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Motor Vehicle Accidents: Know the Process, Options to Claim, and Treatment

We hear about Motor vehicle accidents on TV, we read about them in the news, and we’ve heard others talk about them.

But do we know enough of what our options are if we were to get into one?

*Fun Fact: Did you know that there are 2.3 million people injured each year in car crashes costing $14 billion dollars plus annually.* 

As someone working in healthcare for a number of years I know how things operate from an administrative perspective but as a person being involved in an accident I was unaware of all the processes and options; until I was in a MVA myself.  From my own personal experience, I wanted to help others understand what to expect if/when they get into a MVA as well.

So I decided to write this blog and hope it helps anyone going through this experience or if this ever happens to anyone you may know.

On November 18, 2018 I was involved in a car accident where I was hit by a drunk driver. I was stopped, dropping off a friend from a dinner date. My friend was seconds from stepping out of the car when a drunk driver hit me from behind doing about 60km/hr!  What I thought was a little accident later turned into a life changing event for me.

Even though I was lucky and my car didn’t have much damage, my body would be spending what seems like a life time trying to recover. Sometimes the effects from a car accident can’t always be seen on the surface and sometimes pain doesn’t start right away.

This is why I will explain all you should know about a motor vehicle accident from the moment it happens.

DAY OF ACCIDENT

Whenever we get into any accident we always want to make sure we get pictures (more pictures are better).  Also, we want to make sure we get the other parties personal information no matter how small or big the accident may be.

Then you want to call your insurance company and open a claim. I know some think this would be unnecessary if the accident is small but it’s not unnecessary at all!  Remember, just because you can’t see injuries doesn’t mean you have no injuries.

**IMPORTANT**

Soft tissue injuries can take weeks before symptoms begin and can also take more time than usual to heal.  

You always want to go and see a health professional right away within the first 48/72hrs this can be your Chiropractor, Family Doctor, or your Physical Therapist. It is very important to be assessed by a health professional! Remember, your vehicle insurance is here to protect you during this time so you don’t have to stress out more with trying to recover.

Common car accident injuries we CAN’T always see:

Whiplash, Muscle Tear, TMJ Issues, Soft tissue injuries, Misaligned Hips

Back Pain, Neck Pain, Shoulder Pain, Migraines, and Loss of appetite

Depression, Fear, Anxiety

Car accident edmonton

Step one: Call your insurance company right away & start a claim

Step Two: Call and get in to see your Chiropractor, family doctor or physiotherapist

Step Three: Bring all paper work from your insurance adjuster to your appointment

*Important information to have: Adjuster name, adjuster phone/fax number, adjuster email, and claim number*

Treatments Covered From a Motor Vehicle Accident

  • Any Prescriptions needed due to the accident
  • Dental examination (from your regular dentist)
  • Other exams/treatment Ex: MRI, pain management injections, psychology, etc
whiplash treatment

Don’t stress with thinking once the 90 days are up or the 21 treatments have been used that you will no longer be covered for treatment. It is the practitioner’s job to assess and treat you until you have reached ‘pre-accident’ level of physical health before discharging you. The practitioner who treated you and provided you with your first assessment, will now do another assessment and will be asking your insurance company for an extension (once the 90 days or 21 treatments have expired, whichever one comes first).

Rules with extensions | Section B: if you have extended health care benefits (Sunlife, Bluecross, Great West Life, etc.) the insurance company will require to use your extended health care first, and then any remaining balance will be redirected to your insurance company for payment. Standard dollar amounts covered for an extension are:

                              Chiropractic $1000.00

                              Massage $350.00

                              Acupuncture $350.00

                              Physiotherapy: by treatments with regular biweekly updates inquiring more visits.

-All other treatments will need an approval from your adjuster-

** You have two years from the date of the accident to seek treatment**

The above statement is so important, don’t think that you can’t get help if you don’t go right away. You have two years from the date of an accident to receive treatment. The part to NOTE is if you put in a claim after the initial 90 Days, you will fall into a Section B extension protocol.  To clarify, this means you won’t be entitled to the 10 or 21 treatments and will be covered by the money provided in an extension as mentioned above.

