Understanding Aggravated Injuries 

It is essential to carefully handle situations where the lead mentions an aggravated injury—an injury resulting from the worsening of a pre-existing condition due to a subsequent incident, such as a car accident. Since we do not process claims for aggravated injuries, you must Identifying Aggravated Injuries

Aggravated injuries may not always be explicitly mentioned at the start of a call. Instead, leads may use certain phrases or provide information later in the conversation that indicates an aggravated injury. Be alert for statements like:

• “My back started hurting again.”
• “This accident made my previous injury worse.”
• “I’ve had this pain before, but now it’s gotten worse.”

Such language indicates that the injury may be aggravated, and further clarification is needed.

How to Confirm the Nature of Injuries

If a lead mentions multiple injuries alongside language that suggests one or more may be aggravated, it is crucial to confirm which injury is aggravated and which is not.

Example Scenario:

•Lead says: “I have back and neck pain. My back pain has gotten worse after the accident.”

•Agent’s Response:

1.“Thank you for sharing. Just to confirm, is the neck pain a new injury, or has it also worsened from a previous condition?”

2.“So, your back pain is aggravated, but your neck pain is a new injury. Is that correct?”

This ensures that the injury selected is not aggravated and aligns with our policy of not processing claims for aggravated injuries.

Key Steps for Handling Aggravated Injury Mentions

1.Listen for Clues

Pay attention to specific words like “again,” “worsened,” or references to prior injuries. These are clear indicators of an aggravated injury.

2.Ask Specific Questions

When aggravated injuries are mentioned alongside other injuries, confirm the status of each one individually.

•Example Questions:

• “Can you clarify if this is a new injury or an existing one that has worsened?”

• “You mentioned that your back pain worsened—can you confirm if your other injuries are new or related to a prior condition?”

3.Ask for Other Injuries

If an injury is confirmed as aggravated, ask the lead if they experienced any other injuries from the incident that were not aggravated. 

For example:

Agent’s Response: “I understand your back pain is aggravated. Did you experience any new injuries as a result of this accident?”

This ensures that all potential injuries are identified and any new injuries are properly considered for the claim.

.Communicate Policy Clearly

If an injury is confirmed as aggravated and the lead did not get any other injuries from that accident, inform the lead politely and professionally:

•“Based on what you’ve shared, this injury appears to be aggravated from a prior condition. Unfortunately, we cannot process claims for aggravated injuries.”

Conclusion

When a lead mentions an aggravated injury, it is crucial to confirm the nature of each injury discussed. Clear communication and attention to detail are key to providing a professional and efficient call experience.