by gb298888 » Thu Mar 27, 2008 10:47 pm
The insurance company is giving me a hard time. This is a ho claim third party. They have all medical records and bills and photos. Liability is pretty much clear. I even gave them prior medical records going 6years back just so they can see a prior injury never occurred. i spoke with the adjuster and supervisor and they both stated they cant process or evaluate my claim. The supervisor even started laughing during parts of the conversation. Its not the first time they said this its around the 5th time. Good thing i record the last time. I file a complaint with ny state doi. What do you think will happen? Do the state doi contact them?
Posted: Sun Apr 13, 2008 11:19 am Post Subject:
No, don't have them fax anything unless the adjuster says that's what she wants...GB you need to do EXACTLY what they ask you to, (assuming it's reasonable, and this is)....otherwise, (IMO) you have no gripe about the length of time things are taking, because it is you that is slowing the process by not responding as requested...just sign the dag=gum things as requested..ok? When did they ask you this?
Posted: Sun Apr 13, 2008 02:12 pm Post Subject:
She stated that she needs medical records from them. So i called them up and had them fax everything to her. Its the samething. What she think they are taking records out. so cant close my file because of that. Maybe if most of them didnt deceive ppl all the time. Ppl would trust to sign things. She mailed me a letter saying that a few days ago.
Posted: Mon Apr 14, 2008 10:20 am Post Subject:
She stated that she needs medical records from them. So i called them up and had them fax everything to her. Its the samething.
I'm sorry but NO IT'S NOT.....Didn't you have another post here somewhere about the rep telling you that SHE needs to request the records with your signed med auth...NOT you to send them? Remember? and tcope and I both said, we have done the same thing? We can't accept what the injured party sends and must request (and pay the fee if there is one) them DIRECTLY from the doc ourselves (meaning adjusters/carriers)....?What you said she wanted signed in this latest post was your statement...right? Why would you balk at that? I mean it's your statement right?
The adjuster said the statement i gave to the independent adjuster needed to be signed
All I (and others) are trying to get across is that the adjuster (from what you have said) has asked for things in a particular way or fashion...this adjuster doesn't make up the rules it's the same for every BI she/he handles....all you need to do is comply (again only if reasonable which all of these requests have been)....EXACTLY in the way they need the paper work done....if you don'tthen you, not the adjuster is holding up this claim.
Maybe if most of them didnt deceive ppl all the time. Ppl would trust to sign things
She's asking you to sign something YOU wrote....what is deceiptive about that?She mailed me a letter saying that a few days ago.
I'd recommend doing so and returning it asap...Posted: Mon Apr 21, 2008 03:00 pm Post Subject:
I sented her those forms. She sent me a letter stating that she needs more hipaa forms to be signed because the ones i gave her will expire soon. And she wants a sign statement. I wrote a letter back to her stating i will sign more hipaa forms after she determine liability. She had since january, medical records cant help her determine liability. And about the sign statement i told her i will sign a statement after an agreement is reached. She had more than enough time to at least determine liability. Sorry for the delay i was out of town.
Posted: Tue Apr 22, 2008 10:24 am Post Subject:
And about the sign statement i told her i will sign a statement after an agreement is reached
This ain't gonna' go over very well...(welcome back, hope it was a pleasure trip :wink: )
Posted: Tue Apr 22, 2008 02:22 pm Post Subject:
Hi Lori. She can have a signed statement after we reach an agreement or at least when she has determined liability. This isnt a very complex situation. They had since january to determine it. Im not giving her anymore sign forms until she determine that. Medical cant help her determine that. I dont ever want to deal with another insurance claim again. Would that be ok that i dont sign anymore of her hipaa forms until she at least determine liability. Because what would be the use of signing them if she is going to deny it.
Posted: Tue Apr 22, 2008 03:23 pm Post Subject: claim
GB....I've been reading this thread. Sounds like a 'Catch 22' ( they need THIS before you can do THAT..kind of thing.) In your LAST post (so far) you say you will not sing anything until they have reached an agreement. Well.............maybe it's something you HAVE to sign before they do any kind of 'settlement'. Also.....how do you know they will DENY the claim (or did I miss something)? I know claims can be a pain, but, stick with it.
Posted: Wed Apr 23, 2008 11:35 am Post Subject:
sdchargersfan, you're correct.....
I'm sorry I just don't see the problem in signing the updated forms, and your statement...I'm just telling you that they are going to say your failure to cooperate by signing these (benign) forms is slowing the progress of the claim...
RE: they've had since January...I thought that was when it (the fall) happened but the carrier didn't get the claim for months and months...(?)
Posted: Wed Apr 23, 2008 11:37 am Post Subject:
Hi. I dont know if they are going to deny it. I think she has determined it. Why ask for me to sign a release for medical records. But she havent told me yet. I think im going to give her the more hipaa forms she want with a deadline to come to an agreement because it has been almost a year. She said that her adjuster took notes because i wouldnt sign a statement. he is the one who was asking me ?s and writing down. He should of wrote it in a statement form. She said she needs that to give me a settlement offer. But she havent told me if she accepting liability. It dont take 3month to determine liability. I need some sort of writing of that. In the letter they wrote to the doi. They said a statement and hipaa forms. I gave them the info they need of the incident. There adjuster 4 pages of notes. That is enough and just like a statement just not signed. Should i give them a deadline to settle? Because an atty needs time to get info and file. I even lower my demand i havent told them what my new demand is?
Posted: Wed Apr 23, 2008 12:00 pm Post Subject:
She said she needs that to give me a settlement offer.
If these are the EXACT words she used then they have accepted liability........It dont take 3month to determine liability
I'll disagree with that some times it does...we don't know how uncooperative her insured was...but would expect him to be wouldn't you? If they had to hire independent adjusters to to scene inspects etc...then it could certainly take three months...granted most of the time should've been able to do it in 30-60 days, honestly 90 days isn't that long on a slip and fall, especially if she didn't get all the signed forms from you...one of which will allow her to 'index' you and make sure you aren't a cronic 'slip and faller'....no way will they make any offer before knowing that...then getting all the info from the doc can easily take two months...all doc's don't respond quickly...and she can't even request them without the properly attached authorization...it has been almost a year
Not since the carrier has had the claim though right? you can't keep saying a year when it hasn't been to them! They have only known about the claim for three months correct?That is enough and just like a statement just not signed
no, it's not....Should i give them a deadline to settle?
why would you do that? you just said that she told you that...She said she needs that to give me a settlement offer
Because an atty needs time to get info and file.
If you have an attorney you shouldn't be talking to her PERIOD...what are you doing all of this for if you have an attorney?I even lower my demand i havent told them what my new demand is?
Why are you making any demands if you have an attorney? You are really confusing me here....or is this attorney talk, ''if''? What demand did you make?Look, I'm gonna be very frank with you (again) if you don't sign the necessary documents that they need, (like the auths, hippa and your statement)...re-read the statement before you sign it...and why didn't they just take a recorded statement rather than notes? did you refuse a recorded statement? Then you really have (IMO) zero complaint about the length of time it is taking to get to the settlement discussion of this claim...seriously......It just seems like you are (to them) being uncooperative....
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