Frosted windshields and treacherous road conditions are more frequent this time of year, as are motor vehicle accidents (MVA) related to those conditions. However, despite paying regular car insurance fees, many of us don't know the details of our plans well because we haven't had to "experience" the fine print. I am not an expert on all of the details, but the following information is provided from my experience and perspective as a health care practitioner who has treated the physical injuries sustained in MVAs.
Making a Claim
With your car insurance, you have Accident Benefits which are available should you be injured in an MVA. This is funding for assessment(s) and treatment(s) if they are required to help you recover from your injuries. It’s important to note that it is not uncommon to have a delay in experiencing symptoms following an MVA. That is often the nature of soft tissue injuries as the healing begins to occur.
First, you need to contact your insurance company to make a formal claim. They will assign you a claim number and send paperwork to be completed. They might even suggest a clinic where you can receive an assessment and treatment. This is a recommendation only, not a must, so you can visit the health care practitioner of your choice, particularly if you already have someone you currently see or have seen in the past.
It's important to note that not all health care practitioners can take lead on your claim. A chiropractor, physiotherapist, physician, occupational therapist, nurse practitioner, and dentist all can. Notable omissions include a registered massage therapist, naturopath, or osteopath. Those disciplines may be included in a treatment plan which is something to be discussed with the lead practitioner.
At minimum, your injury will be classified as a "minor injury", which means you sustained a sprain, strain, whiplash associated disorder (WAD), contusion, abrasion, laceration or subluxation and any clinically associated sequelae. This entitles you to $3500 worth of treatment, in addition to any extended health benefits you have available with your practitioner of choice, which must be used first before the car insurance company begins to cover the fees. You initially get access to 12 weeks worth of treatment, at the end of which more care can be requested if needed, all within the $3500 limit. The majority of claims fall into this category.
If your injury is not minor, such as a full muscle/tendon tear, fracture, dislocation, whiplash involving a neurological injury, or you have a pre-existing medical condition that will prevent maximal recovery from a minor injury within the $3500 limit, you will likely have access to funding in excess of $3500 to pay for your required therapies.
The goal of treatment is "functional restoration", which aims to reduce and manage pain as well as maintain and/or resume normal activities at home and work. It is best to remain at work, with modified duties and/or hours if necessary, as research has shown this reduces the risk of developing chronic pain and leads to better long term outcomes with respect to successfully returning to pre accident work activities.
The entire process can be fairly stressful and frustrating, largely due to the paperwork involved. With that in mind, respect the road conditions, give yourself plenty of room and time to stop, and stay safe on the wintery roads!
This article is for general information purposes only and is not to be taken as professional medical advice. Dr. Lusk is a chiropractor in New Hamburg.