don’t be surprised if they do not come

     to the scene.

Everyone thinks to call the police, but unless it is a major accident that is blocking traffic or with seriously injured individuals, they are unlikely to respond.

 

3.  If you are severely injured, go to the emergency room.  If not, make the next

     available appointment with a primary care physician (DC, ND, or MD).

Seriously consider how you feel and take your time to evaluate your condition before you drive and/or decide whether or not to go to the hospital.  If you think your condition is not life threatening, you may opt to avoid the high costs of emergency care, where typically they will take x-rays and send you home with a prescription for pain killers and muscle relaxants and instructions to follow up with a primary care physician within a few days for your whiplash or sprain/strains.  The cost of this visit may equal half to most of your PIP, leaving you with little money for actual treatment and rehabilitation.  The other option is to immediately phone a primary care physician from the accident and make the next available appointment.  Most doctors will be able to fit you in that day or within 1-2 days without the high cost of emergency care.

 

4.  The effects and injuries of an auto accident may take days or even weeks to

     uncover.

Be forewarned that even with a minor accident there can be muscle soreness, decreased mental acuity, headaches, anxiety and fatigue.  These symptoms can take several days or weeks to develop.  So even if you think you immediately feel fine, making an appointment for a few days after the accident is a good idea regardless.  You may be thinking (and hoping), “I just need some days to rest, and this will all go away.” Unfortunately, in cases of even the most minor car accidents, your body has sustained veritable trauma and a little rest and ice is unlikely to eliminate your symptoms completely.  Getting your PIP to pay out depends on a primary care physician (PCP) determining the medical necessity of your care and referring you appropriately.  This can be a Doctor of Chiropractic (DC), Naturopathic Doctor (ND) or Medical Doctor (MD).

 

5. Contact your insurance company to file a claim.

The next crucial step is to contact your auto insurance company and get a claim number.  If the accident was not your fault, the other driver’s insurance will ultimately cover your bills.  If it was your fault, or your accident was with an uninsured motorist, your insurance typically covers it.  As previously mentioned, your PIP coverage is typically guaranteed up to $15,000 for medical bills, assuming you have medical proof of your injuries and referrals from a Primary Care Physician.  If that amount is exceeded, further levels of discussion are required, usually leading to a “settlement” and possibly requiring the help of an attorney who specializes in auto injuries.  These are the general and most common guidelines, but you must find out exactly what your coverage is for your particular situation.  Learn what your PIP coverage amounts are, how much insurance the at-fault driver has, and if you have coverage on your policy for an under-insured motorist (UIM).

 

6.  Do not settle with any agents that contact you, unless you are 100% confident

     that you feel perfect and will stay that way.  And remember, NO RECORDED

     STATEMENTS that can be used against you in the future.

Although the insurance companies will ultimately make sure you are covered, they are very eager to ‘contain’ their potential costs and get things over with as quickly as possible.  It is not uncommon for you to get a call or a visit within a week of your accident from an agent (from the at-fault driver’s company) trying to get you to ‘settle’ for a few hundred dollars.  Unless you believe yourself to be feeling 100% as you were prior to the accident, with no doubt whatsoever --- this is a legal tactic for you to declare the case over – DO NOT TAKE THIS BAIT.  People can take months or even years to fully recover and you must not feel rushed into this.  And above all else, NO RECORDED STATEMENTS that can be used against you in the future.

 

7. As soon as possible, contact a Chiropractor, Medical Doctor or Naturopath that is

    familiar with managing auto accidents, and is open to referring you to other

    practitioners for the best possible care.  Do not delay.

Your rate of rehabilitation and healing are directly related to how quickly you respond to your injuries with a doctor visit.  Each day that goes by without treatment will lengthen your recovery process.  Patients who have sought treatment within a day or two post-accident have often recovered in less than half the time of someone who waited a week or longer.

 

8. Be diligent with your treatment plan so that you can get back to 100% as quickly

   as possible. 

Your recovery can be accelerated and improved with an active and thorough approach to your care.  “The worst you thing you can do is nothing,” says Dr. Ku.  From her experience, “getting 80% better happens relatively fast, but that last 20% may never come without good hands-on restorative care and rehabilitation”.  And she warns not to neglect care for little ones that may have been involved, even if they can’t tell you how they feel. Children of any age are extremely vulnerable and should be evaluated even in minor accidents.

 

9.  If your case becomes complicated and you are concerned about exceeding your

     coverage, you may need to contact an Attorney.

There are several criteria to consider in choosing the right lawyer, and your Doctor will often have a referral for a good one.

 

10. Record the details.

Keep a daily log of the amount of time you spend dealing with all elements of the car accident.  Document everything from the time on the phone with agents, the auto shop, providers and lawyers, to your appointments, as well as how you are feeling each day.  This will all be very helpful in your final settlement.

 

For a complete and holistic approach to MVA (motor vehicle accident) care, visit Dr. Brenda Ku or one of the other chiropractors, acupuncturists or naturopathic doctors at Root Whole Body Health to assess your injuries, treat your physical and emotional trauma and refer you to exceptional acupuncturists and massage therapists.  Private exercise therapy and sauna services are also available.  Accidents are stressful enough --- recovering from it doesn’t have to be.  Contact Root Whole Body Health at (503) 288-7668 immediately should an accident occur and we’ll help you navigate your insurance and care.