by fithos » Mon Sep 29, 2008 11:51 pm
State: California
Hi there. I was rear ended in my car a few months ago. The other car was going about 60mph when he rear ended me. My 2006 compact car was totalled since it cost over $14,000 to repair. Since the accident I have had constant pain in my neck, back, and especially on my left shoulder area down to my arms. I went to the E.R. As of now I have medical bills over $10,000 (E.R., doctor visit, neurology test, chiropractor) and 3/4 of it is diagnostic. My doctor wants to order an MRI now.
The other party's insurance have called and said that those bills are excessive and they will not pay (as in future settlement).
My first question is that they don't have any right not to pay, right? All these visits and tests were ordered by my medical doctor (except the chiropractor). BTW, most of these test were to find the cause of the numbness on my left arm and shoulder.
My second question is that the car that hit me was a pretty old beat up car. Assuming that he (teenager) has just the minimum insurance coverage on his policy (which I believe in CA to be $15,000), would it still be advisable to hire an attorney? It would appear my medical bills would be close to the limit already and it is still ongoing.
Hi there. I was rear ended in my car a few months ago. The other car was going about 60mph when he rear ended me. My 2006 compact car was totalled since it cost over $14,000 to repair. Since the accident I have had constant pain in my neck, back, and especially on my left shoulder area down to my arms. I went to the E.R. As of now I have medical bills over $10,000 (E.R., doctor visit, neurology test, chiropractor) and 3/4 of it is diagnostic. My doctor wants to order an MRI now.
The other party's insurance have called and said that those bills are excessive and they will not pay (as in future settlement).
My first question is that they don't have any right not to pay, right? All these visits and tests were ordered by my medical doctor (except the chiropractor). BTW, most of these test were to find the cause of the numbness on my left arm and shoulder.
My second question is that the car that hit me was a pretty old beat up car. Assuming that he (teenager) has just the minimum insurance coverage on his policy (which I believe in CA to be $15,000), would it still be advisable to hire an attorney? It would appear my medical bills would be close to the limit already and it is still ongoing.
Posted: Tue Sep 30, 2008 04:11 am Post Subject:
They are not "paying the bills"... you sought the treatment so you are required to pay. The insurance company owes settlement to you. It's your choice to accept their offer or not.
From what I recall, there is no PIP in CA. I think you need to have a discussion with the adjuster and see what they can tell you about a possible settlement and their insureds policy limits. That is, will they come out and tell you that there is a policy limits issue. If there is, I see no reason for them not to tell you as it saves everyone a lot of time. It also makes any question of "excessive" bills moot.
Posted: Tue Sep 30, 2008 05:21 am Post Subject:
California is a tort state, and PIP is not a requirement. Hence, you are free to sue the responsible driver for the claim. However, we were right that the limit for one person injury is $15,000 in California. Therefore, to decide whether or not to file the lawsuit you're required to know the policy level of the other driver.
Tcope has mentioned the difference quite correctly, the insurance company will not pay the bills rather will offer you a settlement amount that you may or may not accept. Try to negotiate the amount with the adjuster & present proves in support of your claim. Negotiation is always a part of claim settlement.
~Jeremy
Posted: Tue Sep 30, 2008 05:33 am Post Subject:
First off, thanks for your response.
I understand what you are saying that I don't have to accept their offer when it comes time to settle. They are telling me that they won't even consider some of my medical bills when it comes time to settle as they don't consider them necessary.
I already tried discussing the possibility of a policy limit with them. They refuse the discussion and ended the conversation. I was in a daze after the accident so I am not too certain but I remember someone mentioning that he doesn't actually own the car that hit me. So I don't really know if it is his or the car owner's insurance that I am dealing with. I ask that question to them and they refuse to give an answer to that also. All the info I have on the other party is through a police report I got a couple of days later.
Posted: Tue Sep 30, 2008 09:51 am Post Subject:
Well, I guess that you may need to take steps against the non-co-operation of the insurance company. However, the insurance companies are not required by the law to disclose the policy limit of their clients to the other party. This is done to stop the other party from collecting the maximum from one's policy.
However, you may seek legal assistance if the insurance company denies to co-operate atall, otherwise, if they have made only the initial offer, it implies that they are ready for negotiation. It happens more often that the parties disagree with the first offer made and may wish to negotiate the amount.
Just hang tight, lori or someone else may throw some more light into the matter.
Posted: Tue Sep 30, 2008 10:05 am Post Subject:
Good morning Fitho's and welcome...let me see if I got this right...you're saying that an adjuster from the at fault carrier told you point blank that they will not even be considering some of your medical bills because they are excessive is that correct? Do you have this in writing? What is your injury/diagnosis? When you say the adjuster ended the conversation, surely there was more to it than you asking if they would disclose their insured's limits, what was this about? Do you have heath coverage or medpay on your auto policy? Has anyone been paying these bills?
They do have the right to argue whether or not you are attempt to run up diagnostics unwarranted...which by the way in most cases only eats up a bi settlement and adds nothing to the actual pay and suffering portion of the settlement....'ordered by a m.d.' really doesn't mean that much I could walk into any doc and tell them what tests i want...are you ready to settle this? Do you have under ins. motorist on your policy? Most police reports also will show the owner of the vehicle, if not check with the dmv of your state, and see if you can run the VIN.
Posted: Fri Oct 10, 2008 01:18 am Post Subject:
Thanks again for the replies guys and gals. Sorry for delay in replying. My laptop's motherboard burnt out and I had to send it in for repair so no internet for a few days.
The adjuster has called me again and seem to have taken a different tone now. She still won't disclose the policy limit to me, but I suppose that is within their right.
My medicals bills used up my medpay limit already. The rest I am on my own. As for my injuries, I have the usual back and neck pain. There is also tightness in my chest and numbness/tingling in my arm/shoulder/hand (one-sided). I just had an MRI done. The report says I have 1 disc herniation in my cervical spine that is impinging on the nerve root that leads to the arm in question.
Lori. Thanks for the suggestion. I'll go to DMV to see if they will provide this information.
Posted: Fri Oct 10, 2008 08:49 am Post Subject:
fitho's welcome back...let us know if you have any other questions we'll be glad to help...sorry to hear about the results of your mri, (have several cervical hern. discs and nerve issues myself...no fun)...
Posted: Fri Oct 10, 2008 05:41 pm Post Subject:
Fithis..Hope you are feeling better soon. Lori, I was reading this post and I remember my doc telling me that most insurance companies will not even pay for an MRI if the x-ray doesn't turn up something. This is how they actually missed my true injuries. I really feel for the poster since as you know I am kind of facing the same thing. can a person actually have requested to pay for an MRI or used their pwn personal insurance to pay?
I remember asking and asking just knowing something was definately wrong. They just kept up with the PT and it actually made my situaion and injuries worse.
Posted: Fri Oct 10, 2008 06:33 pm Post Subject:
Hey Fireyone, I know exactly what you are talking about. My doctor told me up front that most insurance will not pay for the MRI too just last week. I told him I wanted the MRI even if I have to pay for it myself. In my case if it were just pain I can probably rough it out. But when your left arm/shoulder/hand gets numbness and clumsy you do whatever it takes to find the problem. Oh, my X-ray didn't show any problems either.
I wish you luck.
Posted: Sun Oct 12, 2008 02:15 pm Post Subject:
Thank You. I have had over ayear to deal with it all. It was some pretty rough going for a while but I believe in that old sayong "What doesn't kill you only makes you stronger".
At the point I was after months of doctoring with out any relief I really would have paid for my own MRI. I hope you keep stopping back and updating us. Good Luck.
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