Results 1 to 5 of 5
  1. #1
    Join Date
    Aug 2011
    Posts
    4

    Angry Insurance Company is Refusing to Pay Medical Bils, Both Parties Have the Same Insurer

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

    We were rear-ended a couple of months ago in this year.

    Though I do not contend that I FULLY understand the collateral source rule or uncoordinated benefits. It has been explained to me by my agents office that my med-pay coverage will pay my medical bills. (which it has done) They then tell me that I can file a claim with the at-fault party insurance company. Further they told me that the at-fault insurance company will pay me for my medical expanses.

    Interesting. But I think I get it. Seems strange, but I think I get it.

    The problem.

    After not hearing from the at-fault party ins company. I sent them a demand letter.
    Car damages under $1,000, medical bills (chiropractor) under $2,000. Pain and suffering $10,000
    After some supporting paperwork they sent me a check for the car.
    They requested full paperwork from chiropractor, I sent that.
    They said, "call you Monday". They did not.

    Two weeks later I call them.
    Adjuster not available. But another adjuster in the office pulls up the file.
    Says the adjuster has made notes saying something to the effect of this...

    We don't owe you anything, The car was not hurt that bad.
    We don't think those injuries were from the accident.
    You did not go to the emergency room.
    You did not ride in an ambulance.
    You did not seek treatment till two days later. (accident was Sat. chiropractor opened Mon.)

    I do not know direct quotes, but that was the basics of the conversation.
    I told them I did not understand at all.
    He told me to speak with the adjuster. (who does not call me).

    I know my p&s number was on the high end. Med X 5
    I expected them to start with a low figure. But $0.?



    The funny/strange part is.
    State Farm is my company and the at-fault company.
    My state farm med-pay is paying as if medical treatment is a result of the accident.
    Then another state farm person says, we wont pay even your medical!

    Help.

  2. #2
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: Insurance Company is Refusing to Pay Medical Bils, Both Parties Have the Same Ins

    If the insurance company is taking the position that you weren't injured in the accident and thus that you aren't owed any money for injuries, you can either attempt to negotiate with them to see if they change their mind or you can sue the driver who caused the accident and try to prove your case in court.

    When somebody receives treatment from a chiropractor and only from a chiropractor, an insurance adjuster is going to view the claim with a jaundiced and skeptical eye.

    To avoid conflict of interest issues, your first party claim is handled entirely independently of the third party claim.

  3. #3
    Join Date
    Aug 2011
    Posts
    4

    Default Re: Insurance Company is Refusing to Pay Medical Bils, Both Parties Have the Same Ins

    I understand that it is handled by different people (as it should be).
    But the fact that med-pay, paid my bills, seems to add some legitimacy to the claim, correct?


    Is there something I should ask for from them. Showing their position before I move forward?
    (In an attempt to let them know I intend to sue the driver)

    Are there resources online that you can refer me to, to help me in my efforts to sue and handle it myself?

    Can I represent my wife in a lawsuit? Or would she have to do it herself?

  4. #4
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Insurance Company is Refusing to Pay Medical Bils, Both Parties Have the Same Ins

    Unless you are a lawyer, you cannot represent anyone but yourself.

  5. #5
    Join Date
    Aug 2011
    Posts
    4

    Default Re: Insurance Company is Refusing to Pay Medical Bils, Both Parties Have the Same Ins

    Is there something I should ask for from them. Showing their position before I move forward?
    (In an attempt to let them know I intend to sue the driver)

    1. Sponsored Links
       

Similar Threads

  1. Traffic Accidents: Can I Claim My Medical Bill to My Auto Insurance Company
    By okokok in forum Accidents and Injuries
    Replies: 2
    Last Post: 11-21-2010, 07:58 PM
  2. Medical Insurance Company Requests Will
    By inquirer1 in forum Estate Planning, Administration and Probate
    Replies: 1
    Last Post: 05-07-2009, 06:56 PM
  3. Traffic Accidents: Accident Parties Insured by Same Insurance Company
    By mikkiyee in forum Accidents and Injuries
    Replies: 1
    Last Post: 03-03-2009, 04:24 PM
  4. Job Benefits: Ex-Employer Rejected Medical Claims by Insurance Company
    By i_need_help in forum Employment and Labor
    Replies: 2
    Last Post: 11-14-2008, 11:28 AM
  5. Traffic Accidents: Insurance Company Wants Repayment Of Medical Care Benefits
    By blau in forum Accidents and Injuries
    Replies: 8
    Last Post: 06-29-2007, 01:30 PM
 
 
Sponsored Links

Legal Help, Information and Resources