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Insurance Adjuster Evaluation: How do they see Doctor’s reputation?

If you are filing a personal injury claim, the insurance company you are filing with will examine many aspects of your case to decide if the claim is legitimate and covered by their policy. A New Jersey personal injury attorney should advise you as to what the relevant factors of your case are and how to negotiate with the insurance company.

One of the key factors they may look at is the identity and reputation of your treating doctors, physicians, therapists, etc. Though you may not see any problem with your doctors or your claim, adjusters look out for claims of soft-tissue treatments that seem inflated to increase your expenses and your pain and suffering, and will push back against such claims. There are certain red flags that adjusters are known to watch for:

  • Is the treating doctor notorious for running a “plaintiff mill” that specializes in treating patients who have insurance claims? Does the doctor have a reputation due to advertising in TV commercials or the Yellow Pages for personal injury clients?
  • If this allegation comes up with your doctor, your New Jersey personal injury attorney can choose to fight back by arguing that the reason your doctor sees so many patients is because he is an excellent doctor, has a well-regarded and established practice, superior credentials, and has been routinely published.
  • Is the level of treatment high relative to the property damage that occurred? If this argument is heard from the insurance adjuster, your New Jersey personal injury attorney can decide to have a board-certified orthopedic surgeon (or other specialist in your injury) argue that property damage is irrelevant to the question of how severe the injury is and the carrier’s position is medically inaccurate.
  • Is your treating doctor known to serve as the doctor for patients who have retained legal counsel, even a specific law firm? If the argument comes up that the doctor is plaintiff-oriented, your attorney can emphasize the doctor’s experience to rebut the claim.

Insurance adjusters are often reluctant and difficult to negotiate with in personal injury claims. For experienced legal counsel, call the New Jersey personal injury attorneys at the Clark Law Firm, PC at 877-841-8855 for a free consultation.


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