How Insurance Companies Evaluate Spinal Cord Injury Claims

The National Institutes of Health estimates that between 255,000 and 390,000 people live with spinal cord injuries. Roughly 18,000 new cases are added annually in the U.S. These injuries can happen to anyone and are often the result of traumatic events such as car accidents, falls, sports injuries, or acts of violence.

When someone suffers a spinal cord injury due to someone else’s negligence, they may be entitled to compensation. Many factors go into the value of a claim. In the blog below, we’ll discuss how insurance companies evaluate these types of claims.

Did you suffer a spinal cord injury in Tennessee? Contact the team at Wagner Workers Compensation & Personal Injury Lawyers to request a free consultation.

Medical care and treatments

Insurance companies typically conduct thorough analyses of medical records. They look at the history, treatment plan adherence, and follow-up appointments. Any deviation from recommended medical care may result in challenges.

Insurance companies are constantly looking for ways to save money. Adjusters are trained to identify inconsistencies or gaps to reduce the amount of compensation provided. An experienced lawyer helps clients to navigate this with their knowledge. They understand what adjusters look for and build strong cases.

Independent medical examinations

Some insurance companies may request injured parties to complete independent medical examinations. Sometimes these are just part of the process, but other times, it is a way to derail claims.

In some instances, the medical providers chosen may unfairly side with the insurer. Or they may create an environment that feels stressful and like an interrogation to intimidate victims. These may be seen as tactics used by insurance companies to get people to accept less than fair compensation. A personal injury attorney helps clients avoid these delays.

Pre-existing conditions

Many insurance adjusters thoroughly evaluate pre-existing conditions. This is to determine if anything other than the accident could have caused the spinal cord injury. It’s a way to justify not paying someone fair compensation.

This may lead to unfair denials or unnecessary delays. Injured parties have enough going on without the stressors of bad behavior. A personal injury attorney may be able to help.

Recorded interviews

Many insurance adjusters request recorded interviews. During these sessions, they ask questions that may be confusing or challenging. Many insurance companies use recorded interviews as a way to identify inconsistencies. They often compare other statements or medical records to the recorded interviews.

Economic losses

Economic losses refer to the monetary losses associated with medical bills, an inability to work, and other related expenses. When determining economic losses, insurance companies assess:

• How will the injury impact current and future working ability?
• How much medical care is needed currently and in the future?
• What is the cost of related property damage?
• What other out-of-pocket expenses occurred? (transportation to appointments, caregivers, etc.)

Insurance companies look at receipts, records, expert testimony, and the duration of loss. For example, a short-term cord injury that heals wouldn’t be valued as highly as a permanent injury.

Non-economic losses

Non-economic losses are the non-tangible losses a person suffers. This could be loss of enjoyment in life, pain and suffering, or emotional anguish. When assessing non-economic damages, the following are evaluated:

• Does the spinal cord injury negatively impact a person’s quality of life?
• How was a person impacted mentally and emotionally by the injury?
• Did the injury result in a loss of companionship?

Non-economic losses are harder to prove and require special considerations. An experienced attorney helps clients calculate economic and non-economic losses.

Spinal cord injury claim FAQs

Many people have similar questions about spinal cord injury claims. We’ve answered some of the top questions below:

What is a spinal cord injury?

Spinal cord injuries result from damage to the spinal cord. This could happen for a variety of reasons and may last a short time or permanently. Spinal cord injuries have a wide range of symptoms, including:

• Paralysis
• Pain
• Numbness
• Spasms or involuntary reflexes
• Bladder or bowel control issues
• Loss or change in sensation
• Difficulty breathing

The severity of the injury is dependent on several factors. Anyone navigating a spinal cord injury should speak to an experienced attorney if they have questions.

What causes spinal cord injuries?

Many types of accidents can result in a spinal cord injury. One of the most common causes is vehicle accidents. But other situations may also lead to these types of injuries. Examples include:

• Falls
• Violent acts
• Sports
• Surgical or medical complications
• Birth injuries
• Infections

Sudden trauma to the spine may result in a cord injury.

How much is my spinal cord injury claim worth?

It would be impossible and unethical to give an estimated value for a claim without speaking to someone. The specifics of each case are essential to determining the value. However, in general, lawyers fight for the following types of compensation:

• Current and future medical expenses
• Lost wages and future earning capacity
• Non-economic damages, such as pain and suffering or emotional anguish

Tennessee law may cap noneconomic damages, including pain and suffering, though a higher cap may apply to certain catastrophic injuries.

We recommend that anyone curious about the potential value of a claim speak to an attorney. They can hear the case details and provide customized insight into your unique situation.

How does a spinal cord injury lawyer help?

Attorneys help their clients in several ways. They investigate claims and gather evidence to build strong cases. Lawyers also provide compassionate, insightful legal support. They represent their clients in court and negotiate with insurance companies.

A knowledgeable personal injury attorney eases the stress related to a claim for their clients. They also provide peace of mind during a challenging time.

Do I really need an attorney?

You may or may not need an attorney. Each case is unique, so the specifics are important. Are you curious about whether a spinal cord injury lawyer could help, and how? We encourage you to request a free consultation.

Contact Wagner Workers Compensation & Personal Injury Lawyers

Navigating an insurance claim while trying to adjust to a spinal cord injury can quickly become overwhelming. Injured parties do not have to go through the legal process alone. Spinal cord injury lawyers deal with insurance companies daily. They have the knowledge and skill needed to complete negotiations and build strong cases.

The team at Wagner Workers Compensation & Personal Injury Lawyers offers free consultations. This allows us to hear the specifics of your case to provide personalized legal insight. Contact us today to request yours.