Key points
- The medical assessment is an essential step in any personal injury compensation process.
- It makes it possible to evaluate the victim’s injuries, after-effects, and future needs.
- The expert report directly influences the amount of compensation.
- An insufficiently prepared assessment can lead to an underestimation of the losses suffered.
- A counter-assessment or court-appointed medical assessment may be considered in the event of disagreement.
- Support from a lawyer and an independent medical expert helps effectively defend the victim’s interests.
When a victim initiates a compensation process following an accident, the medical assessment is a decisive step.
Indeed, the medical assessment makes it possible to accurately evaluate injuries, after-effects, and future needs. It directly determines the amount of personal injury compensation.
Attorney Marilyne Letessier, a personal injury lawyer in Nice, assists victims in effectively preparing for this essential stage and in obtaining fair and full compensation.
What is a medical assessment?
A medical assessment is an evaluation carried out by a medical expert.
Its purpose is to:
- analyze the injuries
- determine the after-effects
- assess future needs
- determine the heads of loss
It therefore forms the basis of any compensation following a road traffic accident, a medical accident, or a life accident.
How does a medical assessment take place?
The medical assessment follows several steps.
First, the medical expert examines the victim and reviews their medical records.
Then, they ask questions about pain, daily difficulties, and the impact on personal and professional life.
Finally, an expert report is drafted.
This report is essential, as it will serve as the basis for discussions with insurers or before a court.
Why is the medical assessment so important?
The medical assessment directly determines the amount of compensation.
In practice, a poor assessment can lead to:
- an underestimation of the after-effects
- the omission of certain losses
- insufficient compensation
Conversely, a well-prepared assessment makes it possible to obtain compensation that reflects the true extent of the damage.
Can a medical assessment be challenged?
Yes, a medical assessment can be challenged.
Indeed, if the report is incomplete or unfavorable, several options are available:
- request a second opinion (counter-assessment)
- request a court-appointed medical assessment
- submit written observations
In this context, support from a lawyer helps to effectively defend the victim’s interests.
Why should you be supported during a medical assessment?
When facing medical experts appointed by insurers, victims may find themselves at a disadvantage.
This is why support makes it possible to:
- prepare the medical file
- anticipate the questions asked
- avoid detrimental mistakes
- present all heads of loss
Attorney Marilyne Letessier can assist the victim at this stage and work with independent medical experts to ensure a comprehensive and objective assessment.
Medical assessment and compensation: a direct link
The medical assessment determines every stage of personal injury compensation.
Thus, it makes it possible to determine:
- the duration of incapacity
- the rate of functional impairment
- the need for assistance
- professional losses
Therefore, a thorough assessment is essential to obtain appropriate compensation.
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Legal References and Useful Information
To better understand the role of the medical assessment in personal injury compensation, you may consult the following resources:
- Article 16-3 of the French Civil Code — sets out the principles governing medical procedures and the integrity of the human body.
- Article 9 of the French Code of Civil Procedure — governs the burden of proof and highlights the importance of medical evidence in compensation proceedings.
- Service-public.fr — information on medical assessments and procedures available to victims.
- French Association for the Support of Accident Victims (AFAVA) — information and resources for victims facing a medical assessment.
- Dintilhac Nomenclature — the reference framework used to identify and assess the various heads of compensable loss.
Frequently asked questions about medical assessments
What is the purpose of a medical assessment after an accident?
The medical assessment is used to evaluate the physical consequences of the accident. It examines the injuries sustained, the medical treatment provided, medical stabilization, permanent after-effects, and the victim’s needs in order to determine the various compensable heads of loss.
Can you be accompanied during a medical assessment?
Yes. Victims may be accompanied by an independent medical expert and a lawyer. Such support helps them prepare for the medical assessment, present the relevant documents, explain the difficulties they have experienced, and challenge the medical conclusions where necessary.
What documents should be prepared before a medical assessment?
It is important to gather medical certificates, hospital discharge reports, imaging results, prescriptions, sick leave certificates, proof of medical expenses, professional documents, and any other evidence demonstrating the concrete impact of the accident on the victim’s daily life.
What is medical stabilization?
Medical stabilization is the point at which the victim’s medical condition is considered stable. It does not necessarily mean a full recovery, but it allows permanent after-effects to be assessed and permanent losses to be quantified.
What should you do if the conclusions of the medical assessment are inadequate?
If the conclusions do not accurately reflect the victim’s situation, they may need to be challenged. Depending on the circumstances of the case, an adversarial discussion, a further medical assessment, or court proceedings may be considered in order to obtain a more comprehensive evaluation of the losses suffered.