#5 What should I tell my patients when the Personal Injury Protection (PIP) adjuster keeps calling them for updates?

QUESTION: What should I tell my patient when the Personal Injury Protection (PIP) adjuster keeps calling them, asking for updates?

ANSWER: Your patient has a legal obligation to cooperate with the PIP carrier. That means they have to 1) sign a medical records release authorization — which they should NOT do until they’re done with their treatment, and 2) throughout the time they’re receiving treatment, they’re required to give updates about their recovery status when the PIP adjuster asks. One of the biggest mistakes your patient can make when giving a treatment update to the PIP adjuster is giving too much information. The critically important thing they need to understand is that less is more when talking to the adjuster. Advising your patient to keep their answers short and succinct will not only protect their PIP benefits, it will also protect their personal injury claim.

What should I tell my patient when the personal injury protection, PIP, adjuster keeps calling them, asking for updates?

Your patient has a legal obligation to cooperate with the PIP carrier. That means they have to 1) sign a medical records release authorization — which they should not do until they’re completely done with their treatment, and 2) throughout the time they’re receiving treatment for their injuries, they are required to give updates about their recovery status when the PIP adjuster asks.

One of the biggest mistakes your patient can make when giving a treatment update to the PIP adjuster is giving too much information. The critically important thing they need to understand is that less is more when talking to the at-fault insurance company adjuster.

Advising your patient to keep their answers short and simple will not only protect their PIP benefits, it will also protect their personal injury claim.

When the PIP adjuster contacts your patient, the purpose of their call is actually to find reasons why they can justify stopping your patient’s PIP benefits. Your patient providing short and succinct answers to the adjuster’s questions and stating that the treatment they’re receiving is helping in their recovery will help maintain their PIP coverage and prevent the insurance company from stopping paying for your patient’s medical treatment.

If your patient is not improving, the adjuster is going to require that your patient be sent to an Independent Medical Exam (IME) — which in 95% of the cases will result in your patient’s medical expenses no longer being covered by their PIP policy.

You can support your patient in keeping their PIP benefit so they can get the treatment they need to help them fully recover from their car accident by advising them to communicate to the PIP adjuster that they are getting better and to provide a percentage range of their improvement — ‘60% – 65% percent better’ as an example.

Explaining to your patient so that they understand this is what the adjuster is looking for will help them respond to their questions in a way that won’t jeopardize their PIP benefits and will reduce the likelihood they’ll be sent to an IME.

We’re here to be a bridge of support for you and your patients.

We have developed a robust library of information for your patients who have been injured in an accident, which can be found in the INJURED? START HERE portal on our website.

There are 40 topic-focused articles, with accompanying videos, organized into the four categories that include the personal injury claim-related questions we’re asked most often, which include:

• Top 10 Personal Injury Claim Mistakes to Avoid
• What You Need to Know About Your Claim
• How Are My Medical Bills & Wage Loss Paid
• How to Prepare for Your Independent Medical Exam

Each article provides advice and guidelines to help your patients navigate each phase of the personal injury claims process. Whether we represent your patient or not, we are passionate about them knowing how to protect their rights, get the medical care they need, and avoid the mistakes that can harm their personal injury claim.

Each article provides advice and guidelines to help your patients navigate each phase of the personal injury claims process. Whether we represent your patient or not, we are passionate about them knowing how to protect their rights, get the medical care they need, and avoid the mistakes that can harm their personal injury claim.

Additionally, if it would be helpful to have the information we feature on our website available in your office to pass along to your patients, we’ve developed brochures for each of the four article series -- in both English and Spanish that we’re happy to send to your office. Please complete the form below and we’ll get them out to you promptly.