Accident at Work

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I had an accident at work early 2020 which was not my fault. The accident cause injuries to my face & body and teeth. My NHS dentist did fantastic work in fixing my teeth, although they made it clear I would need regular routine/hygienist appointments & eventually re-root canal/implants. The insurers will not pay any compensation until an independent dentist can offer their opinion on the injuries I sustained and the long term prognosis. They say because of COVID it’s really hard to find a dentist due to the demands placed on the NHS & can offer no date as to when this may be resolved. Whilst I totally appreciate the unprecedented demands placed on the NHS, I can’t help wondering if the insurers should accept my dentists records & contact them to clarify/verify - they are an NHS dentist and everything they told me about the likely prognosis is generic information on the governments website. It could be months/years! I wonder if anyone else has experienced this? Is it reasonable for them to offer another solution which would then enable me to continue with my dental care? Like I say I totally understand the demands on the NHS I just think there has to be another way? It’s been nearly two years since the accident.

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  • powerful_Rogue
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    Angie07 said:
    I had an accident at work early 2020 which was not my fault. The accident cause injuries to my face & body and teeth. My NHS dentist did fantastic work in fixing my teeth, although they made it clear I would need regular routine/hygienist appointments & eventually re-root canal/implants. The insurers will not pay any compensation until an independent dentist can offer their opinion on the injuries I sustained and the long term prognosis. They say because of COVID it’s really hard to find a dentist due to the demands placed on the NHS & can offer no date as to when this may be resolved. Whilst I totally appreciate the unprecedented demands placed on the NHS, I can’t help wondering if the insurers should accept my dentists records & contact them to clarify/verify - they are an NHS dentist and everything they told me about the likely prognosis is generic information on the governments website. It could be months/years! I wonder if anyone else has experienced this? Is it reasonable for them to offer another solution which would then enable me to continue with my dental care? Like I say I totally understand the demands on the NHS I just think there has to be another way? It’s been nearly two years since the accident.

    You would be better posting in the below section

  • Sandtree
    Sandtree Posts: 10,628 Forumite
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    Do you have legal representation in your claim or claiming directly? Normally it'd be your solicitors wanting to instruct the medical report.

    Your medical records will be very factual, you presented with a broken tooth and they fixed it, medical reports for accident claims go beyond that in multiple directions... they will opine on if the injury is consistent with the accident circumstances, any underlying aspects that may have impacted the injury, how the injury has impacted you beyond the purely physical damage etc. Needless to say that whilst these are "independent" solicitors (and insurers) prefer to use the ones that produce favourable reports.

    For a low value claim then basic records from GPs etc can be used in the case of direct claimants but a medical report is generally preferred in higher value claims (and almost universally preferred if using a solicitor)
  • olgadapolga
    olgadapolga Posts: 2,277 Forumite
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    Angie07 said:
    I had an accident at work early 2020 which was not my fault. The accident cause injuries to my face & body and teeth. My NHS dentist did fantastic work in fixing my teeth, although they made it clear I would need regular routine/hygienist appointments & eventually re-root canal/implants. The insurers will not pay any compensation until an independent dentist can offer their opinion on the injuries I sustained and the long term prognosis. They say because of COVID it’s really hard to find a dentist due to the demands placed on the NHS & can offer no date as to when this may be resolved. Whilst I totally appreciate the unprecedented demands placed on the NHS, I can’t help wondering if the insurers should accept my dentists records & contact them to clarify/verify - they are an NHS dentist and everything they told me about the likely prognosis is generic information on the governments website. It could be months/years! I wonder if anyone else has experienced this? Is it reasonable for them to offer another solution which would then enable me to continue with my dental care? Like I say I totally understand the demands on the NHS I just think there has to be another way? It’s been nearly two years since the accident.
    Who is looking after your claim? Are you dealing directly with your employer's insurance company? Or going through a third party? 

    If the insurance company directly, then they should be seeking a private dentist, not using the NHS!

    When I had an accident that involved a personal injury claim, all of the doctors etc., that I saw were under their private practice, not NHS.
  • Angie07
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    The company I work for have a claims department & they are liaising with their insurers. I’m assuming that when my Employers claims dept keep telling me their hands are tied because of demands on the NHS, private dentists are somehow supporting the NHS? It’s all very vague! After my accident I was taken to hospital & then transferred to a dental hospital (NHS) I then carried on receiving treatment from my own NHS dentist (although this was difficult as it was early COVID) 
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