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Gap in Treatment–One of the biggest mistakes after a car accident case.

Have you been hurt in a car accident, dog bite, or pedestrian injury? Maybe you’re considering “taking it easy” to see if you can make your symptoms go away. It’s a reasonable route in some situations but it can also be a very bad choice if your injuries are due to someone else’s negligence. That’s because injury accidents are adversarial in nature. Insurance adjusters may sound lovely and caring in the first few weeks after you’re hurt. That is part of their training. But, if you change your mind and decide you DO need medical care and you DO want some compensation for all the time and trouble, the adjuster’s demeanor is going to change dramatically. This is where the delay in getting medical care, known in PI cases as “gap in treatment,” is going to really hurt you.

Unfortunately, while the “wait and see” approach is common, it is also one of the most significant mistakes that injured people make after an accident. By the time you realize those injuries are bad, it can still take weeks to see a primary care doctor. Yet, if you choose to go to the Emergency Department weeks after the accident, it not only looks “strange” in a case but it will also add a significant expense to your case. That can make sense if you have serious trauma, fractures, or broken bones. However, if you have a soft tissue case (whiplash), that $5000 dollar hospital visit a month after the accident can greatly diminish what you get in your pocket at the end. And, if you take your case to trial, be prepared that juries tend to agree with defense that “seriously injured people don’t wait to get help.” Without a reasonably-timed diagnosis and ICD codes, a jury is likely to see you as faking your injuries or at least see you as not very credible when evaluating your alleged pain and suffering.

The reason the undervaluing of injuries (hence, low reimbursement from the third-party insurance adjuster) is so important is that medical bills (or any insurance paid on your behalf during the treatment period) will all be paid back out of your gross settlement. It can be upsetting if you do not understand subrogation. It can also be a VERY costly mistake if you are handling your own case and do not understand your financial obligations.

As a side note, for those who are seeking a subsidized health plan that will cover an emergency room visit retroactively, this can really save your case if done in a timely way. Instead of having a $5000 bill outstanding, you may qualify for a subsidized plan that picks up emergency visits (and pays a very reduced amount so subrogation is low) only following your approval for the plan. Unfortunately, going to the Emergency Department for a non-emergency weeks or a month after the accident (even if it “feels” like an emergency) means the visit is billed differently–often resulting in a much bigger patient balance. Those balances come out of your settlement.

So, it is important to get informed about how personal injury and, specifically, auto accident cases are evaluated by attorneys, adjusters, and juries. Two cases with the same injuries can result in very different settlements based on how the injured person manages and mitigates issues from the outset of the accident.

If you have been injured in an auto or pedestrian accident in western Washington and are uncertain if you need an attorney, we can offer you a consultation. If it’s not a case we handle, we will try to suggest a good local referral. Just don’t delay in getting that advice because, the longer you wait after being injured, the higher likelihood you have made mistakes that will limit your recovery or create a risk that you could be upside down financially when the accident wasn’t your fault.

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