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How the Insurance Company Uses Your Gap in Treatment As an Excuse to Minimize Your Claim

By Omid Rejali, Esq.

Insurance companies are looking for anything to belittle your injuries and minimize the value of your claim. The gap in treatment excuse is one of their favorites. Make no mistake, they are always trying to use human biases and prejudices in their favor to further their objective and, it is your job to explain to them why your gap in treatment should not have any bearing on the gravity of your injuries.

Here’s are three ways the insurance companies like to take your gap in treatment out of context

1) Since you did not see a doctor right away your injury must not be that serious

This is one of their favorites. The truth is, when you get into an accident you are usually in shock. Even if you have had a serious injury you may not feel it right away. You may also not have insurance and, would not want to take an ambulance to the hospital for the fear of the costs that it will have. I have had many of my clients with serious injuries-requiring future surgery, that did not go to the emergency room with an ambulance.

The best way to overcome such an argument is to have your doctor write a report explaining your injury and, the evolution of that injury. Many injuries do not manifest themselves right away, and others could be masked by other more serious injuries. Masking is the process of which our brain masks one injury in favor of another more significant injury. It is only when the more significant injury has stabilized when our brain begins to unmask the other injury that has been there all along.

2) That you did not complain about the injury close to the accident

Another favorite of the insurance companies is because you did not complain about a specific injury close in time to the time of the accident, then it must not be related to the accident. This goes hand in hand to the masking of injuries I was discussing. There are also many injuries that become more difficult to diagnose when your body is suffering from a more serious injury. For example, in a recent case, a client of mine had a significant injury to his spine. At the same time, he had a dip in his walk. For almost two years the doctors were treating his spine and the entire time thought that the dipping was related to his lower spine, more specifically his sciatica. It was not until the spine was stabilized and the he was still dipping that they realized, he in fact had a torn ligament in his hip.

3) Because you have not seen a doctor for years by the time of your trial, you must not need anymore future care

This cannot be farther from the truth. Only because the doctors have deemed that you have reached you maximum medical improvement (MI), does not mean that you will not require any future care. This of course depends on the type of doctors you have been seeing. For example, you may have been seeing an orthopedic surgeon for your neck injury and, the doctor has treated you for approximately two years with different moralities. And has also suggested that you would not be a good candidate for a surgery. However, that does not mean that the pain is just going to go away and you will not require any future care for that injury. Other care, in the form of pain management treatment would certainly be something that could be helpful to you.

Don’t let the insurance companies fool you with their illogical arguments.

Hope this information helps you.

If you have any further questions, feel free to call my office 24/7 at 619-887-4148 send me an email at; send us a text message at 619-485-6313 or reach us here and we will get back to you.

Born to get you justice.

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