Auto insurance claims

[Wheetsin 714]

I was rear-ended late January. The other driver was 100% at fault.

I finally got my car back at the beginning of the month, then they fixed something incorrectly and it had to go back in Friday. In the meantime, they tried to put me in a Ford Focus as a replacement. I drive an SUV. I'm a hair under 6 foot and DH is 6'5. Plus non-negotiable passengers. Fools.

I was on medication therapy for the back/muscle issues but stopped due to pregnancy, so my Dr. prescribed physical therapy (which she was going to do anyway since she wasn't seeing as much progress as she wanted with just the relaxers/pain meds/etc.). That will start this week.

Because of this accident, I'm out to the tune of about $8000 between missed work, medical bills (this one has a caveat, but for the sake of keeping it simple...), copays, etc. I just called to see about submitting my expenses and found out they pay in a single lump sum, so if I submit now, they will not cover physical therapy. And once they pay, they're allegedly "free and clear" of anything else that may come up. I'm not sure I buy this, nor am I sure they should be telling people who call. If my head falls off 3 weeks from now and 10 doctors can testify that it's because of this accident, I don't see how having processed payment for my bills removes their liability.

I asked if they planned on paying the current interest rate on my $8000 since it would be accruing interest right now if I hadn't had to spend it, and she literally laughed at me. I really wasn't kidding.

It makes me wonder -- if I was in a position where I didn't have the cash to spare, and had to use a credit card, would they pay the interest on the charges?

When they told me, "Our goal is to keep you from experiencing a change in your standard of living" they didn't add, "...one year from now." That's soooo what's not happening. If my life is supposed to be as though the accident, where are teh gains I'm missing because my 8k is elsewhere?

I've been no-fault in accidents before, and I know for a fact that things were paid as I went. I used the example with her, "So if I needed surgery and rehab, the surgery couldn't be booked for 4 months and then my rehab was 6 months, it would be 10 months before you even thought of paying anything, and I would have to foot those bils or at least pay copays, then my insurance company would have to go after you?" and she confirmed that was indeed the case.

So, so, so messed up.

[anonemouse 1]

My brother's a lawyer and we were actually discussing situations somewhat like this over the weekend, since my former roommate was sued over a wreck (the other woman waited until the day before the 1-year deadline was up before filing the suit). He said that people wait as long as they can to sue insurance companies because they don't necessarily know how much money they are going to need. For example, if they are badly injured, they may have ongoing medical expenses. If they settle for a certain amount before before they finish treatment, they are limited to the amount of the settlement, even if their medical expenses wind up going over that amount. So if you are still undergoing treatment, you do NOT want to settle right now. You can't go back and renegotiate for a higher amount.

Now, are you talking about your own insurance company or another one? I can sort see what I talked about above happening if it's the other person's insurance company that is paying, but I think you should call back and talk to another person if it's your own insurance company.

If I've totally missed the point of your post, ignore me! I'm a little scatter-brained today!

[miztrniceguy 1]

i suggest getting a lawyer

[Skinny_Jill 36]

When I was in a car accident quite a few years ago and needed physical therapy I informed the company that other driver's insurance company was responsible for all charges. They contacted the insurance company and got a claim number and I did not pay a dime. When therapy was complete the insurance company sent me a check made out to me and the company providing the therapy. We both endorsed the check. I also received money for the time I missed from work. As a matter of fact they paid me 3 times my total expenses which was for pain and suffering I guess. I didn't ask for it and was surprised. I did have to sign off stating that were "free and clear."

The worst part was that my car was totaled and was fully paid for so that means I had a car payment again. What a pain.

Good luck Wheetsin!

[VegasGrace 1]

There is a secret number...a number an adjuster can write a check for w/o approval.... 10 years ago it was like $2,000. Now, I'm certain it's much, much more.

Find out what that number is...and see.

Well, that is true, once they pay...they are done and you do have to sign a waiver. Don't want to 'settle'...don't. There is no law saying you have to settle.

Just check with your state to see what the Statute of Limitations is on these things and be sure you file within the time limits. Save all your receipts and present them. The judge will determine if there is any further possible expenses at that time...yes, they get to decide so if you've not had any receipts for anything for a while....you may not get future benefits.

good luck

[Wheetsin 714]

Appanretly my state is one the few where your health insurance provider is the primary provider, regardless of who is at fault. I had to go through way too much subrogation process to find that out. So in other words, even though he hit me, my insurance company pays for my bills, meaning I'm charged copays, out-of-network fees if applicable, etc. Then I submit my expenses to the at-fault driver's insurance and they reimburse what I paid out-of-pocket.

My point being - it's an annoying concept, because I'm out the costs until I file with his insurance company, which I wouldn't do until my treatment is complete (which it isn't).

From there, it's the whole idea of them telling me "our goal is to ensure you have no change or interruption in your life because of this." But I have paid out money I wouldn't have had to pay if their customer had not hit me, so that's not a true statement. Maybe in a year it will be true, but right now it is not. Right now I have ~8k of money "in limbo" -- that's reimbursable, but not yet, but that also is not in an account drawing the interest I'd otherwise be drawing.

I happened to have the money on hand, but if I hadn't, I would have had to charge these expenses or seek some kind of loan for them, and I'm pretty damn sure the guy's insurance company wouldn't be paying my finance or origination costs, at least not voluntarily. So I was just wondering out loud how situations like that are handled.

Really it's just the absurdity of the whole idea that no matter what, being the victim of an idiot costs you money in some way, shape or form. :thumbup:

I know I don't have to settle, etc. It's just the concept of what insurance is supposed to do for you, versus the reality of this (and other) situations. It's so annoying. (Hence I'm venting)

[Skinny_Jill 36]

Just more proof that the insurance industry is totally screwed up.

[stacy73 2]

Wheetsin- I am assuming that you live in the state of Michigan-As far as I know-please don't hurt me, but I work for an insurance company :thumbup:-your health insurance provider is supposed to pay ALL of your auto accident related medical bills-now the co-pays I believe may be able to be reimbursed through your auto insurance carrier-No fault pip coverage-I am not sure it would depend on the policy-but in Michigan the health insurance carrier is primary and the auto carrier is secondary- I do believe they would be responsible for paying your out of pocket expenses that your health insurance does not cover- I would make a call especially if you are out of pocket $8000-might be worth looking into.

[vgerbus 1]

Wheetsin, I have been in almost the exact scenario but with a 4 year old in the car as well. Hire a good lawyer, a good lawyer is worth every penny you pay him and can handle all the paperwork hassles and BS from your insurance and the persons who hit you!

[Wheetsin 714]

Stacy - nope, I'm in MO. His provider will (eventually) cover my OOP expenses, I'm not worried about that. It's just annoying because that's money I would have accruing interest were it not for their covered who hit me. It just chaps a bit that it costs me money, even temporarily, for this kid to be an ass looking for his cell phone while going 70 mph down a 40 street... but such is life.

[stacy73 2]

I hear ya- i know it sucks.. even with me working for insurance I feel really bad when our insureds call in situations like these- keep after those bastards though, you should not be paying out of your own pocket for anything!!

[snuffy65 1]

i suggest getting a lawyer

I agree with Miztr. You need a lawyer, sure they take some money but they will get all the money you are entitled to.

[Wheetsin 714]

but they will get all the money you are entitled to.

Exactly! :huh2:

(emphasis mine)

[snuffy65 1]

Exactly! :biggrin:

(emphasis mine)

LOL, I didn't mean it that way But too true!