by Guest » Sun May 25, 2008 11:04 pm
How does an insurance company rate pain & suffering? I was in an auto accident in January , suffered what they first called whip last and back pain. After several trip to the doc I was sent to a neurologist which did a MRI and found a ruptured disc. I have 2 nerve block injections done with no relief and then he removed the disc and put in a graft and a steel plate in my neck. It did help some but the pain is still there and he had already told me that there was just a 65 % chance that it would stop all of the pain. So now I have a scar across the front and side of my neck and still have pain, how do they rate that?
Posted: Mon May 26, 2008 02:50 am Post Subject:
They would look at your medical records (doctors notes) and bills (current and prior), nature of the impact, local of accident, age, occupation, marital status, etc. Probably in that order of importance... and then also apply local laws.
Then they get the "settlement hat" and pull a figure from it as an offer! :)
Posted: Mon May 26, 2008 07:40 am Post Subject:
Hi tcope,
Would you please care to explain what this 'settlement hat' is all about?
Are you talking about a kinda settlement slab that corresponds to a particular type of treatment.
Please help.. PressJerky77
Posted: Mon May 26, 2008 07:44 am Post Subject:
Hey janet,
Sometimes it would happen in a different way.
If you'd have opted for a cashless settlement with your health insurance carrier, then I believe it is natural for them to look forward to their third party administrators who are responsible for monitoring your entire treatment & figure out the exact hospitalization amount.
If they find the healthcare unit charging any unnecessary amount or performing any treatment which is not related to your treatment, they would be the ones to settle it out with the healthcare unit under who you're being treated. Once all the bills would accumulate, the third party will send an estimation the insurer. Then it will be the tsk of the insurer to reimburse it to the carrier.
Thanx!
Cucumber-hopper
Posted: Wed May 28, 2008 05:04 am Post Subject:
Would you please care to explain what this 'settlement hat' is all about?
I was just kidding about the hat. :)Posted: Wed May 28, 2008 11:25 am Post Subject:
So now I have a scar across the front and side of my neck and still have pain, how do they rate that?
maybe pretty high...as tcope said it will depend on all the other things he listed...also any prior conditions?Posted: Wed May 28, 2008 04:51 pm Post Subject: yes
Yes, as cucumber said they may engage third party for doing this stuff and then look for the things need to be given.
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