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What is the role of medical expertise, the obligations of the insurer and the missions of the compensation expert? What accident victims need to know?Victims of accidents (traffic, medical, domestic, offenses, etc.) are very often helpless in the face of a complex compensation system. The accident lawyer is the best option there now.

Definition

Expertise is an act performed by a technician, intended to measure the consequences of damage suffered by a person by performing several medico-legal operations. Determining the extent of the damage in this context will make it possible to quantify the compensation for the various damages suffered by the victim: These operations consist of:

• An analysis of the facts to shed light on the grievances of the victim and his entourage, the various parties involved and their counsel;
• A clinical examination intended to assess the physical, psychological or physiological consequences of the damage;
• An analysis of medical documents and other documents necessary to assess the damage.

The insurer's obligations

As part of a procedure aimed at guaranteeing bodily injury with medical examination of the victim, the insurer must comply with a certain number of legal rules.As soon as the insurer becomes aware of the damage:

• He must ensure that the victim is informed of his right to obtain a copy, if applicable, of the police or gendarmerie investigation report and remind him that he has the possibility of being assisted by a lawyer and doctor;
• He must inform the victim of the recourse of third-party payers organizations paying social security benefits against him up to the amount received from the insurer as compensation;
• He must inform the victim, fifteen days before the scheduled date of the medical examination, of the identity and titles of the doctor responsible for the expertise, of the object, date and place of the examination as well as the name of the insurer on whose behalf it is carried out;
• He must inform the victim of the possibility of contesting the choice of the appointed medical expert. This information is necessary insofar as the expert is unilaterally appointed by the insurer;
• He must inform the victim of the possibility of being assisted by a medical adviser of his choice.

With regard to victims of road accidents, the insurer must also meet other legal obligations.

The victim can refuse to attend the medical examination if the information has not been communicated to him within the legal deadline of 15 days before the scheduled medical examination. He can also refuse to be examined by the doctor chosen by the insurer, who in this case has the obligation to suggest another doctor or to request, from the competent court, the appointment of an expert doctor.

The amicable nature of medical expertise

The amicable expertise assumes that the expert has been chosen and that his mission has been determined by mutual agreement between the parties.As a general rule, unlike forensic expertise where the expert is appointed by a judge, on a list of sworn experts and who performs his mission under the authority of a magistrate responsible for the control of expert operations, the expertise amicable is carried out at the initiative of the company of the author of the accident and the lawyer of the victim. It consists of having contradictory medical examination carried out in the presence of medical adviser.

The role of the medical adviser

The presence of a medical consultant of choice by the victims’ side is essential insofar as the expert responsible for examining the victim is appointed by the insurer. However, the examination of the victim presupposes the total independence of the expert. The victim's medical adviser can ensure that this independence is respected.