Not every victim of a car accident will need attendant care. Hence, insurers cover the cost of care benefits for victims with a serious injury. Insurers often combine the care benefits with those meant for a rehabilitation patient. In addition, insurance companies sometimes issue a figure for the maximum amount that any policy holder can receive, in terms of money for attendant care.
Frequently, this particular benefit cannot be granted for longer than a designated period of time. That designated period typically extends for 5 years. Still, an exception is made if the cared-for victim is a child. In that case the benefit will be delivered on schedule, until the victim reaches the age of 18.
Which victims get a payment that can be used to pay an attendant?
The insurance company decides who deserves reasonable and necessary services. In other words, such a company can deny a policy-holder’s claim. Yet, even when a claim has been approved, an adjuster will not start making the payments until all of the specifics have been identified and have been handled properly.The adjuster will want to know for how long a period each day the victim will need an attendant’s care. What will be the nature of that care? Will it entail doing any of the following services?
• Meal preparation, clean-up and feeding
• Grooming; dressing
• Going to bathroom
• Accompany to appointments
Insurers only cover incurred expenses. In other words, the victim must be paying someone for services when the insurance company gets the victim’s claim. If a relative has been providing the services free-of-charge, the insurance company will not agree to cover non-existing costs.
That may seem unfair, but victims must understand that their requested help should be for something that is obviously necessary. If someone else has stepped forward in the past, and has provided a needed service, then the presence of an attendant does not seem necessary. The one service for which an exception might be made could be any one that fell under this particular heading: supervision. With a lawyer’s help, a victim’s family could make the case that the victim needs to be supervised, so that the volunteer worker does not get placed in a risky situation. A victim’s request might be for performance of a task that could put the volunteer worker at risk.
Mention of that one exception underscores the victim’s need for legal counsel. In other words, smart victims arrange to hire a lawyer. An injury lawyer in Lloydminster can work to show the reasonable nature of a victim’s request. They can help the victim to handle the tasks associated with any possible appeal. The injury lawyer can do a better job of learning the reason for the unexpected denial. Once the reason has been identified, it should be easier to prepare for any scheduled repeat hearing.