How Does Medical Treatment Affect Your Personal Injury Settlement Amount?

After an injury, there are a few things the insurance company wants to know before they write you a check.

That is – how badly you were injured, who was at fault, and what damages you sustained.

And above all, they want proof.

They will sift through the evidence until they find what they need. This makes how, when, and where you were medically treated after your accident critical in determining fair compensation.

Even though we know that medical records can’t tell the whole truth to the insurance company, they are tangible accounts of your accident and injuries. Therefore, they’ll use this information to calculate your settlement.

Here’s how choosing the proper medical treatment can help maximize compensation in your personal injury or workers’ compensation claim.

Medical Treatments and Your Settlement or Award

When it comes to medical treatment, insurance companies favor tradition. That means treatment provided by a medical doctor in a private practice or emergency setting will be viewed as more serious and legitimate when compared to treatment provided by a chiropractor or acupuncturist.

You can still receive medical treatment from qualified healthcare professionals who aren’t medical doctors, but the insurance company won’t view that medical treatment the same way. The insurance carrier wants you to keep your medical bills as low as possible.

When reviewing your medical records, the insurance adjuster is trying to answer questions such as:

  • How severe are your injuries?
  • What limitations will you have?
  • Are you able to work?
  • How long will your recovery take?
  • Did you suffer a permanent disability?
  • How much will all of these expenses cost?

If your treatment is not considered medically reasonable and necessary, you will have difficulty getting the insurance company to pay you fair compensation.

Here are some common types of treatments and how they impact a personal injury case.


Injuries that require surgeries—broken bones, traumatic brain injuries, internal damage, etc.—are more severe than other types of injuries. Surgeries are serious, life-altering procedures, signaling a serious injury, which means a higher settlement.

Emergency Medical Services

Emergency Medical Services (EMS) is the emergency medical care you receive before reaching the hospital. It is the combined effort of firefighters and paramedics to stabilize you at the accident scene. If you require EMS, your injuries are likely severe, which will often increase the settlement value of your personal injury case.

ER/Urgent Care

Treatments received at an urgent care facility will often be viewed less favorably than medical treatment provided at a hospital. However, if the care you received in the emergency room was purely diagnostic or involved minimal medical treatment, you might not see much difference in the impact on your settlement.

Chiropractic Care/Physical Therapy

Visiting a chiropractor or physical therapist following your accident can be very helpful for whiplash and other types of injuries commonly sustained in car accidents. However, some adjusters don’t view chiropractic treatment as being on the same level as medical treatment provided by medical doctors.

Is Medical Treatment Considered Evidence?

Yes – the medical treatment you receive is evidence in your personal injury case. To be successful in your case, you must prove the at-fault party’s negligence caused you to be injured.

We can help you l do that by showing that there was a:

  • Duty of care: The other party has certain rules or obligations that they are expected to follow
  • Breach: The other party didn’t follow the rules and expectations
  • Causation: The other party’s breach of duty resulted in your injuries and damages.

Records of your medical treatment help prove the causation portion of your argument and provide time-sensitive information related to medical care for your injuries.

However, medical treatment alone will not prove your case. A personal injury lawyer can help you build a strong case against the at-fault driver by including testimony and other evidence that will help the jury understand the full extent of your injuries.

What is ‘Reasonable and Necessary’ Medical Treatment?

The insurance company wants to ensure they’re not paying for frivolous or unrelated medical costs. This is why the car insurance carrier will only pay for medical treatment that is “reasonable and necessary.”

To do that, you will have to prove that the type of medical treatment you received was medically necessary to your recovery and that the costs were reasonable.

This may be easier said than done. That’s why it’s recommended that you have a knowledgeable attorney from a trusted law firm backing you.

How are Personal Injury Awards Calculated?

Insurance adjusters weigh several factors when determining a fair settlement amount. Most importantly, they’ll consider your economic and non-economic losses associated with your accident. These costs are purely circumstantial, so injury settlements will look different for everyone.

The insurance adjusters will consider the following:

  • Medical expenses
  • Lost wages
  • Lost earning capacity
  • Disability
  • Pain and suffering
  • Physical Impairment
  • Loss of consortium
  • Disfigurement

How to Maximize Compensation in Your Case

Medical treatment after your accident will be heavily scrutinized. However, not receiving any medical treatment for your injuries will guarantee you will receive little if any, compensation.

So first things first, to protect your right to compensation, you should seek medical attention immediately and complete all treatments your doctor recommends.

Also, hire a personal injury attorney to oversee your case and medical treatment. We will work with the insurance adjuster directly, negotiate a fair settlement on your behalf, and make sure all the harm you’ve incurred is considered in your personal injury settlement.

Contact our team at Allbee Law Firm today for a free consultation.


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