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Why do insurers automatically suspect fraud in whiplash cases?

On Behalf of | Oct 20, 2017 | Injuries

Not all car accidents are violent rollover crashes that result in fatalities. In most cases, car accidents are minor accidents, frequently referred to as fender benders, that typically result in non life-threatening injuries. In fact, one of the most common injuries associated with minor rear-end collisions is whiplash.

Herein lies the problem, however, for many accident victims. For many insurers across the nation, including here in Florida, using the term whiplash on an injury claim can spell disaster for recovering damages. That’s because many insurers automatically assume fraud or minimal injuries when they see this term, even if the victim has been diagnosed with this injury by a medical doctor.

What is whiplash?

According to physicians (or for those of you who rely solely on the internet for information, WebMD and other medical websites), whiplash is defined as a neck strain that occurs when the sudden deceleration or acceleration of the human body results in the jerking forward and backward of the neck. This sudden force can cause muscles and tendons to tear in the neck, causing immense pain for those suffering from this injury.

What are the symptoms of whiplash?

The symptoms associated with whiplash are perhaps the main reason why so many insurers suspect fraud. As some insurers may argue, the following symptoms that doctors look for could be faked or exaggerated and have been by people in the past:

  1. Pain and stiffness in the neck
  2. Limited range of motion
  3. Soreness in neck and shoulders
  4. Headaches that radiate from the neck and shoulders

Judging an accident victim based on the prior misdeeds of others isn’t fair, however, and only leaves a victim with medical costs that should be covered but have been denied, a fact that only further bolsters the need for a good attorney when the time comes.

Why don’t insurers trust a doctor’s diagnosis?

As we said earlier, insurers have been known to deny whiplash injury claims even when a victim has a valid diagnosis from a doctor. You may be asking, “Why wouldn’t an insurer trust the doctor’s medical opinion?” The answer lies in the suspicion that the doctor could be lying, exaggerating the injury, or mistakenly thought the victim had injuries when they didn’t.

While there are tests doctors can run in whiplash cases, most rely on the honesty of the patient and a keen eye for when someone is telling the truth. In other words, a whiplash diagnosis requires insurers to trust a claimant’s word and a doctor’s judgment — trust insurers are generally hesitant to give.