any insurance reps or attorneys on here that might be able to give advise?

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92Maxin
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Joined: Fri Apr 13, 2007 12:12 pm
Car: 92 Maxima GXE

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Heres the low down. A couple months ago my GF was in an accident. I guy tried to cut across the main strip in our town and ended up T-boning her in the drivers side. The Entire drivers side had to be fixed and she has done damage to her shoulder/back area. She was unaware of anything due to the adrenaline ect from the wreck at the time and was not taken in an ambulance but the next day went and saw her doctor and has had to on several occasions. All the visits are out of pocket and insurance will not refund her until she settles.

Due to the constant migrains and enough pain to where she sometimes can barley lift her arm, she is now being told that she needs to see a specialist to find out exactly what is wrong but again, she will have to pay out of pocket and what she is being quoted there is no way we can. We finally found a doctor that is willing to bill the person at faults insurance but the doctor will have to set up a contract with them but insurance refuses to sign and keeps trying to get my GF to hurry up and settle. They dont refuse all contracts but told my GF they arnt signing this one so she should just go ahead and settle. I know we have 2 years to do so and dont plan to until everything is taken care of. Ive called a personal injury attorney who tells me that they cant do anything until she is diagnosed and they know what the extent of the injury is in order to get her compensation and full reimbursement on everything but we cant afford to get the diagnosis.

This is kinda the jist on everything so does anyone know if the insurance company can deny the contract and is there any other kind of legal action we can take before hand? Shes already looking to go after the man that hit her since the paint dosnt quite match now and insurance is refuseing to repaint the car to make it match ect but that could be forever to see any kind of payment if we get any at all. Your thoughts would be appreciated!


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thekage
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Find a better lawyer.

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92Maxin
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Joined: Fri Apr 13, 2007 12:12 pm
Car: 92 Maxima GXE

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Yeah thats what im doing. Been calling around somemore since i posted this and found one that said they can help us so will be seeing them on monday. Gona keep our fingers crossed!

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bmike818
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Good luck!

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frapjap
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1. Find a better lawyer.2. Suck it up and charge the doctors visit for the diasnosis on a credit card. You'll get it back.

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ShionS14
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well since i work with insurance all day i'll chime my two cents in. first as for the diagnosis the insurance company is in the right not signing until she has it done. if your gf has medical insurance through work she can use that to pay for the diagnosis. as for them trying to hurry her up and make her settle, they are just using that tactic in order to hurry up and release their liability and limit the amount of money they have to pay out. as for the car the insurance company has to satisfy your quality levels as long as it does not exceed the pre-wreck conditions in this situation if they are denying the repaint you will have to take them to court which is a gamble because if it is decided in the insurance companies favor then you are out the repaint and you will have to pay attorney fees court costs etc. you have to get that diagnosis done though, the sooner the better.

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C-Kwik
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I don't know of any company that would ever agree to any contract that would bind them into paying anything before they have all the facts of the case (medical claim info as well). A claim's worth is not something that can be determined prior to having all the info an adjuster needs to make that determination. It's unfortunate, but necessary. In large part, a reason for this is fraud. Unfortunately, it would be an open invitation to get an insurance company to pay for all kinds of unneccesary treatment. A person faced with paying and being responsible for the cost of treatment would be more likely to only treat as much as it is necessary. It's not a perfect system, but from a legal standpoint, it works.

I'm sure the insurance company already told her this, but do whatever you can to treat as necessary.

I don't know everything about claims in Virginia, but in many cases here in CA, attorneys work out a lien against a future settlement with doctors. You might ask your own doctor and the specialist he refers you to if this is something they can do directly or through an attorney if they feel uncomfortable about you handling your own bodily injury settlement negotiations. I recommend that you try your best not to let an attorney refer you to a doctor or your doctor refer you to an attorney. It can look bad and you may be led into a situation where your claim is padded without your full knowledge. While I don't typically recommend an attorney unless you absolutely need it (Since they take a cut), it could be necessary if your doctor won't work out a lien arrangement without one. Ultimately, she needs to do what's best for her...

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92Maxin
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Joined: Fri Apr 13, 2007 12:12 pm
Car: 92 Maxima GXE

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I understand that they wont sign a contract without proof that she is being diagnosed. The contract is to the point that once she is and starts treatment, the doctor will be able to send them bill for the treatment. She ust started a new job so her medical insurance hasnt kicked in yet and just the x-rays alone are going to cost out the ***. Its not that the insurance company is telling her what it can and cant do and why, its the fact that they are telling her they wont do anything so she needs to just settle ad be done with it. They have reciepts and doctors reports from her seeing her personal doctor. I know they wont refund her until she settles but the report from the doctor even states that she needs to see a sepcialist to find out to what extent she was hurt and will more than likly need physical therapy wich they then said "Well we dont care how long she might need the PT. If she does go we wont pay for more than 60 days!" both her insurance and the doctor told them that in some cases people need to go longer so what then? They replied with "Its not our problem!" The BS like this plus a bunch of other **** i havnt stated is why were getting the attorney. Its not what we wanted to do but it seems to be what its gona take to get the job done. Thanks to all for your response and suggestions. Its very much appreciated.


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