a car slammed into me from behind while i was waiting at a red light in february.... i had major headaches and neck pain, esp muscle tension.....i couldn't exercise normally.. so i had to go to a chiropractor for 3 months, and he told me to rest, and i started exercising again (slowly)...and my shoulder muscles were tensing so much it was painful... so i had to go back to the chiro for another two weeks. now the insurance company is saying they don't "believe" that the 2nd session was related to the accident.... what can i do? do i have to sue them? is that going to be a hard process?
:( i'm sad.....
2006-10-20 10:33:32 · 12 answers · asked by sasmallworld 6 in Business & Finance ➔ Insurance
Get an opinion from your legal advisor.
Good Luck!
2006-10-20 10:35:53 · answer #1 · answered by Smilin' Fred 4 · 0⤊ 0⤋
This does not surprise me at all. You had a soft tissue injury. They resolve themselves without treatment normally in 6-8 weeks. I am shocked that a chirpractor or any doctor would tell you to rest due to muscle tension. The best thing to do is try to get back to normal activities as soon as you can. Resting doesn't help your muscles, because they can atrophy or weaken and make it that much more difficult to recover. Most of the time as you treat, a good physical therapist will teach you home exercises and the goal will be that you can do them at home and be discharged.
So, obviously that didn't happen. Then 6 months or so later you go to the gym or overdo it at home and now you feel badly. Well guess what? It will be very hard to say that it's from your injury from the accident and not something else that happened during the time you ended your care and started again, or something you did while exercising. It is just not common for a sprain/strain to need any treatment 8 months after an accident. People who sustain serious injuries that require rehab don't usually even need that much treatment. If you're only talking a total of two weeks, that isn't worth much more additional $ for pain and suffering anyway. If you expected them to toss a bunch of money on there in the first place- WRONG- especially for only two more weeks. Sometimes you may experience a flare-up, but whether you require more active care is a different story.
So your options are as follows: continue to treat with no guarantee that it will be considered, see what they offer and negotiate or file suit, don't treat, move towards settlement discussions and see how that goes or file suit, or get an attorney. A good attorney will probably tell you up front that getting them to pay for this second course is going to be a long shot. One that wants to help you will, anyway. The outcome of a suit is a big question mark all the way to the end, and it costs money. An attorney will take 1/3 of your settlement and 40% if the case goes to suit most of the time.
You have to decide what to do, and in the end that's up to you, not us. The advice we give you is worth what you pay for it. I'm just telling you right now, there are no insurance companies out there who will immediately accept a second course of treatment this late and long after your last.
All claims are handled on a case by case basis on their own individual merits. Based on where the loss occurred and other variables, this may not apply. This is just a general statement about situations like yours, and is not unique to you or specific to your situation.
2006-10-20 21:50:32 · answer #2 · answered by Chris 5 · 2⤊ 0⤋
It seems like most of the injuries you've suffered are soft tissue, which are actually hard to prove. Only you know how much pain you're in, and there are no tests that can show the level of pain you are experiencing. Insurance companies have to cover any reasonable medical expenses related to the original accident for up to 3 years after the date. It doesn't sound unreasonable to me 6 months down the line you are having symptoms again. You may have a hard time getting the bills paid because people take advantage of them and file fraudulent claims, which reduces their trust in people when claims are made. Soft tissue injuries are just so difficult to prove, and they will probably tell you that you are the reason for your newest symptoms as you decided to exercise. It is very difficult to fight insurance companies, and even if you hire an attorney, you'll end up paying a ton. I would have your doctor document the proximate cause of your pain was the auto accident, and even see another doctor for a second opinion in writing. It's not impossible, but you have to fight hard and don't give up!
2006-10-20 19:49:38 · answer #3 · answered by Rexy 3 · 0⤊ 0⤋
Been there, sue! Now. Don't wait any longer, they wont give, get an atty. My case took about 6 months to get insurance company to cough up the money and pay my medical bills.
Good Luck
2006-10-20 17:37:10 · answer #4 · answered by Erica 2 · 0⤊ 0⤋
Since the insurance company has paid for most of the bill and you are only talking about two weeks I would forget about it. You could get a lawyer, but not for that little of an amount.
2006-10-21 01:24:11 · answer #5 · answered by andy 7 · 0⤊ 0⤋
Mostly, the insurance company should cover all the medical expense within 2 years from the date of loss, except your insurance company ask you or Dr, who you 've been visiting to get a release note from a Doctor for closing the claim. within 2years you will be insured
2006-10-20 18:19:38 · answer #6 · answered by Jenifer K 1 · 0⤊ 0⤋
Yes, you'll have to sue the driver of the accident. All your medical records will have to get turned over to his lawyer for review, and they can demand you have a physical from their doctor.
You'll have to prove that the injuries were caused by the accident, and were not preexisting. If you had extensive damage to your car, that will help your case. If not, it will hurt your case.
2006-10-20 21:20:38 · answer #7 · answered by Anonymous 7 · 0⤊ 0⤋
Your Dr. should be willing to help with detailed information about your need for the treatment for the insurance company, otherwise, get a new Dr.
2006-10-20 22:23:24 · answer #8 · answered by The Advocate 4 · 0⤊ 0⤋
get a detailed paper from you chiro. stating that the visit was conected to the wreck and was needed in the healing of your neck. do that FIRST before you get any lawyers involved. if you go to them first the insurance company will make it harder for you.
2006-10-20 17:44:20 · answer #9 · answered by jarheadndn 2 · 0⤊ 0⤋
get an attorney.
you're entitled to not only the cost of damages, but also the pain/suffering and other items.
insurance companies....the biggest scam going.
2006-10-20 17:37:29 · answer #10 · answered by Robert 5 · 0⤊ 0⤋