Why insurance claims for soft tissue injury are so critical?

by Modelkrb » Mon Apr 13, 2009 10:01 pm

Filing for an insurance claim is a tedious process. You eventually get paid for the losses, but only after the insurance company verifies that your claim is authentic. You would rather not expect them to pay more than what your loss had been. On the contrary, the insurers may try in every way to pay as less as possible. In that case, you may have to fight hard to receive a satisfactory compensation. Demanding insurance compensation for soft tissue injuries might be all the more difficult.

What is a soft tissue injury?

Soft tissues in a human body include everything except the bones and the organs. Thus, any injury to the muscles, ligaments, tendons, and other connective tissues can be termed as a 'soft tissue injury'. Bruises, sprains, strains, abrasions are the common soft tissue injuries that might affect an individual. Whiplash is one of the most prominent forms of soft tissue injury that affects the neck and upper back of the individual, if his/her car is rear-ended during an accident. Top

When to claim compensation for a soft tissue injury?

Claims for the soft tissue injuries are incorporated as a part of personal injury compensations that you can seek from your insurer after an accident. It is only justifiable to file a soft tissue injury claim when the injuries have been caused by:
  1. Auto accident
  2. Reckless or violent activity
  3. Defective equipment
  4. Defects in playing surfaces
  5. Lack of proper supervision
  6. School sporting activitiesTop

How are the injuries treated?

The soft tissue injuries cannot be easily diagnosed and there are no specific treatments for such injuries. However, health care specialists often use prescription drugs to relieve the pain from the injuries. The most recommended forms of treatments include:
  1. Rest
  2. Physical therapy
  3. Chiropractics
  4. Oral pain relievers and muscle relaxants
  5. Soft cervical collars (to immobilize neck after a whiplash injury)
  6. Massage
  7. Heat
  8. Ice
  9. Injection
  10. Ultrasound.
    11. Top

Why soft tissue injury claims are different from other injury claims?

Soft tissue injuries cause pain and soreness to the affected individual. Not only that, it also affects the earning capability of the individual. However, unlike other injuries, it's difficult to document them. Most of the time, the injuries don't show up on the skin. Even X-rays may fail to point out that injury in the area. The treatments may not follow the conventional path, as for other form of injuries. It's also hard to determine the claim amount for pain and suffering and loss of pay. The insurers often take a long time to settle a claim for a soft tissue injury. Often, the injured has to go to a trial to get a reasonable amount as compensation. Top

How much to claim for settlement of soft tissue injury?

The claim amount for soft tissue injuries differs from person to person. Your soft tissue injury settlement claim would depend mainly upon the factors mentioned below:
  1. The treatment - Your diagnosis and the mode of treatment will affect the claim amount, since you'll be asking your insurer to reimburse the corresponding expenses.
  2. Your income - Your income will affect your claim amount, since you'll be asking compensation for the loss of pay. Losses of past and future income along with the cost for future care are included when an insurance claim is filed. Besides, it would also depend upon the duration for which you were unable to work.
  3. Attorney fees (if any) - In case you're hiring an attorney, your claim amount should be more than the actual expenses for the treatment and loss of pay. It is so, since the attorneys deduct a share of the settlement amount that the insurer pays you.Top

Points to remember when filing claims for soft tissue injuries

Certain factors should be kept in mind, if you want to file an insurance claim for a soft tissue injury, as mentioned below:
  1. Take pictures of any visible symptoms - It is difficult to prove the extent of injuries. Therefore, any physical symptoms like swelling or bruising should be documented with the help of photographs.
  2. Save the documents - All details of medical advices and treatments should be stored in a proper order. You might need them to substantiate the treatments for your injury.
  3. Negotiate on your own - Try to settle the amount yourself initially. Negotiate with your insurer to arrive at a reasonable claim amount.
  4. Consult an attorney - Hire an attorney to represent you, only when your insurer refuses to pay anything. You should keep in mind that you'll need to pay the attorney, out of the claim amount that you receive.
  5. Don't make haste - You must have patience when dealing with your insurer. A settlement will take time, if you want to receive a decent amount at least. You can claim for any soft tissue injury, if the other party is responsible for it in any way. Every insurance claim needs to be proved. As for a soft tissue injury claim, substantiation is all the more vital.

