qustion about pi auto accident claim?

Question

my g/f was in an auto accident last september with an uninsured driver. she had uninsured driver coverage up to $25,000. it was 100% other persons fault b/c they ran their stop sign. her car was totaled and insurance paid for that. she was also injured in the accident having lots of back and neck pain for a few months. she was diagnosed by a chiropractor with 4 pinched nerves and soft tissue damage, so she went through about 4 months physical therapy........she finished therapy and has felt alot better but still has back pain, she has been cleared by the chiropractor for her pi claim.....anyways a few of her bills were sent to collection.....shouldnt the insurance have paid these bills from 6 months ago? also her bills totaled around $15,000 because her ER bill was $12,000....so shouldnt she at least get the policy limit of $25,000 if calculated $15,000 for bills $10,000 pain and suffering?

Answer 1

Did you turn the bills in to the insurance company? They can't pay them if they don't have them.

What have they paid so far? Just the car?

What communication are you having with the insurance company? It didn't sound like you were staying in touch with them at all.

You need to gather all the bills together and call the adjuster. Do they know she's been release from treatment?

Whether she gets the policy limit or not, I don't know. It's hard to say without sitting down and adding all the bills up, looking at her actual injuries, etc. But until you pick up the phone and call the insurance company and find out what's going on, you probably won't know.

I do find it a bit odd that they haven't contacted you but I also have no idea what her policy says, what the police report said, what the doctors reports say, etc.

Answer 2

Have you or your g/f tried to settle the medical bills with the insurance claim?

When it comes to UM(uninsured Motorist) Claim, it is handled as a libility claim. And yes, both have limits.

After the treatment, the patient must gather all the medical bills and talk to the claim adjuster. Ask for at least the double of the total medical bills. That is including the medical bills and your compensation. The reason for that is the insurance company has their own doctors to review the injury claim and they bring on many stupid reasons to cut the payments.

You actually have to spend time and argue with them to get paid more. That is your responsibility unless you have a lawyer.

The best way to do is to hire a lawyer and have them argue with the insurance companies and get medical bills paid and also get compensation. You don't need to pay anything to the lawyer. They work for their money. They are able to ask for higher compensation and get their pay out of it.

First, contact all your medical providers for this claim and find out if any of the medical payment has been made by the insurance company. If not, you need to gather all the medical reports and bills and talk to your claim adjuster.

If they are being too stiff about paying you then it will be better to think about hiring a lawyer.

All the claims should be filed and finished within 2 years. The insurance companies have right to drop the whole case after 2 yrs.

And even though you have 25,000 limit, insurance company does not have to pay upto the limit. They always come up with good reason not to pay.

Good Luck.

Answer 3

Her uninsured motorist coverage is not going to pay anything until settlement is obtained. It is your GF responsibility to take care of the bills until it is time to settle claim. Settlement means a signed release of all claims from her insurance company. If she has med pay or PIP on her policy that would pay medical bills up to the med pay/PIP policy limit while she is treating. That limit is often under 5k.

With regards to getting 10k for pain and suffering it isn’t impossible but I wouldn’t count on it. Her meds are relatively low for treatment. Let me explain what I mean by this. Her ER bill was 12k…well that was all diagnostic testing, probably a MRI and xrays. Her actually treatment was only 3k. This day and age meds seem really high because of all the diagnostic tools available. Bills add up really fast. I worked a claim once that had 3500 in meds and the diagnosed injury was a headache another claim with 4500 in meds and no diagnosed injury. The 3k from her chiro probably also had 500 or so in diagnostic as well. In all the claims I worked I never gave 10k for a back injury that required a few months of physical therapy. With that said I have not seen you GF medical records and don’t know what the exact medical diagnosis and prognosis is. Let me put it this way though, she is not going to get rich of off this and I would be stunned if policy limits were paid but she may get lucky. Uninsured motorist claims sometimes pay better because the insurance company doesn’t want to be accused of bad faith. Good luck!!! I hope you get the payout you are looking for just don’t be disappointed when the P&S offer is under 5k. You can always negotiate a little.

Completely off the topic…your GF is completely underinsured. What if her injuries would have been severe and meds were over 25k. She would have been out of luck. I always suggest people carry minimum limits of 100/300 but that is just my opinion.

ADDITIONAL INFORMATION!!!

Some additional information. The 2 year limit as listed below may not apply to you. Statute of limitations vary from state to state and are often longer for UM/UIM claims. With regards to obtaining a lawyer they would take 33% of settlement - including medical. That would mean you would have to pay back 100% of the medicals with your 66% of the settlement. With 33% of the settlement gone the most you could get is $16,500, leaving just 1,500 for pain and suffering. I would think you could do better without a lawyer.

Again good luck.

Answer 4

Did you herad about PIP Coverage (Personal Injury Protection)?

Personal Injury Protection or PIP provides medical expense coverage if the driver or another individual covered under the policy is injured in an automobile accident. It is often called no-fault coverage because it pays medical expenses no matter who has caused the accident. PIP coverage pays hospitals, doctors, trauma centers and other medical providers directly for treatment of injuries from automobile accidents. It also pays for medical equipment that may be needed as a result of an accident. Under current law, automobile insurers provide "first dollar coverage" to hospitals and trauma centers up to $250,000.

Individuals who purchase auto insurance have several coverage options including the option to have any medical claims paid for by their health insurance provider. The PIP coverage option is usually not available to those who receive their health insurance through ERISA or self-funded programs. Shifting the medical claims coverage from auto insurance to health insurance is seen as a direct way to lower the cost of auto insurance to individuals in the state.

Many states is compulsory this coverage. Check your policy and verify if you have this coverage.

Good Luck!!!!

Answer 5

Clueless has no idea what she/he is talking about.

She is wrong about the lawyer as mamatohaley illustrated above. The blanket statement about when the claim needs to be settled is most likely incorrect. The insurance companies I have worked for in the past have not had medical staff on hand to help with personal injury claims. They have had nurses but that was to handle medical payments for PIP and MedPay. Your claim is not worth 2 times meds ESPECIALLY since well over 10k of it is likely diagnostic.

I agree with MamatoHaley's answer.