If you’ve been in a car accident in Florida, life can suddenly become very challenging. The trauma of a car accident can cause serious injuries that require specific treatments from several different medical specialists. Sometimes, people end up missing appointments or not adhering to their doctor’s prescribed treatments. There are legitimate reasons for this, but what you need to understand is how gaps in treatment can impact your personal injury claim with your insurance carrier.

A Floridian involved in a motorcycle accident fills out their injury claim form.

If you asked Lauren Pozna, one of our personal injury attorneys in Pinellas Park, she’d tell you this is an important aspect of the injury claim process that she covers with her clients ASAP. This isn’t something the general public gets much information about unless they’re going through it personally. It can be all too easy to miss a follow-up appointment or let other aspects of your prescribed course of treatment lapse without realizing the impact it can have in the long run.

Our law firm will work with each of our clients to help them manage and document the medical care they receive for any injuries sustained in an accident. However, we can’t force someone to go to the doctor if they choose not to. We hope that sharing this information can help prevent more people in Pinellas (or anywhere in Florida) from undermining their injury claim accidentally. Some of the best advice personal injury lawyers can give to clients is to follow the treatment plan prescribed by their doctor.

The Cliff Notes: Key Takeaways From This Post

  • 1
    Treatment plans for personal injury claims vary greatly depending on the severity of the injury, the individual’s age and pre-existing health.
  • 2
    Gaps in treatment may be used by insurance carriers to pay less for or deny claims, so keeping thorough documentation is important.
  • 3
    Common gaps in treatment include needing to see a specialist, dealing with a sick family member and recovering from surgery.
  • 4
    Most people begin with non-invasive treatments and progress to more advanced treatments if needed; follow-up appointments are important.
  • 5
    If an insurance claim is denied, underpaid or if someone was recently injured in a car accident in Florida they should speak to a personal injury lawyer.

The prescribed treatment plan can vary significantly depending on the severity of the injuries sustained in an accident. Someone who breaks an ankle in a slip and fall accident may only need a cast for the joint and a couple of months of physical therapy to restore full mobility. Compare that to someone with a spinal cord fracture or traumatic brain injury. They could require specialized medical care for the rest of their life.

Of course, the treatment plan a doctor recommends for a broken ankle will also vary depending on the underlying health and age of the individual. A broken ankle for an older person may require surgery to reset the joint and restore some mobility. Then that person may also need to have screws removed months or years later.

The factors that can impact a personal injury claim are as varied as the people who have been injured. The one consistency is there will be a prescribed treatment plan for the injured person and it will be evaluated critically by an insurance adjuster after you file your claim. The injured person’s lawyer and the insurance adjuster will get access to their medical records and that will show what the prescribed treatment plan is. If there are gaps in treatment, they will be noted and brought up during the claims process.

A Floridian involved in a motorcycle accident fills out their injury claim form.

What Qualifies as a Gap in Treatment?

During the evaluation of a personal injury claim, the insurance carrier will look for two types of gaps in treatment:

  1. Was there a gap between the date of the accident and first seeking medical care?
  2. Was there a significant gap between initially seeking medical attention and seeing the appropriate doctor for a follow-up visit?

Once you have filed a personal injury claim in Florida, your insurance company will assign an adjuster to investigate. This is a professional who has been trained in identifying red flags the carrier can use as a way to pay less for the claim or deny it completely. Gaps in treatment are major red flags that will be investigated.

The insurance adjuster will take this stance if there are gaps in treatment that can’t be defended: You would not have these gaps if you were truly injured as you claim in that accident.

We’ll cover this more later in the post, but keeping thorough documentation about the medical care you receive is super important too. Some gaps in treatment can be defended, but insurance adjusters may also take the stance that the injuries you have weren’t caused by the accident you’re filing a claim for. Documentation will give a personal injury attorney the means to sidestep this in pursuit of the compensation you need.

Treatment Plans & Personal Injury Claims

Gaps in Treatment That Won’t Undermine Your Injury Claim in Florida

Life throws a lot of challenges at us that just don’t have any respect for our schedules. Sometimes, people miss doctor’s appointments due to unforeseen circumstances and that doesn’t mean they aren’t seriously injured. During the COVID pandemic, for instance, the injured party may end up having to miss an appointment if they test positive.

Other acceptable gaps in treatment can come from:

  • Needing to see a specialist that was booked out for a while
  • Dealing with a sick family member
  • Recovering from surgery

One thing you need to do is let your personal injury lawyer know if you have a gap in treatment for any reason. Your attorney can properly document any gaps in treatment following a car accident and will note if it was for a legitimate reason. This will prevent the insurance carrier from using that against you while negotiating the injury claim.