Factors Considered by Insurance Company in Resolving Personal Injury Cases

Insurance companies consider many factors in determining the amount of money that need to be settled in personal injury cases.

Most cases need proof of fault that can be found on intentional conduct, reckless conduct, or negligence. Most of personal injury cases are produced as a result of negligence. So, the injured person can only recover (protected) if his or her negligence is less than the negligence of the person against whom the demand is made.

  • Insurers analyze previous medical history
  • Pre-existing related illnesses or injuries
  • Earlier claims history
  • When the treatment following the injury began
  • Who referred the patient to the health care providers
  • What the original history and chief complaints given by the patient were
  • Subjective and objective physical findings on examination
  • Laboratory and radiological findings, the original diagnoses
  • The original treatment plan, follow-up treatment
  • The identity and credentials of the treating health care providers
  • The continuity or lack thereof in patient complaints and treatment
  • The length of the healing period

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