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Insurance Companies Usually Don’t Cover Expensive Rehab for Brain Injuries

The tragedy that befell U.S. Representative Gabriel Giffords and her family is regretful. Thankfully, she is responding to the intensive rehabilitation program she has been placed on and seems to be recovering. Good for her! She was exercising one of the most sacred freedoms we enjoy in this country and deserves all the care we can give her. Sadly, not every American that suffers a brain injury gets the kind of rehabilitation benefits she is getting. She is among the lucky few that will get the benefit of a full rehabilitation program because as a federal employee injured on the job, the Federal Employee’s Compensation Act covers her rehab for as long as needed.

However, according to a USA Today article, insurance companies rarely cover the kind of rehabilitation necessary to recover from brain injuries similar to those recently suffered by Mrs. Giffords.

Scott Hamilton, a motorcycle rider that was involved in a accident a few years ago in San Francisco was another “lucky” case. However, coverage for his full rehabilitation was not automatic…He was covered only after his wife got a VIP family friend to ask another VIP he knew at Scott’s insurance company to look into the case. Good for her, their VIP family friend and specially, for Scott.

Unfortunately, the vast majority of Americans that suffer a traumatic brain injury will not be federal employees covered by the Federal Employee’s Compensation Act or have a VIP friend that can intercede with a VIP at the insurance company (if they’re lucky enough to have medical insurance)…

Unbelievable Numbers

1.7 million Americans suffer traumatic brain injuries each year. These are usually the result of motor vehicle accidents, strokes, assaults, falls, gunshot wounds and sports activities. The total cost of rehabilitation per patient is on average $162,194.00 for initial brain trauma care and $59,862.00 for two weeks of inpatient rehab. This is about as much as is covered by insurance and other medical programs like Medicare and Medicaid, when anything is covered. However, if successful, the medical procedures covered to this point only assure the patient’s survival. If we want the patient to have a chance at enjoying any kind of meaningful recovery, the necessary rehabilitation can last for weeks, months or years at a cost between $600.00 and $1,000.00 a day…And that is not covered by most insurance programs.

An Attorney May Be Able To Help

Until insurance carriers are forced to cover full rehabilitation (as it is in Texas, the only state with such legal requirement), the only hope for any American that suffers a brain injury in a motor vehicle accident, as a result of a fall or even during an assault, may rest with an attorney with experience handling personal injury cases. The attorney can help recover the funds necessary to provide the injured person with the medical care and, as importantly, with the rehabilitation he or she needs from the insurance company of the person that negligently caused the accident.

For example, if his injured client had UM/UIM coverage, the lawyer may be able to pursue a case against (and recover the necessary funds from) his own client’s insurance carrier.

On the other hand, if his client was injured as a result of a slip or trip and fall accident in a supermarket, a mall, or any other place of business, the attorney can file a claim against the proprietors of the premises that may lead to the recovery of the funds needed for rehabilitation.

Similarly, if the brain injury resulted from an assault at a bar, at the parking lot of a mall or other place of business, the attorney can initiate the appropriate action against the owners of the place (and their insurance company) for negligent security.

Moreover, should the injury result from an collision with a truck or a tractor trailer, a personal injury attorney can demand that the trucking company and/or it’s insurance company provide funds sufficient for the rehabilitation.

Finally, if a boating or jet ski accident were the cause of the brain injury, a personal injury attorney can help you recover the funds necessary for rehabilitation not from the boat owner (whom you may hesitate to sue due to close friend or family ties), but from his or her marine insurance carrier.

If you or a loved one have suffered a brain injury in an accident, you should immediately contact a law firm experienced in handling these cases. The Miami Dade County Personal Injury Law Offices of Greenberg, Stone & Urbano has throughout the years represented many clients involved in traffic fatalities, traumatic brain injuries and serious personal injuries. Visit our website to learn more about our firm and contact us today for a free consultation.

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