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North Seattle Chiropractic - Dr. Ian R. Congdon - What to do if you have a Auto Accident

Automotive Accidents and what you should know….

Often, around this time of year in Seattle, we see an increase in our patients who have been involved in some manner of automobile collision – whether major of minor.  The insides or windows are foggy, the light is flat, the roads are wet, and well... if you're ever had a fender-bender, you know the rest...  If you already know the nitty-gritty, and want to contact me directly, or schedule an Chiropractic Appointment to get checked out, click here, or if you're wondering if there's any need to go see a doctor at all, view my blog entry about that topic here.

  If you're one of the over 100,000 Washington Drivers that end up in this situation each year, it pays to know what to do - and it may not always be what you would think at first!  Usually on the back of your insurance card, your insurance company has put forward some quick guidelines – Pull over to a safe location out of traffic if currently unsafe, Call the Police, Call your Insurance Company, and don’t discuss fault with the other party.

  While these are a reasonable start, they don’t give much guidance for what to do in the hours, days, and weeks following a car insurance claim - when to see a doctor, what to expect, and when it comes to dealing with insurance companies, and attorney's, who to trust, and who actually has your best interests in mind.
    Hopefully, if you find yourself in such a situation, both you, and the other driver both have good insurance.  If not, do yourself a favor, and speak to an insurance agent, and get some coverage.  If you don’t drive that much, and want to avoid some of the expense of a traditional insurance policy, there are increasingly many options for “pay-by-the-mile” insurance.
  If you do have insurance, hopefully you have what is called “PIP”, which stands for Personal Injury Protection, and is the first and best insurance to use any time there has been an automobile collision, whether it’s your fault or not.  I see many patients who were involved in a collision, where the other driver was at fault, and their sense of right and wrong tells them “I’m not at fault, why should my insurance be the one paying?”.  The answer to this is simple: You have a contract with your insurance company, and you pay them for the benefit of receiving care, when and if you need it.  In contrast, you do not have a contract with the other party’s insurance, and they have no contractual obligation to you at all.  They may have a legal obligation for damages, but they have a bureaucracy in place that will make dealing with a error on a cable bill like a walk in the park, no matter how friendly they be on the phone at first.

     So before we move on, here are the best reasons to use your PIP coverage:              
  1. PIP is a contract between you and your insurance company
  2. PIP Pays for your Medical Bills as you get Care
  3. PIP pays your providers directly, so you don’t have deal with all of the paperwork, or pay out of pocket
  4. PIP Travels with you, as a pedestrian, cyclist, or passenger of another driver. 
  5. PIP will pay for lost wages
  6. PIP will pay for the things you cannot due because of the accident – Housework, Yardwork, caring for a dependent, etc.

  One of the predictably worse courses to take, when injured in a motor vehicle collision is to insist on using the other party’s insurance if the other party was at fault.  While it may feel “right” that the other party’s insurance pay for your health care, that is not what it’s designed for.  First and foremost, when you are relying on the other party’s insurance, you will have to cover all  of the bills as they occur, leaving you out of pocket all of the cost of treatment – if there are emergency room visits, special tests, such as MRI’s or X-Ray’s, or a stay overnight, this could literally be thousands of dollars that you have to come up with until the case settles – sometimes years later, if at all.  I say “if at all”, because the 3rd party adjuster can make the determination, not just for chiropractic, massage, or rehabilitative work, but even for routine care or special tests done under the direction of your primary care doctor, that these expenses are “Not Medically Necessary”.   It is true, 3rd the other party’s insurance does have its place – namely to pay for property damages to your vehicle, and as a fallback if your PIP benefits become exhausted, or if you do not have PIP coverage and the collision is deemed to be their fault – but that is the only time 3rd party insurance should be used.

To summarize, here are some of the biggest problems with using 3rd party insurance

  1. There is no contract between you and the 3rd party insurer – they have no contractual obligation to at all
  2. You will be responsible for paying all medical bills until the case settles – which could be months or years
  3. You are vulnerable to the 3rd party adjuster deciding after the fact, that the bills are not reasonable or necessary, which means you will be stuck with the bills.

  For this reason, our office will not take 3rd party insurance cases unless the following conditions are met:  1) You retain an attorney, 2) You agree to have a medical lien filed against the settlement, and 3) You agree to pay for both the medical lien filing fee with the State of Washington, as well being responsible for paying the fee to release the lien.  These are unfortunate steps, but are necessary after having entire claims, small and large both, dismissed by the 3rd party insurer as “Not Medically Necessary”, which then forces us to collect the full cost of our services from the unhappily surprised patient.
While the back of your insurance card offers some guidance for what to do, here is what I consider  “Best Practices” for what to do if you are involved in a collision, (Borrowed from a local Personal Injury firm)