I was in a car accident and it wasn't my fault, I already settled but...?

Question

I have been going through physical therapy and such off and on and I am owed PIP benefits(michigan) but my agent wont respond or return my calls. Right now he owes me roughly 1500 for my expenses over a year and owes some medical places for tests and medical work done on me as a result of the accident, I am now being taken to collections over those bills. I have called numerous times and left lots of messages. I filed my PIP claim in time and its been months and still no response at all, what actions can I take to fix this. any help would be nice, I can't even work a regular job till I go back to physical therapy but he wont pay so I can't!

I have been calling the adjuster and he was paying my bills after I forwarded them, then he just stopped and dont respond. I filed my PIP forms over 2 months ago, no responses and some bills are only half or partially paid....

I have since found out that the adjuster was promoted to manager and they lost half of my paperwork...so I am 2 months over my statute of limitations for filing and I have no way to prove that I sent it in on time.......dont ever get progressive

Answer 1

PIP- Personal Injury Protection is similar to Medical Payments coverage. It pays for medical bills and lost wages. You see PIP in "no-fault" states - in a no fault state a person limits their right to sue in exchange for having medical bills processed faster.

Your agent does not process PIP claim - the adjuster does.

If you have been calling your sales agent - you are calling the wrong person. You need to call your PIP adjuster.

If you are calling your PIP adjuster - make a copy of all medical bills owed. Send it certified mail to your adjuster. I would not send it restricted delivery since clerical staff picks up the mail - not adjusters. Enclose a letter requesting that the PIP bills be processed with in 15 days of receipt of the letter. If the bills are unable to be processed or PIP benefits are denied for them to please respond in writing. If you do not get any response with in this time frame you will consider further legal action. Wait about 25 days - so that if they wrote a letter or cut a check on the 15th day you will have time to receive it. If no action with in 25 days contact the Department of Insurance and file a complaint.

I do not live in Michigan but in my state - the DOI has go teeth - they can suspend insurance licenses and fine companies. DOI complaints here go to the vice president of claims for my company. They are reviewed by upper management.

But first, make sure you car calling the right person. If you have too call the claims department and give them your claim number and ask the for the name and extension of the PIP adjuster.

Can't work with out physical therapy? I don't know anything about your injury but that sounds suspect to me. Have your doctor give you a set of home exercised that you can do to strengthen what ever it is you injured and do them every day. Can you go back to work at light duty?

Also - does PIP in your state have a network? If so, are you going to a doctor that is outside the PIP network? That could be a problem right there.

Again, you need to speak to the PIP adjuster not your sales agent.


*** not to be taken as legal advice - I am not an attorney and only an attorney licensed to do business in your state can give legal advice. This is just my opinion/suggestion. Use at own risk. ** **

Answer 2

OK, several comments.

1. An agent that doesn't return calls needs to be fired.
2. What's your PIP limit? Did you run out of PIP benefits??
3. You are ultimately responsible for all medical services provided. The medical provider will take you to court, and win, and garnish your wages. You getting reimbursement from the insurance company is a seperate issue, and irrelevant to the medical provider being paid. Pay the bills.
4. If you have limit left, and you are still not getting any response within a reasonable time (five business days) from your adjuster or agent, try calling the adjuster's manager. Maybe the adjuster dropped dead, or is out on maternity leave or something. If you STILL can't get anyone to help, you can file a written complaint with your state insurance department, and ask them to intervene.

Answer 3

MSAD gave you the right answer. Do not call your agent. Contact the adjuster that is handling your claim. There may be many reasons why it is not being paid....you may not have submitted all the proper paperwork, the bills are being sent to you and are not being forwarded to the company. I am not placing blame on you but many people assume that if their company is taking care of it that the bills are going to them. The hospital or clinic sends the bills to you and you have to forward them to the insurance company. Call the company directly and they will be able to handle it for you. I am an agent in a PIP state and the bills are usually paid immediately after all paperwork is completed.

Answer 4

OK. Don't pass watching for methods to get extra out of this than damages that coverage will care for. You're assuming matters approximately the opposite motive force! The police might have recognized if he used to be intoxicated. They would inform if he used to be at the mobile by way of asking him, and checking his mobile. And his age? Really? You're being very bigoted there! 60s is not in any respect that ancient! The truth that he is been riding for greater than forty years, is an skilled motive force, and IS a mature grownup is in his want as facts turn out that he is a bigger, more secure, extra wary motive force. That's why older drivers have the bottom coverage premiums! I'm over 50 and understand this as truth. The truth is you are pondering with feelings, no longer with intent. Accidents occur at all times! People make mistakes in judgment. The different motive force admitted fault. What extra do you desire? Blood? Look at it this manner. Turn the crisis round. How might you think when you had an errors in judgment, and have been at fault in an coincidence, and anybody made up our minds that coverage taking good care of the whole thing, and although nobody used to be severely injured, just a little inconvenienced, wasn't sufficient? They desire to take you to court docket for cash effortlessly when you consider that of an coincidence, no longer when you consider that of any REAL loss, or damage, however when you consider that they desire to play the litigation lottery for the colossal cash! This gentleman did not got down to purpose an coincidence, purpose you damage, and wasn't out to get YOU or anybody! It used to be an coincidence! So, both permit your automobile coverage care for matters, or get an legal professional. It's particularly as much as you your moral sense, and your morals.

Answer 5

Typically, PIP has a LIMIT - it is purchased for a certain amount of coverage.

It appears to me that if your claims WERE being paid, and now they have STOPPED....this might be as simple as "your well has run dry."

Take a look at your policy. See what limits of PIP you have listed on your policy and then look at the amount of your bills. Do your bills exceed what is shown on your policy? If so, end of story.

If not, contact your State Department of Insurance and file a complaint. Depending on your State, you can probably find the complaint forms on their website. Normally (in my humble opinion) an attorney won't get involved in PIP cases as there's not enough money in it for THEM to make any money.

Good luck and I hope this helps!

Answer 6

Michigan should have an insurance commissioner. It is the duty of his office to ensure all actions of licensed insurance dealers follow the law, EXACTLY! Contact your state government and find out how you lodge complaints against your agent. They will really help you out.

Answer 7

look in your local phone book for a personal injury lawyer. call to find out if they will give you a free consultation. if so, make an appointment and take with you every bit of paperwork you have regarding the accident and the settlement. if they take your case they get a percentage of the settlement if you win it. good luck!

Answer 8

You would get more answers if you'd tell us what PIP benefits are. I have no idea what you're discussing... unemployment, disability, on-the-job injury benefits, or what???

Answer 9

FILE A CLAIM WITH YOUR LOCAL BOARD OF INSURANCE AGAINST YOUR INSURANCE COMPANY, YOUR AGENT WILL HAVE TO RESPOND.

Answer 10

bring law suit in small claims court