You can claim for any soft tissue injury, if the other party is responsible for it in any way. Every insurance claim needs to be proved. As for a soft tissue injury claim, substantiation is all the more vital.Top

Related discussions

i have a similar post but i am going to go into detail with this.i need you alls advice.i am wondering what is the highest amount i can get from soft tissue injury settlement after my attorney takes her 33 percent out.Here Is My Situation,On December 26,2008 I Was At A Stop Light Waiting For It To Turn Green.The Light Finally Turned Green.As I Was Pulling Off The Lady Behind Me Ran Right Into The Back Of Me.We Pulled Over She Came To Check On Me To See If I Was Ok.At The Time I Was Fine.She Immediately Got On Her Phone And Called Her Insurance Company In The Process Of Doing That She Was Telling Me I Dont Have To Call The Police She Will Take Care Of My Car.I Called The Police Anyway To Make A Long Story Short She Ended Up Getting A Citation For Following To Close.This Was 11am On A Friday.I Didnt Feel Sore Until I Want To Say 12 To 1.A Member Of My Church Reffered Me To An Attorney,She Gave Me The Name Of A Chiropracter To Go To.I Went In And Basically I Went For 3 Months At 3times A Week.To Make A Long Story Short My Car Damage Was 559.78 .My Lawyer Said That Usaa Doesnt Believe That The Damage To My Car Was Bad Enough For Me To Be Hurt.If I Wasnt Hurt I Would Have Never Went Threw The Process Of All Of This.My Lawyer Asked Me To Contact My Insurance Company To See How Much Is My Med Pay.Ok To Make Another Long Story Short My Entire Bill With The Dr Was 3,692 And Some Change,My Med Pay Paid My Entire Bill So I Am Ok With That Portion,My Lawyer Put A Demand To Usaa For 16,000.I Understand I Am Not Going To Get That Much Back.Usaa Is Offering 4,225 That Is Too Low And My Lawyer Already Said She Is Going To Put In Another Demand.My Question To You All Is What Is The Most I Can Get From A Soft Tissue Injury Settlement Claim.If You All Have More Advice For Me Feel Free To Reach Me On Yahoo Messenger My Id There Is Kai30034 I Need All The Advice I Can Get.

Total Comments: 97

Posted: Sat Oct 03, 2009 07:07 am Post Subject:

She'd need to get an account of her medical bills till date as also an estimate of probable medical expenses for the future (arising out of her injuries). Did the lawyers give you an explanation for this $20,000?

Posted: Wed Nov 11, 2009 06:21 pm Post Subject: soft tissue injury to sternum

due to car accident i had a soft tissue injury to sternum aand bruised ribs how much compensatipon should i get

Posted: Wed Nov 11, 2009 08:08 pm Post Subject: car accisdent

after car accident i recieved soft tissue injury to sternum and bruised ribs and whip lash i have been offered 1100 pounds in soft tissue injury settlement should i accept

Posted: Wed Nov 11, 2009 08:25 pm Post Subject:

Modelkrb mentioned that his insurance has already paid for his medical bills.

In this case, any proceeds from action against the other insurer would firstly go back to his insurer as proceeds of subrogation and only the balance left after the insurers costs are recovered would go to Modelkrb - right?

If thats right then if the soft tissue injury settlement is 5K and the laywer takes 33%, that leaves a net settlement of $3350.

His insurer paid out $3700 so all of this would go back to his insurer wouldn't it (other than his excess)?

