I have osteoarthritis to the area that a new injury occurred the other party is at fault thats not contested, but I need surgury to the area. The claims rep said that if the doctor states that the surgury is need because of the accident they will pay. But my doctor says in the not the accident exuberated the injury which neccesitated the need. The claims rep said thats not clear enough and it has to be very clear that the surgury is needed 100% from the accident. How do I approach this with the doctor. The doc says they cannot assign a percentage and that the note saying it exuberated it should be enough. I know that lawyer can get these letters easier and I am working on getting one, but what do you guys do to get the letters? or how can I get my doc to write a letter ????
I am not licensed in NH, and can offer you general advice. The legal standard is that the collision be a significant contributing cause of the condition requiring surgery, and that but for the collision you would not have needed the surgery more likely than not. Often doctors do not want to assign a percentage, but you are not asking that he say that this is a certainty. Only 51% - more likely than not that without the collision you would not have needed the surgery.
Having a lawyer early on in a personal injury case can help to avoid some of these problems. Some doctors do not like to get involved in litigation and may not want to use language that you or the claims representative suggests. If a surgery is required due to an accident you should consult with a good personal injury lawyer. By contacting the doctor yourself you may risk damaging your case. You will be better served by retaining a lawyer to insulate you from the process of obtaining the necessary legal opinions. The claims representative is not looking out for your best interests, that is not his job. He probably understands that a good attorney may increase the value of your case. Good luck.
As I am licensed in Vermont and Florida, I cannot comment specifically on New Hampshire law. However, generally, in this circumstance you describe, you will need the assistance of a personal injury attorney who is knowledgeable about how to obtain the information needed from the Dr. Your attempt to deal directly with a claims representative from the insurance company, in a case where clearly you have pre-existing conditions, may not be the wisest thing to do. You should consult a personal injury attorney as soon as possible. You may also wish to review some of the Legal Guides I have published on A V V O .com which address some of your concerns.
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