Car accidents can be life-changing events for anyone who experiences them. For mentally disabled individuals, the aftermath of a car accident can be even more challenging. Besides the physical injuries, the psychological and emotional impact can be severe, given their pre-existing conditions. When such individuals file an injury claim with their insurance companies, there are specific evaluation procedures that these companies undertake. Understanding how insurance companies evaluate injury claims for mentally disabled individuals is crucial in helping them obtain the compensation they deserve.
Medical Review and Investigation
After an accident, the first step for an insurance company is to conduct a thorough investigation and medical review of the claimant’s condition. For mentally disabled individuals, the review process is more complex, given the pre-existing condition that may hide any new injuries. Insurance companies would need to investigate the claimant’s medical records before the accident and compare these with their current medical condition. The investigation would also include interviews with medical professionals who may have treated the claimant.
The insurance company would also need to validate the claim to establish the extent of liability and damages. For instance, if the mentally disabled person was injured due to the negligence of the other driver, the insurance company would need to establish the extent of the negligence and the claimant’s injuries resulting from the accident. The insurance company would also evaluate the disability case and the level of functioning affected by both the car accident and pre-existing conditions.
Once the validation process is complete, the insurance company would begin to assess the damages and value the claim. For mentally disabled individuals, there may be additional factors considered such as the cost of future medical care, loss of future earnings, diminished quality of life, and the need for personal care. Insurance companies may use different methods to assess damages such as the multiplier method or the per diem method.
If the claimant and the insurance company are unable to reach an agreement on the claim value, the case may proceed to litigation. In litigation, the court would hear the case and make a decision based on the evidence presented. Mentally disabled claimants who proceed to litigation may require legal representation to help them navigate the complex legal process.
Finally, if an agreement is reached or the court decides on a verdict, the insurance company may provide a settlement offer to the mentally disabled claimant. The settlement offer would be based on the claim value and the damages assessed. If the claimant accepts the settlement offer, they would sign a release of liability form, and the insurance company will provide them with the agreed amount.
Understanding how insurance companies evaluate injury claims for mentally disabled individuals after a car accident is crucial to help them receive fair compensation. The insurance company’s evaluation process involves medical review and investigation, claim validation, damage assessment, and litigation when necessary. The claimant may receive a settlement offer once a decision has been made, or the case may proceed to litigation. Mentally disabled individuals filing injury claims would require legal representation from qualified attorneys to help them navigate the complex legal process and obtain the full compensation they deserve.