What Is an Open Medical Agreement?

Insurance companies often include what’s called an “open medical agreement” in their settlement release forms. An open medical agreement is essentially a promise by the insurance company to pay “reasonable and necessary” related medical expenses within a specific period of time and up to a maximum dollar value.

While this may initially sound like a reasonable deal to most people, the truth is that you’re always better off not agreeing to anything (verbally or signed) with the insurance company until after you’ve finished treatment—and for good reason.

If an insurance adjuster tries to convince you to sign a release before you’ve completely healed from your injuries, they’re doing so in their best interests—not yours. Many victims innocently sign such a release, only to realize later that the open medical agreement doesn’t even come close to the cost of their medical bills, medication, and physical therapy.

Even if your medical expenses do not reach the maximum value set in the agreement, by the time the insurance company finally sends out a check, the amount they issue is completely at their discretion. If they arbitrarily decide to say that you were 30% responsible for your injury, they may issue you a check for thousands less than you actually owe in medical bills. Unfortunately at this point, it’s probably too late for an attorney to help… and the insurance company knows this.

• How Much Is Pain and Suffering Worth?
• What Is a Letter of Protection (LOP)?
• How Much Is The Typical Personal Injury Case Worth?