Whether you are injured in a car accident or have a work-related injury, it's important to understand who you may need to deal with during the litigation process for your injury claim, and what their roles are during the process. Here are 3 professionals you may become very familiar with during the litigation process.
Adjuster
You will need to deal with at least one adjuster. Adjusters work for the insurance company. Their role is to determine the extent of your injuries and the damages to your personal property. Then, the use that amount to negotiate a monetary amount that will cover your injuries, damages and expenses while protecting their insurance company's bottom line.
You will need to answer questions the adjuster asks you, but it's important to do so without giving too many complicated details that may cause confusion with your injury claim. This could cause the litigation process to take longer than it would have. It's important to understand one of the adjuster's primary roles is to keep their employer from losing too much money. Therefore, always be on your guard when disclosing information to the adjuster. While there are honest adjusters, some unscrupulous ones may attempt to take advantage of your situation by bringing up previous injuries or legal matters.
Nurse Case Manager
A nurse case manager may be assigned to you. This person also works for the insurance company. They are brought in to make sure you attend your physician's appointments and receive your treatments in a timely manner. Just as with the adjuster, one of the main roles of the nurse case manager is to protect the insurance company's bottom line.
Nurse case managers often schedule the appointments and treatments, often to suit their own schedules instead of yours. Also, they usually speak with the physician and other medical staff members to determine if you are receiving the appropriate treatments and how long it will take you to recover from your injuries. Then, they report back to the insurance company and the adjuster.
While it's important to be honest with your nurse case manager, it is important to understand that he or she is simply a liaison and not someone who can provide you with medical advice or treatment. A nurse case manager may attempt to talk you into saying you feel better than you do, or taking the treatment recommendations that are the least expensive.
Ombudsman
An ombudsman is someone you can go to when you have a complaint about the way your claim is handled. An ombudsman is an unbiased third party who works for neither you nor the insurance company. They work to resolve issues and complaints that are brought to their attention by determining whether or not someone acted inappropriately or illegally.
This person does not provide the same information or advice that you can get from a lawyer. You can correlate this person's role as similar to that of the complaint department. Many people speak with an ombudsman after receiving compensation for their injuries and then realizing they were tricked into taking less than they should have been compensated for. This sometimes happens when the injured person does not seek legal counsel and/or representation.
After your accident, the last thing you probably want to do is to meet, read more, and deal with strangers who seem to want to know all the personal details about your medical problems and your life. You will probably feel like these people are prying, but they are just trying to do their jobs. However, it's important to know who they work for and what their primary roles are.
Share23 December 2014
Too many single people assume they don't need to plan their estate. My brother fell into this category, and his unexpected passing left our entire family struggling to deal with his home, belongings, and financial accounts. It took nearly three years for the courts to set up a deal because he left no paperwork detailing how he wanted his estate divided. The situation immediately convinced me to work on my own estate, even though I'm still in my early 30's and don't have children or a spouse to worry about. Since it's a little harder to pick beneficiaries and estate managers when you're single, I collected the resources I used for making my own decisions and decided to publish them here on my blog. Use these resources before talking to an estate planning attorney so you're prepared for making hard decisions.