Casualty Flashcards

1
Q

Categorized

A

traumatic or chronic

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2
Q

Exacerbation

A

injury which preceded the accident but which the accident may have made temporarily worse

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3
Q

Aggravation

A

cause the injury but aggravated it to a certain degree for a specific duration

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4
Q

Factors to Consider

A

age
overall physical condition weight
activity level
compliance with medical recommendations

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5
Q

Questions to Ask

A

What is the alleged injury?

How did the injury occur?

Is there a causal relationship?

Did the injury result solely from this accident?

Is the injury complicated by a prior physical condition?

Where and what type of treatment is the claimant receiving?

Is the claim being inflated or built-up by excessive treatment and charges?

What is the disability?

Is there permanency of disfigurement?

Is the claimant a “malingerer”?

What are the objective complaints versus the subjective complaints?

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6
Q

Medical Authorization

A

explain what a medical authorization form is to the injured party and email or mail it to them

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7
Q

Medical Reports and Records

A

foundation of a medical investigation as they include the information needed for a proper evaluation of the injury

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8
Q

ESBI

A

Early Settlement - Bodily Injury

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9
Q

ESBI

A

occur during the
first 30 to 60 days

after a loss is reported where the claims professional and claimant agreed to a full, fair and final settlement of the claimant’s BI claim

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10
Q

Qualify for Early Settlement

A

Coverage confirmed and liability determined (using LIQ if eligible)

Injured party can be claimant or insured driver or passenger (may be UMBI vs BI)

Injured party may be pedestrian

No attorney involvement

Minor to moderate vehicle impact

Inconvenience is not an injury and should not receive an offer

If treating actively with a chiropractor, physical therapy

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11
Q

INJURIES that Qualify for Early Settlement

A

Soft tissue neck and back

Minor sprain/strain of other body parts (e.g. wrist or ankle)

Bruises, lacerations, abrasions and scrapes

Headache

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12
Q

INJURIES that DO NOT Qualify for Early Settlement

A

Fractures (arm, leg, ribs, etc)

Disc injuries

Scarring

Closed head injuries

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13
Q

Settlement Options
ESBI

A

Straight ESBI up to $1,000

Medicals Incurred

Open-Ended

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14
Q

ISO

A

“in search of”

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15
Q

TLO

A

“the last one”

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16
Q

Statutory Lien

A

imposed by statute

17
Q

Equitable Lien

A

doctor’s lien

18
Q

Common Law lien

A

workers compensation

19
Q

Judicial lien

A

operation of judgement