How Much Treatment Should I Get?
An injured person has the burden of proof in establishing that the medical treatment they obtain is reasonable, necessary and causally related to the accident in question. If the amount of medical bills is excessive and found not to be reasonable because of the length of treatment or the amount of money charged for each treatment, the medical bills will not be recoverable. In other words, just because a person incurs $10,000 in medical bills, it does not follow automatically that the claim is worth $10,000.
This problem is most common in cases involving chiropractic care, massage therapy, naturopathic care, and excessive physical therapy. Chiropractic and naturopathic care are generally discounted by the insurance industry and deemed to be suspect by definition. Whether or not you desire chiropractic care or alternative treatment such as naturopathy or acupuncture, you should be advised that your bills will be more highly scrutinized.
Insurance companies use computers to evaluate your claim. These programs also determine what bills the insurance company will pay. For example, the program used by Allstate Insurance (the good hands people?) and Farmers Insurance (fast, fair, and friendly?) is generally believed to allow only for payments to Chiropractors and Massage Therapists for treatment less than 8 weeks in duration or 22 visits, whichever comes first. These companies, and other insurers that use computerized claims adjusting, simply will not reimburse an injury claimant for treatment by these types of providers beyond these amounts, in other words, it is as if it didn't happen.
In some cases over-treating and/or over-billing creates a situation whereby the injured person gives money away to his doctor for unnecessary treatment that otherwise would go to him to compensate for pain and suffering.
Our suggestion to our clients is to be objective about their treatment, and continue to treat only if they are receiving benefit from it. If an injured person wants to receive chiropractic treatment or alternative treatment, we suggest that they also obtain concurrent medical evaluations and recommendations as to the propriety of the treatment program.