What to do if I was not at fault for a car accident ans was injured but had to stop medical treatment due to work travel and now the insurer refuses to pay?

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What to do if I was not at fault for a car accident ans was injured but had to stop medical treatment due to work travel and now the insurer refuses to pay?

What are my options? I want to continue medical treatment either in the city I am in, or when I get back home. Insurance says that even when they are at fault, they will not continue to pay due to gap in treatment. I have not consulted a lawyer because I did not want to make things difficult. Now with them refusing to continue to pay for treatment, I want to know what I could do.

Asked on May 4, 2012 under Personal Injury, Texas

Answers:

S.L,. Member, California Bar / FreeAdvice Contributing Attorney

Answered 9 years ago | Contributor

It would be advisable to speak with a personal injury attorney, who may be able to send you to a doctor, who will be paid out of the settlement of the case.  The doctor takes the case on a lien which means the doctor is paid out of the settlement of the case.  This will allow you to continue and complete your medical treatment.

Unfortunately, when there is a gap in treatment, the insurance company will use that as an excuse to make a low settlement offer because the insurance company will claim that a gap in treatment means to them that you weren't seriously injured.

If you do go to a doctor, who takes the case on a lien basis, when you complete your medical treatment and are released by the doctor or are declared by the doctor to be permanent and stationary, which means having reached a point in your medical treatment where no further improvement is anticipated, obtain your medical bills, medical reports, and documentation of any wage loss.  Your personal injury claim filed with the at-fault party's insurance carrier should include these items.  Compensation for the medical bills is straight reimbursement.  Compensation for wage loss is straight reimbursement.  The medical reports will document the nature and extent of your injury and will be used to determine compensation for pain and suffering, which is an amount in addition to the medical bills.  If you are dissatisfied with settlement offers from the insurance carrier, reject the settlement offers and file your lawsuit for negligence against the at-fault party.  If the case is settled with the insurance company, NO lawsuit is filed.  If the case is NOT settled with the at-fault party's insurance carrier, you will need to file your lawsuit for negligence against the at-fault party prior to the expiration of the applicable statute of limitations or you will lose your rights forever in the matter.

 


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