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: Wed Apr 23, 2008 02:21 pm Post Subject:
No, that is what they wrote to the doi. they stated that in order for them to offer me a settlement they would need hipaa forms and a signed statement but if she accepted liability why doesnt she just tell me. She got hipaa forms already but they had expired and she said i might have to sign more if the providers recieve them after the date. I understand she needs them to know the injury. but why doesnt she just wrote me saying she accept liability. Than she states that she needs a signed statement. i didnt say the her adjuster cant take a statement. All i said was that i wasnt willing to sign one at that time. The independent adjuster took 4 pages of what she called notes. I believe they are maybe trying to get me in a trip to answer some unfair question that would give them a reason to deny liability. I dont have an atty yet, but if i see they are going to take there sweet time, i rather just have an atty deal with them. I dont have time on my hands to spare. I mailed her a letter stating i wasnt going to give her any more hipaa forms until she determine liability. you think she would write and let me know no she doesnt. but i stated an atty needs time to file because some people wait until a month or so when statute of limitations are about to run out and than try to find an attorney.
Posted: Wed Apr 23, 2008 11:26 pm Post Subject:
If people wait that long to get an atty. (right before statutes run out) they will risk not having alot of evidence that could have helped in their claim.
Posted: Thu Apr 24, 2008 10:03 am Post Subject:
Than she states that she needs a signed statement. i didnt say the her adjuster cant take a statement. All i said was that i wasnt willing to sign one at that time.
I don't understand that AT ALL???????? :? :? Why would you feel ok giving the statement but not signing it that 'this is what I said'? If it's a written statement (which I haven't done in about 20 years! ) then of course it must be signed...without your signature it's the same as if you hadn't given them one at all......The independent adjuster took 4 pages of what she called notes. I believe they are maybe trying to get me in a trip to answer some unfair question that would give them a reason to deny liability
could be but I doubt it they have to have a formal statement from your re: the facts of loss...it's that simple....either sign the dag gum thing after through review or tell them sorry about that, can I just give you a new one? Maybe a recorded one rather than hand written.????I dont have an atty yet, but if i see they are going to take there sweet time,
I don't mean any disrespect but from their opinion (and I can see this) you are causing a huge part of this delay...with not signing the statement, the not returning the new hippa forms, you sending doc's records rather than them requesting them etc...and apparently the DOI agrees....re: attorney you have already done a lot of the messing around with them and spending way too much time not signing these benign forms they have asked you to (that an attorney would've promptly had you do by the way), so really the wasting of your time has already occured....if you get an attorney now, well you've done most of the work for him/her.....but totally up to you....I mailed her a letter stating i wasnt going to give her any more hipaa forms until she determine liability
Well I think she already did and her response to the DOI indicated same....frankly again I think you are slowing this process...yourself...by not signing these...when did you mail 'this' letter?Posted: Fri Apr 25, 2008 09:36 pm Post Subject:
I decide to sign a statement and hipaa forms. No she has no excuse to not evaluate and give an offer. And if she accepted why not tell? Would you accept liability and not tell the person? This whole thing is getting old to me now. These claim thing are dumb. Lets see how long it takes her to come up with an offer
Posted: Sat Apr 26, 2008 11:28 am Post Subject:
I know you're rightfully frustrated....a big part of it is though, (if I'm remembering correctly) the accident happened months and months prior to the ins carrier getting notice of it right?
I personally would've told the person yes, that my investigation was completed and that I was accepting liabity....however....sounds like she is 'assuming' that you know.. :roll: or atleast that is what I'd hang my hat on based on her statement to the DOI, (don't lose that paper!)......she may after receiving the new hippa papers request additional info from the doc.....after there has been enough time that she should've received them call and ask if she has them now in her possession and if there is anything else she needs....then ask how long you should expect that it will be before she makes you a formal offer...
Posted: Sat Apr 26, 2008 10:21 pm Post Subject:
I would give her a call after a week from sending the forms. I know hippa forms are a big part of everything now. By not signing the new forms you were probaly holding yourself up. I know waiting on a settlement can be frustrating...walking down that road myself but hang in there.
Posted: Mon May 05, 2008 10:18 am Post Subject:
thank you all for the great advice. Sry for the delay reply. A good friend of mine killed himself. I faxed over the hipaa forms and sign statement to her on the 25th of April. The statement i had to do myself because her independent adjuster would never answer or return any of my calls. So finally after a week and a half of waiting i wrote one myself of when, and where it happen, the time, where i was coming from, why i was at those places and where the pipe was located. And i signed it with my dob and other information to identify it was me. When do you think i should give her a call to ask if she got it and if she needs anything else.
Posted: Mon May 05, 2008 10:41 am Post Subject:
If you mailed it the 25th then she should have received it by no later than what the 29th or 30th at the latest right? So I'd call her this Wed the 7th should have had it in her possession a week by wed...
Posted: Mon May 05, 2008 11:41 am Post Subject:
I faxed it to her the 25th.
Posted: Mon May 05, 2008 11:42 am Post Subject:
I faxed it to her the 25th. But i will still give her until wed the 7th.
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