Posted: Thu Nov 12, 2009 08:18 am Post Subject:

A soft tissue injury with no permanent damage will not get you a gold mine. I got whiplash from a auto accident & went to physical therapy 10 times & 5 drs visits. I also had headaches & mental anguish. My med bills totalled $3700.00 & i got 3k for pain & suffering. I may have been able to get $500.00 more but im not sure. Soft tissue injurys (whiplash) are not money makers & lawyers know that. I didnt get a lawyer & i think if i did i would of received less.

Posted: Mon Nov 30, 2009 12:59 am Post Subject:

I was hit by a truck. I have a elbow cotussion back and neck aches i missed three weeks of work.i was a driver at my job fulltime but i only get 3 days now .i was a pedetrian do i have a strong case and whats the value of it

Posted: Mon Nov 30, 2009 01:00 pm Post Subject:

Well shizz, let's start at the beginning..

I was hit by a truck.

A side from the obvious, "ouch", why were you hit by the truck? Were you in a parking lot, a cross walk, how did the truck happen to hit you? I

have a elbow cotussion

that's long for bruise right?

back and neck aches

Any diagnosis at all?

i missed three weeks of work

Did a doctor take you off work for three weeks? or you just felt that you couldn't work ? (yes, it makes a difference)...

i was a driver at my job fulltime but i only get 3 days now

Why? Did everyone get cut back? Or do you mean that due to your injuries you can only work three days a week? Again, did a doc tell you this? Were you working at the time? Did the police come?

i was a pedetrian do i have a strong case and whats the value of it

It all depends...answer the questions and we'll see if we can help you. Have you talked to the insurance company for the truck that hit you?

Posted: Mon Nov 30, 2009 04:24 pm Post Subject:

How sad! People with "injuries" wanting to know how much "compensation" should they get. What a misunderstanding! It's a shame that our society has descended to the point that people are now expecting something for nothing. And when they get nothing because it was what they were entitled to, they turn to an attorney to try to get more.

Casualty insurance does not pay "compensation." It provides "reimbursement" based on actual losses. If you suffered an injury and had $500 in medical bills, that's your loss, and that's the most that you're entitled to collect on the basis of your injury.

On the other hand, liability insurance pays for "damages" as the result of a negligent party's breach of a duty to (or not) do something. Like not cause a collision. But the fact that you suffered an injury does not similarly entitle you to a liability claim.

OK, so you lost an hour or two of your time to go to the ER. But if you never lost a day of work, you really have no damages. Despite what a lawyer might tell you. It costs them little or nothing to send a letter to the insurance company hoping to get anything from which they can siphon their 33-1/3%. But that costs all of the rest of us to pay inflated insurance premiums.

When people talk about "tort reform," it's situations like those in this thread that give rise to the discussion. One of the only seemingly valid claims is the one in which the vehicle damage was $8000. I would expect significant injuries to have resulted. But in the initial post, in which vehicle damage was $500-$600, I can hardly believe there was an injury. Some kid "keys" my car door, and I need a $600 paint job, not $4,000 of chiropractic treatments.

Although I have personal friends who are chiropractors, it has never failed to amaze me how a chiropractor can find with a $50 x-ray and their finger tips what a multimillion dollar MRI machine cannot when it comes to "soft tissue injuries." And how unscrupulous lawyers even manage to get a few thousand dollars out of an insurer as a result.

If there is an offer on the table of a couple of thousand dollars, Modelkrb, take it before it evaporates, because it's likely far more than you are even "entitled" to receive.

Posted: Mon Mar 22, 2010 11:49 am Post Subject:

i was a passenger in dec 08 no fault insur paid bills 6 month cut me off after ime , i was being treated for sacal dysfuntion and soft injuries leading to fibromyalga, and brain injury i have a history of minor pains from work injury in 02 also i have a felony and a hitory of cocaine but i've was clean 4 years prior instead i turn my life around got in college stayed on dean's list and 1 year before grad i was in this accident stop my life.. do i stay a chance with the no fault insurance company?

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