Case Management, Legal Support, Medical Consultation

Case Managers Should Be Patient Advocates

 June 29, 2017

By  Deborah L Weiner Katz, OTR/L, CCM, CLCP

The medical experts employed by AdvancedRM are patient advocates. If the patient should happen to be the victim of an auto accident, the advocate is an expert witness to the medical needs and expenses generated by serious trauma to the spinal cord, brain, or other serious personal injuries.

No case manager hired by an insurance company is going to have the patient’s best interest in mind. That is why accident victims in Michigan are protected by the state’s No Fault law. Victims are free to hire their own case manager while their insurance company is obligated to pay for it. A case manager hired by an insurance company will only be concerned with keeping costs down, after all. The law makes it quite clear that insurance companies are required to pay for victims’ necessary care, recovery and rehabilitation.

The term “No Fault” emphasizes that fault should not play a factor when insurance companies are paying benefits to both parties in a car accident, regardless of who was at fault.

There are two different types of “No Fault” cases:

First-party Step one in a first-party case is to immediately file a no-fault application for benefits with the applicable insurance carrier. Do this within one year from the date of the accident or risk losing your benefits all together. This type of case is between the victim and his or her insurance company for no-fault benefits, or personal injury protection (PIP) benefits. Naturally, an insurance carrier may advise you to use their case manager. You must resist and hire your own. Just think about what is potentially at stake. There are the medical expenses related to the accident, loss of wages, and payment for mileage to and from medical appointments. That’s just for starters.

Third-party The time limit on claiming damages in third-party cases is three years, longer if a minor is involved. This time, the case is actually between the accident victim and the driver responsible for the accident. The driver who is at fault winds up being sued for pain and suffering damages, not to mention excess economic benefits. The damages are still paid by an insurance company, the one covering the negligent driver. Once again, the paying party will want to assign their own case manager to assess the situation. Once more, you must resist and hire your own.

Michigan’s No-Fault law even applies to accidents with only one car. Hit a telephone pole or a deer and you are still entitled to insurance benefits, regardless of fault. You still retain the right to hire your own case manager.

AdvancedRM has been managing catastrophic accident cases in Michigan for over thirty years.  We help patients with serious injuries navigate through the often daunting medical system. We understand the No Fault system and the complexities that arise from serious injuries. We are familiar with the perspective of the injured party, family members, insurance carriers, and attorneys involved in the litigation process. Our case managers are ready to share their expertise in order to make the recovery process easier for you. Call us for a free consultation.

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