Casualty

Question 1

Categorized

Answer 1

traumatic or chronic

Question 2

Exacerbation

Answer 2

injury which preceded the accident but which the accident may have made temporarily worse

Question 3

Aggravation

Answer 3

cause the injury but aggravated it to a certain degree for a specific duration

Question 4

Factors to Consider

Answer 4

age
overall physical condition weight
activity level
compliance with medical recommendations

Question 5

Questions to Ask

Answer 5

What is the alleged injury?

How did the injury occur?

Is there a causal relationship?

Did the injury result solely from this accident?

Is the injury complicated by a prior physical condition?

Where and what type of treatment is the claimant receiving?

Is the claim being inflated or built-up by excessive treatment and charges?

What is the disability?

Is there permanency of disfigurement?

Is the claimant a “malingerer”?

What are the objective complaints versus the subjective complaints?

Question 6

Medical Authorization

Answer 6

explain what a medical authorization form is to the injured party and email or mail it to them

Question 7

Medical Reports and Records

Answer 7

foundation of a medical investigation as they include the information needed for a proper evaluation of the injury

Question 8

ESBI

Answer 8

Early Settlement - Bodily Injury

Question 9

ESBI

Answer 9

occur during the
first 30 to 60 days

after a loss is reported where the claims professional and claimant agreed to a full, fair and final settlement of the claimant’s BI claim

Question 10

Qualify for Early Settlement

Answer 10

Coverage confirmed and liability determined (using LIQ if eligible)

Injured party can be claimant or insured driver or passenger (may be UMBI vs BI)

Injured party may be pedestrian

No attorney involvement

Minor to moderate vehicle impact

Inconvenience is not an injury and should not receive an offer

If treating actively with a chiropractor, physical therapy

Question 11

INJURIES that Qualify for Early Settlement

Answer 11

Soft tissue neck and back

Minor sprain/strain of other body parts (e.g. wrist or ankle)

Bruises, lacerations, abrasions and scrapes

Headache

Question 12

INJURIES that DO NOT Qualify for Early Settlement

Answer 12

Fractures (arm, leg, ribs, etc)

Disc injuries

Scarring

Closed head injuries

Question 13

Settlement Options
ESBI

Answer 13

Straight ESBI up to $1,000

Medicals Incurred

Open-Ended

Question 14

ISO

Answer 14

“in search of”

Question 15

TLO

Answer 15

“the last one”

Question 16

Statutory Lien

Answer 16

imposed by statute

Question 17

Equitable Lien

Answer 17

doctor’s lien

Question 18

Common Law lien

Answer 18

workers compensation

Question 19

Judicial lien

Answer 19

operation of judgement