You should know that the medical expenses originated by a traffic accident are not covered by the Social Security, but they should be paid by the insurance companies, and for that purpose they will give you a form with the data of your company and the Social Security will claim the cost of the medical assistance provided.
You must also know that the patient has the right to free choice of healthcare center. This centers can be arranged with insurance companies or even not at all. The only problem, if you choose a non-concerted center, is that you will have to pay the cost of the medical or rehabilitative treatment (unless you have private health insurance and go to your health insurance clinics) and then ask the insurance company to pay it, like the other expenses directly derived from the accident.
In the cities where there are several care centers arranged with the companies, it is always interesting to know how they work, and for this it is important to have a lawyer specialized in accidents, because we know those centers that tend to discharge the patient prematurely, or to give less diagnostic test to save the companies physiotherapy sessions, and therefore are preferred by them to save costs and that in the first place will be offered by the insurers, but do not conform and freely choose the most convenient health center or rehabilitation for treatment. We can advise you on all of the above. Keep in mind that if they give you fewer physical therapy sessions than necessary, or do not perform the necessary diagnostic tests to detect any injury, for example, in addition to the fact that it may not heal properly, the compensation will be lower And in any case, the medical, pharmaceutical and hospital assistance expenses will be paid in the necessary amount until the healing or consolidation of the sequels, as long as the expense is duly justified according to the nature of the assistance provided, but it is not usual for the company to claim that we have been subjected to diagnostic tests or non-advised treatments with the injuries we have suffered. Thus, the insurance company will pay all the expenses of medical assistance, hospital, diagnostic tests, medicines, orthopedic prosthesis, ambulance transfers, trips to clinical centers, home assistance, crutch or wheelchair rental, rehabilitation and physiotherapy, etc.
There are some cases in which the insurance company may refuse to take care of the health expenses of a traffic accident, but if the responsibility in the production of the accident is clear, it is not the usual. Among these exceptions we find cases such as: the vehicle is not insured with that insurance company, the accident was due to a driving under the influence of alcohol, it is not a traffic event, or it is proven that there was fraud, or the evident lack of causal relationship between the injuries suffered in the accident and the damages that cause the billed assistance.
Another usual case that we can find when we go to the agreed center that the insurance company sends us to is that they tell us in that center that we can no longer go to the physical therapy sessions because they have reached the limit of sessions that the company pays for and that the insurance company does not authorize an extension, even though the injuries have not yet healed or stabilized, and in this case (if they don’t have private insurance) the only thing we can do is either pay them directly from our own pocket, in that or another center, and then claim their amount or go to the Social Security, with the problems caused by the lack of means and the almost impossibility that they can give us the rehabilitation sessions we need.
If you have suffered a traffic accident contact our office, we are lawyers specialized in accidents. We can advise you free of charge by contacting our office on 958 63 19 38 or by sending an e-mail to info@fcabogados.com stating your case. We will answer you without any cost as soon as possible.