For example, if someone involved in a car wreck has PTSD and it's been well-documented and managed for over 10 years and they were not liable/not at fault for said accident and the incident is already causing a "flare-up" of symptoms, should that be addressed with the the at-fault insurance company? For example, I would ideally like 6 sessions with a local psychiatrist of my choice because I don't feel like my insurance visits should be impacted because I wasn't at fault for an event which caused the extra visits, which I know I will inevitably need. (Perfect example--other than for a follow up with my primary care in the same office, I feel like I need one of the medications I take the dosage adjusted in direct relationship with the added symptoms after we were rear ended.)
Is this a normal sort of "ask" or insurance payout or settlement situation? Or are those hypthetical visits and extra doctor fees /co-pays factored into one lump sum with everything else medical?
*Note: I am not the owner of the vehicle but an authorized, insured driver so I will not expect to be receiving compensation for a car in my spouse's name ;)
Alabama does allow for damages for an aggravation of a pre-existing condition. This would likely need to be documented by your doctor.
A settlement agreement is generally inclusive of all damages and medical bills. There can be an amount the insurance company considers for future medical bills but that is factored into the settlement as well. It is not like workers comp where medicals are left open for the future after a settlement is consummated. Basically you get one bite at the apple so to speak and that includes everything.
You've asked for a lot of information and let me preface my response with, "you really should consult an experienced auto-crash attorney about these questions directly. This forum is for general informational purposes. First thing to keep in mind is that even though you are not "at-fault" when making a claim for insurance benefits, you (the claimant) carries the burden of proof on all issues. This includes liability of the other driver and medical damages. Second, a liability claim is a reimbursement type of claim. Meaning you incur the expenses (damages) then if the liability insurance company thinks they are related to the accident, they'll consider reimbursing the damages. It would be very unusual for a liability insurance company to agree up front to pay for "6 visits" to a healthcare provider. Finally, a pre-existing condition that aggravated or exacerbated by an accident can be a claimable damage; HOWEVR, under Ala law a health care professional will have to relate the aggravation (and it's related treatment) to the accident to a "reasonable" degree of medical certainty. While PTSD is more commonly accepted today than ever before, insurance companies are VERY skeptical of these type claims and are reluctant to compensate for victims without strong evidence in support of the claim. I'm again recommending that you consult with a lawyer in your area and I'm attaching a link to a publication from our firm about auto-crash insurance claims. Good luck and I hope your recovery goes well. http://www.bfw-lawyers.com/pdfs/Auto_Claim_Guide_Web.pdf
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The short-and-sweet answer is yes, but you have to show that the pre-existing condition was aggravated by the new accident and you have had to have treatment for the aggravation. This must all be documented by your treating doctor.
Your best bet to obtain the maximum injury settlement amount in this case is to consult immediately with a personal injury attorney in your area to obtain a more specific answer and get all of your legal options before deciding what to do and then also complete all medical treatment necessary for any injuries you received. The attorney will also investigate any liability issue and check for all available coverages to ensure you have the maximum amount of coverages available to you. You may have some coverages on your own auto policy as well that can assist you. You can use the "Find a Lawyer" link at the top of this page for the names of attorneys in your area. Most offer a free consultation and work on a contingency fee basis, so you won’t have to pay anything up front.
Please do not message me for further advice or call my former law firm if you have any further questions. If you are in need of an attorney to assist you, please search for another attorney in the jurisdiction involved in your case, as I am now retired, and my former law firm is no longer handling these types of cases. I am active on AVVO and answer questions only as a public service at this point.
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Medicals bills including psychiatric services in an auto injury case have to be related by medical expert testimony just like any bills you might claim (if you want to get them admitted into evidence in a trial). However, most cases are settled without taking the doctor's deposition. The claim is going to be approached by the adjuster like any preexisting condition such as DDD, DJD, arthritis, prior bulges, etc. You're going to have the burden of showing it aggravated or exacerbated your existing condition and you will be met with skepticism from the outset. As a Plaintiff you will have the burden of proving liability, damages and causation. You need a personal injury attorney.
This a motor vehicle negligence claim with a claim for aggravation of pre-existing injuries. Consult with local personal injury counsel.
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