Sometimes soft tissue damage doesn’t always have side effects right away, and this is why you have the right to get treatment within the two year mark.

SEEKING LEGAL COUNSEL (Optional) 

During the recovery process, you may start to feel overwhelmed with phone calls, emails, and appointments.  I suggest keeping a journal of all appointments, phone calls, emails, missed work, or having to leave work early for an appointment, this may all sound like a lot of effort but you may need this information in the future (as I will soon get to).

One option that you may want to take is legal action (this is not necessary but I do get asked this question from patients).  Finding THE RIGHT personal injury lawyer can be more difficult than initially expected.  Certain lawyers will bill you differently depending on the whole process.  Some will just charge a flat rate of 33% of the amount you eventually settle on regardless of how long litigation takes. 

Others will charge 33% if a settlement happens in 2 years or less, but if litigation goes past 2 years, they will increase their rate (rate increases vary but can be up to 40% or more)!  From my experience talking to a few different law firms, there shouldn’t be an upfront or flat fee that needs to be paid before a settlement.

**The other parties’ insurance company**

This is important! Near the 90 day mark or sometimes much sooner, you may receive a call from the other party’s insurance adjuster (some don’t) and they may ask you questions such as:

How are you feeling? How’s treatment? Are you recovered? Are you ready to settle?

This is to get an idea of your current condition and may ask you to settle with a cash payout which can range between $1000.00 to $5000.00 (NOTE: the maximum pay out for soft tissue injury is just slightly over $5000. This does not account for any other issues you may suffer from like TMD/jaw pain, PTSD, compensation for missed work, etc.)

Make sure to speak with your practitioner to see how your recovery is progressing.  It’s the other insurance company’s job to try and get you to take an early settlement, but your health and long term care is far more important then what they will offer you at this moment.

Getting in a car accident can be life changing, don’t let the fear of not knowing stop you from recovering! You have the right to seek as much medical care with whomever you see fit during your recovery, and you also have the right to speak with a lawyer for what you feel is right for you

A Few Tips:

I would recommend only communicating with email (or if you communicated via phone, ask the adjuster to email you the topics and answers you discussed). You want to keep a record of these conversation in the journal as mentioned above

CONSISTENCY is key.  Not only will regular treatments and consistent home care help with your healing long term, insurance companies want to see that you are getting treatments consistently (at least 1 treatment every 1-2 weeks).  

If they see that you are only getting treatments once every month or two then they may conclude that you don’t actually need more treatments and deny an extension or if you have gone the legal route, may determine your injuries are not severe enough and offer a lower settlement. 

If you are a passenger in a car accident, you are still entitled to treatment.  Speak with the person that the car is insured under, ask for their insurance information, and let them know you are putting a claim in for treatment.

Just because the insurance is under someone else, you do not have to wait until they put a claim in first before receiving treatment. 

Keep in mind, If you’re not happy with your medical provider you have the right to switch to any provider you wish.

Things to keep in your journal:         

    • KM to and from appointments
    • Leaving work for appointments
    • Missed days
    • Days of pain (pain from 1-10) 
    • Migraines, loss of sleep
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Something to consider if you are conflicted with taking legal action, how will you afford treatment after the two year mark?  For some, this is an issue that worries them along their healing journey.

A lawyer will help make sure you are compensated fairly to continue treatments after the two year mark.

NOTE: If your injuries aren’t severe and you feel like you will recover within the 90 day protocol with no lingering issues or if you are in a single vehicle accident, then legal counsel is probably not necessary for you

You only ever need to deal with your own insurance company (or the insurance company of the car you were in when the accident occurred). Your personal insurance company will contact the other party’s insurance for all payments.  There is no need to contact the other involved party’s insurance company.

I hope this helped all who have spent the time to read through it! Remember, the more information you have, the easier it is to make an informed decision for the benefit of your health. 

If you decide that you want to seek Chiropractic, Massage, or Acupuncture treatment in south Edmonton for your injuries related to a car accident, click ‘Book Appointment’ to book with our Edmonton Chiropractor to start an assessment or give us a call at 780-431-1201 and we will be happy to find a time and date that works best to get your recovery process started!

Author: Corinne Siteman