Medical advisers disagree: define the difference before choosing the next step

Identify the actual difference before requesting more assessment

Write out the disputed sentence from each opinion. Does it concern diagnosis, symptoms over time, limitations, prognosis or the link to the accident? One adviser may be provisional and the other definitive, or they may answer different questions. Saying only that the doctors disagree then fails to identify what additional information is needed. Ask for a short explanation in understandable language.

The medical assessment guide describes the roles. Your treating professional provides care, whereas a medical adviser assesses the claim medically. Your own adviser must also work carefully and objectively within their expertise; their role is not to defend every desired legal conclusion. A differing opinion alone does not prove bias. Ask about method and source rather than merely which party instructed them.

Compare questions, information and assessment timing

Ask which medical records each opinion used and the date or recovery period assessed. A recent treatment letter may explain a changed conclusion without making an earlier assessment careless. Check whether both advisers know the same history and work description. Missing information often first calls for a targeted addition, not a contest between professional titles.

Use the table to compare equivalent points. Request correction with a source for a factual error and reasoned explanation for an expert disagreement. The report guide helps distinguish them. Share relevant medical information through an appropriate channel and for a clear purpose. Equal information does not mean complete medical files should be sent without limits to every claims handler.

Separate medical connection from legal significance

An adviser can assess what medical information shows about causes and limitations. Which loss is legally attributable to an accident is another stage. A lack of medically observable abnormalities is not, by itself, a complete legal answer to every complaint or loss item. Clarify which conclusion is medical and which legal inference the insurer or representative subsequently draws.

For pre-existing symptoms, the disagreement may concern aggravation, new limitations or expectations without the accident. Ask exactly what is disputed. An earlier condition does not automatically explain all present loss. Conversely, an accident does not make every later development an accident consequence. Identify relevant facts and uncertainties without assigning your own medical percentage to the total.

Arrange targeted discussion between advisers on the unresolved issue

The GBL Medical Section describes transparent advice and discussion between advisers. Opinions relied on by the parties are exchanged; this is not the same as demanding unrestricted access to all confidential internal thinking. Request a question list identifying the difference, source and answer needed. Establish who arranges contact and who reports in writing afterwards.

Under that good practice, discussion does not automatically bind advisers or their clients. A jointly discussed medical point is therefore not an automatic settlement of all damages. Ask what has been clarified, where agreement exists and which question remains open. Keep an understandable record. The code provides no universal statutory deadline; agree practical feedback timing without presenting it as an expiry period.

Only then choose additional information or independent examination

If specialist knowledge is still needed or disagreement persists, independent examination may be considered. De Letselschade Raad favours one jointly selected expert and set of questions where possible. Ask which remaining problem the examination resolves and why an additional letter is insufficient. Another examination can involve time, expense and personal burden; more assessments do not automatically create greater clarity.

Discuss expertise, assignment, records, costs and participation beforehand. A unilateral second opinion does not automatically carry the same significance as joint or court-ordered examination. Have the prior agreements and possible legal value of the result explained. Do not frame the question so it already assumes the desired answer. The medical issue must remain within the specialism; legal and financial evaluations follow separately.

Retain control of information and rights in further assessment

Ask what information is needed, who receives it and what consent is appropriate. Do not block everything out of frustration or circulate the entire file without purpose. Access, factual correction and possible blocking depend on the assessment framework. KNMG identifies exceptions, including certain assessments within ongoing employment, private insurance and social legislation. Have your situation checked.

Replacing an unfavourable professional opinion is not a simple factual correction. Blocking can also affect the ability to prove the claim. Before deciding, ask about the actual procedure and consequences. A medical examination in a liability case must not be equated without explanation with every assessment under your own insurance. Keep consent, assignment and response arrangements separately identifiable.

Do not let the remainder of the file silently stop progressing

Ask which loss items are sufficiently established and which depend on the unresolved medical issue. Disagreement about prognosis need not replace every discussion of evidenced expenses already incurred; equally, urgent financial pressure does not automatically make all disputed damages payable. Request a substantive position for each item so medical disagreement does not become an unclear label covering the whole file.

Agree progress reporting and deadline responsibility while discussion or assessment continues. A doctor’s appointment does not automatically protect legal deadlines. For a persistent legal obstacle, the dispute guide helps define the question. A complaint about a doctor’s conduct, a request for examination and proceedings about damages have different aims. Have costs and the suitable route explained before starting several tracks simultaneously.

Bring a decision note to the next discussion

Prepare one page listing agreement, actual disagreement, missing source and proposed next step. Ask who acts and how you learn whether the point has been resolved. Use the meeting preparation tool and timeline tool for questions and arrangements; upload no medical information. A short note prevents each new case handler having to reconstruct the disagreement from the general complaint.

A final offer should identify the remaining medical uncertainty and how it is handled legally. Where needed, seek legal help and discuss the assignment and costs. You need not decide which doctor is right to ask clear questions. The aim is a supported next decision respecting expertise boundaries and your evidential position, without automatically guaranteeing agreement or compensation.

• Write down the actual difference using both passages.
• Compare question, assessment date, records and uncertainties.
• Separate medical conclusion, legal attribution and damages amount.
• Arrange targeted information or discussion before choosing further assessment.
• Keep data arrangements, costs, outstanding items and deadline ownership visible.