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  1. #1
    Join Date
    Oct 2011
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    11

    Default Injuries from Rear-End Accident by Uninsured Driver, Not Sure How to Proceed

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

    My kids and I were in stopped at a light and were hit from behind hard by a large pickup. I was dazed when it happened but my son started talking to me and the other driver came up and I was able to focus after a few minutes. We agreed to drive to a close side street in order to not cause another accident, and I called the police. Quite a bit of damage to my van, needs a complete back trunk and drivers side bumper. Main impact was on rear drivers side. My kids all said they were fine and seemed okay, I immediately had back and neck pain but it seemed minor. We exchanged insurance info, police came and wrote a report that said the other driver was 100% at fault, but issued no citation. When I initially spoke with his insurance the adjuster said it was a new policy so he needed to verify coverage, but that he was sure everything was fine. I have never had back or neck issues, and I hoped it would resolve with time, but the next day it was worse. I went to ER two days after accident, they took xrays and prescribed meds. I saw my primary doctor on the fifth day after the accident, he wanted to wait a week and see if it resolved. My kids still haven't had any complaints of pain, but I did take them to their primary doctor just to be safe. On the sixth day, the adjuster called and said that the at fault driver's new policy was not yet effective, so he wasn't insured on date of accident and they were denying the claim. I then called my insurance, I have full coverage. They sent out an adjuster for the inspection, my car has about $3500 worth of damage. The adjuster would not open the trunk because he knew he wouldn't get it closed again. I had to pay for a rental car out of my pocket since it's not part of my coverage, but I do have uninsured motorist coverage.

    My car is now in the shop, with the shop owner telling me that as hard as I was hit, he is certain that he'll find more damage once he gets working on it. I have been taking the prescribed meds for two weeks with no relief, the pain is in my upper back,neck, right shoulder and down right arm. I can't work because my job is entirely computer work, and it kills my arm and neck. I can't sleep, have dizziness and nausea. I saw an orthopedic specialist and will be starting PT four times a week next week. If the pain isn't gone or much improved after four weeks, he'll do an MRI. Here are my questions:

    1. I have Medpay up to $1000 on my auto coverage. I've surely used that up already, so do I have the dr continue to bill my auto insurance (State Farm) or just bill my health insurance now?

    2. Since I have the Uninsured Motorist coverage, shouldn't that coverage pay all my medical bills and copays, rental car expense, lost wages up to my policy limit ($50,000)? Before the at fault drivers insurance claim was denied, my insurance agent made sure to tell me that they'd only cover up to $1000 medical, and anything over that or lost wages I'd have to sue the other driver for. But now that they have a denial from the other insurance company, shouldn't my UIM coverage kick in?

    3. The at fault driver has contacted me and apologized for the insurance mess, and said he knows this will come out of his pocket. However, he has not made any offer to pay for anything, even though my insurance company said he could go ahead and pay me directly for my deductible and rental car expense, as long as I don't sign any release. Is it best to just not deal with him directly since my insurance company is involved now? I hate to say this, but if he helped with my out of pocket costs right now it would be great, this isn't something I was prepared for and I know it will be awhile before I get anything reimbursed from the insurance company.

    4. I assume that since my insurance is going to cover this, there will be no settlement for medical, lost wages or pain and suffering, is that right? My insurance will pay for the things they are required to pay then go after the at fault driver, is that how it works?

    Thank you for any advice. I've never been in this situation, and I can't afford these extra expenses right now. My insurance company has not mentioned my UIM coverage to me at all, all they said is that they will pay for the car repair and for up to $1000 in medical, so I've been trying to research this and figure out if there's anything else they are supposed to pay for.

  2. #2
    Join Date
    Sep 2011
    Location
    Oklahoma
    Posts
    232

    Default Re: Injuries from Rear-End Accident by Uninsured Driver, Not Sure How to Proceed

    Medpay- You should bill your health insurance for all of it. The Medpay coverage will be paid to you directly. The $1000 should pay for your health insurance deductible and any percentage you have to pay afterward (like if your health insuance only pays 80%). They will want receipts showing you spent over $1000 in medical bills. You give them the full bill, not just your portion after health insurance has paid. If your out of pocket medical expenses are less than $1000 after health insurance pays for everything, you still get the $1000 in medpay. This is a first party coverage. You pay the premium so you get the money.

    UM -Your uninsured motorist coverage does not pay for repairing your car or rental expenses. Your collision coverage pays for your car while you pay your collision deductible. You are simply out of pocket on the rental car. When you have completed all your medical treatment, they will place a value on your total injury claim. This will be all your medical bills, lost wages and will include pain & suffering. The bills you used to justify your $1000 medpay claim I believe will be calculated into this also. This is legal double-dipping. But don't count the dollars yet because this second dip is just paying for what health insurance has paid and if they have a lien on your settlement, it's all going to them. The total UM payment made to you is what the insurance company is going to go back after the at fault person over (and the property damage and your collisioin deductible).

    I am not sure if your health insurance will put a lien on your UM settlement. I know worker's comp cannot. I know they would if it were your settlement from the other company, but I'm not sure if they do it from your own UM coverage. I actually think they do, but I'm not certain. Either way, you should still pocket the pain & suffering and be paid for lost wages.

