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  1. #1
    Join Date
    Aug 2010
    Posts
    1

    Default Payment for Medical Care After an Insurance Company Tenders the Policy

    My question involves an injury that occurred in the state of: Nevada

    I was rear-ended over a year and still seeking medical attention. I have had severe back pain and headaches ever since the accident. As of this week, my current medical bills exceed $65k. During my last visit with the doctor, I twas recommended back surgery, more specifically a fusion. This alone will will come close to or exceed the policy limits for the at fault driver, 100k per individual, not including the $65k already racked up.

    My attorney said the next step was getting a letter from the doctor explaining what medical procedures need to be done, why they are needed, and the estimate cost. Then send this information to the insurance adjuster for review. He then will determine if they are going to "tender the policy" or not. Maybe I just misunderstood the way it was explained to me from the attorney, but it sounds like I am SOL if they tender the policy for $100k. Seems like then I am on my own for the surgery that will no doubt cost $75-100k alone. Is this true? Did I misunderstand? Maybe someone can explain it differently.

    As for my insurance, my policy will only cover another $15k of my medical bills.

    So main question, what happens after the letter is sent to the insurance adjuster? If they tender the policy? If they dont?

    TIA

  2. #2
    Join Date
    Mar 2008
    Posts
    1,995

    Default Re: Payment for Medical Care After an Insurance Company Tenders the Policy

    Quote Quoting brian13
    View Post
    My question involves an injury that occurred in the state of: Nevada

    I was rear-ended over a year and still seeking medical attention. I have had severe back pain and headaches ever since the accident. As of this week, my current medical bills exceed $65k. During my last visit with the doctor, I twas recommended back surgery, more specifically a fusion. This alone will will come close to or exceed the policy limits for the at fault driver, 100k per individual, not including the $65k already racked up.

    My attorney said the next step was getting a letter from the doctor explaining what medical procedures need to be done, why they are needed, and the estimate cost. Then send this information to the insurance adjuster for review. He then will determine if they are going to "tender the policy" or not. Maybe I just misunderstood the way it was explained to me from the attorney, but it sounds like I am SOL if they tender the policy for $100k. Seems like then I am on my own for the surgery that will no doubt cost $75-100k alone. Is this true? Did I misunderstand? Maybe someone can explain it differently.

    As for my insurance, my policy will only cover another $15k of my medical bills.

    So main question, what happens after the letter is sent to the insurance adjuster? If they tender the policy? If they dont?

    TIA
    So what you are saying is that you have your own "limited" medical plan, and you would hit the limit spending another $15,000??

    Assuming NV is not "no fault", did I hear right they had not paid anything as of yet?? Yeh, if they have a 100K policy, and the driver is not wealthy where you can sue him personally for more, then you're SOL.

    While I don't want to make this a thread on Obamacare, but I see Susan Angle, the Tea Party gal, is running in your state, and against Obamcare, I would like to hear more about her claim of "we have the best health care in the world", and let "private enterprise handle it, we don't need big governmemt", especially how she would handle cases like yours with "limited government" with "the best health care system in the world".

    The place I work for has a $1,000,000 lifetime cap on health care, which had worried me, and I understand Obamacare would lift that cap, so I am assuming the cap would go away, hopefully soon. I don't know about your policy, but maybe Obamacare would even help you too, particularly the caps.

  3. #3
    Join Date
    Jul 2010
    Posts
    4

    Default Re: Payment for Medical Care After an Insurance Company Tenders the Policy

    Obamacare would lift the cap...in its own policy. But you work and earn to much, so you would still be stuck paying for your policy. Shop around and buy your own or get a different job.


    Quote Quoting SChinFChin
    View Post
    So what you are saying is that you have your own "limited" medical plan, and you would hit the limit spending another $15,000??

    Assuming NV is not "no fault", did I hear right they had not paid anything as of yet?? Yeh, if they have a 100K policy, and the driver is not wealthy where you can sue him personally for more, then you're SOL.

    While I don't want to make this a thread on Obamacare, but I see Susan Angle, the Tea Party gal, is running in your state, and against Obamcare, I would like to hear more about her claim of "we have the best health care in the world", and let "private enterprise handle it, we don't need big governmemt", especially how she would handle cases like yours with "limited government" with "the best health care system in the world".

    The place I work for has a $1,000,000 lifetime cap on health care, which had worried me, and I understand Obamacare would lift that cap, so I am assuming the cap would go away, hopefully soon. I don't know about your policy, but maybe Obamacare would even help you too, particularly the caps.

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