Any options when the claim administrator not complying with medical care

Get Legal Help Today

Compare Quotes From Top Companies and Save

secured lock Secured with SHA-256 Encryption

Any options when the claim administrator not complying with medical care

We are located in Sacramento California. I am researching on behalf of my brother as it’s his case. Essentially him and the Hartford insurance company agreed to a settlement where the Hartford agreed to provide him lifetime medical support for his injury. He has been going to all his appointments, check-ups, fully compiling on his end. The Hartford is denying him a surgery that his workman comp doctor says he desperately needs. They requested 2nd and 3rd opinions and all say the same thing he needs surgery and medical evidence to support it. The issue is the company is denying his surgery, other treatments and medications for pain. Is it possible to either reopen the case or sue in a new case because they are not complying with the court ordered medical care he was approved for?

Asked on July 9, 2019 under Personal Injury, California

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 4 years ago | Contributor

You write that your brother and the insurer "agreed to a settlement": that means there must be an actual settlement agreement, which is a contract and therefore which is enforceable. If your brother believes that the other side is violating the terms of the agreement, by not paying for treatment which under the plain language of the settlement they should, he could sue them for "breach of contract" to force them to pay.


IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

Get Legal Help Today

Find the right lawyer for your legal issue.

secured lock Secured with SHA-256 Encryption