    One thing you need to do is go to all the places you have had treatment and get copies of all your bills that were sent to your health insurance. You want the version prior to them being paid. Your health insurance will receive huge discounts on all your treatment. You use the full, pre-negotiated bills for your claim. Your pain & suffering is partially calclated off these bills so you don't want it based of the "deals" your health insurance receives. If your health insurance does come back for their money, you can keep the difference from being paid full value.

    IMO, I would not even speak to the other person let alone accept money from them. Your company will go back after their money. You taking partial payments I would think would only complicate the situation.

    Does State Farm know you are injured? Not your agent, but the claims department. Call 1-888-650-1917. That's the claim's department. Do you have your claim number? If the adjuster left you an estimate, it's in the upper right corner about the 2nd or 3rd line. If you have it, there are two types. It either starts with "36-A" and will look like 36-A7xx-xxx01 (and all those upper case digits will be correct for your claim) or it won't start with the "36-A". If it's a 36-A claim, your claim is being handled by Team 1. If it's anything other than 36-A, you're Team 2. That's a shortcut on the automated system when you call. Tell them you want to set up an uninsured motorist claim. The adjuster for that is not the same person who handles the property damage. They will set up the claim and the UM adjuster should call you back within 48 hours (depending on how busy they are). That person should be able to answer everything for you.

    Do not worry about the shop tearing into your car and finding more damage. That's extremely common. If you used their Select Service program, there will be no delay in your repair. They will simply take a picture of the additional damage, upload it into your file and bill the company for it. If you chose a shop that is not on the program, then any additional damage found will have to be documented and approved by them (basically the guy that looked at it the first time will have to look at it again). Sometimes this can take a few days for them to come back out.

    What city are you in?

  3. #3
    Join Date
    Oct 2011
    Posts
    11

    Default Re: Injuries from Rear-End Accident by Uninsured Driver, Not Sure How to Proceed

    Thank you, that is very helpful information! We are just outside of OKC. I have notified State Farm and talked to Team 2, but that was before the at fault driver was determined not to have insurance. I haven't called SF since I heard from the other insurance company.

    So if I understand right, doctors bill health insurance, but whatever UM money I get will have to pay back the health insurance, right? And I guess I misunderstood about the Medpay, I thought that meant that State Farm would pay the doctor directly, but I just submit the full bills to State Farm and they send it to me. That is good to know, because I haven't asked for any paperwork so far from the doctors I've seen, I'll do that asap.

    Thanks again, I just was not sure how this worked, and I haven't gotten very much info from State Farm so far.

  4. #4
    Join Date
    Sep 2011
    Location
    Oklahoma
    Posts
    232

    Default Re: Injuries from Rear-End Accident by Uninsured Driver, Not Sure How to Proceed

    I'm pretty sure your health insurance will put a lien on your settlement to recover what they've paid out. But the amount they paid out should be less than what the initial bills showed and those higher numbers should be used to value your claim. I am not sure who Medpay pays the money to. Obviously if you paid out of pocket, they'd pay you back. There may be a option for them to pay the bills directly for you. I haven't used that coverage yet.

    I also live in OK and was hit in June. I have an open UM claim with State Farm as well. So I'm not an attorney, but I am going through the same thing you are. I was in a company car though so it's a worker's comp claim too. Medpay doesn't pay out on worker's comp claims. I've talked to a couple of local attorneys now and have learn a lot about the process in the past couple on months.

  5. #5
    Join Date
    Oct 2011
    Posts
    11

    Default Re: Injuries from Rear-End Accident by Uninsured Driver, Not Sure How to Proceed

    I think I do need to call State Farm and talk to them about a UM claim, since it wasn't being handled that way at first. I hope I haven't made too much of a mess of things so far, I didn't know better and the ortho doctor is going to bill State Farm. I thought that's what I was supposed to have them do, but she did take both forms of insurance just in case, so I can call Monday.

    My biggest concern right now is my out of pocket expenses; doctor visits and PT copays will add up quickly, and lost wages. I'm self employed/independent contractor, so I don't have any sick time to use, I just lose the pay. Hopefully this will resolve itself quickly.

    I have been told by several friends that I should start talking to attorneys too, I just never thought I'd have to do that. If State Farm is handling the UM claim, what difference would an attorney really make?

  6. #6
    Join Date
    Sep 2011
    Location
    Oklahoma
    Posts
    232

    Default Re: Injuries from Rear-End Accident by Uninsured Driver, Not Sure How to Proceed

    I wouldn't go to the attorney yet. They are going to take 1/3 of your claim. Give State Farm a chance before you sign 1/3 of your money away. Call them tomorrow. The claims dept is open on Saturday I believe from 7A-7P. That's their M-F hours, I'm not sure if they shorten them on Saturday though. I do know they are open tomorrow. The UM people won't be woking tomorrow though. At least they can set up that part of the claim though so maybe they can call you back on Monday.

  7. #7
    Join Date
    Oct 2011
    Posts
    11

    Default Re: Injuries from Rear-End Accident by Uninsured Driver, Not Sure How to Proceed

    I will call tomorrow then. Thanks again, it helps to have some idea of what is going on. Good luck with your claim.

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