Need Help! Lying adjuster

[alisha]

What is the name of your state? SC

Hi
Please note: I know absolutely *nada* about legal issues; I have been searching the internet for any information which led me to this forum. Please excuse my lack of knowledge!

My boyfriend was involved in an 3-car accident about 5 weeks ago where a truck hit him head-on without stopping from behind when he was stopped (full stop, not rolling) behind another car at a yield sign. (He hit the car in front.)

Well my boyfriend was driving my car, and although the truck wasn't damaged much, my car was totally crushed in from behind.


Okay for the lying adjuster:
My bf went to the ER because he hit the steering wheel (seat belt didn't lock) and neck injury.

He has been to his doctor several time since, and just recently his doctor sent him to physical therapy.

Well even with health insurance (employer's) he has to pay some of the $ for the physical therapy, and his doctor has him going 8 more times which will add up.

My boyfriend obtained a lien from the physical therapist stating that the insurance company would pay for the bills. However, when he talked to the physical therapist- they told him the adjuster (or claims person, whoever handles the case!) said that they wouldn't sign the lien because my boyfriend told her that he WASN'T going to seek any medical care--which is a TOTAL lie!!

Even after my boyfriend told the physical therapist that he never told her that and it wasn't true (he has been to the doctor probably 4 times since the accident) the adjuster told them the same thing again and refused the lien.

David (my bf) has tried to contact the adjuster, who is 'conveniently' not around after business hours and does not return his voicemails when he calls during business hours. He goes to college and works 2 jobs and they are closed on weekends.

Now I think I understand that we can get all the money spent on bills back in a settlement, but the bills are stacking up for a 19 year old supporting a family.

I think because we are so young and uneducated in these matters that perhaps the physical therapist will believe the adjuster over us?

We have kept all receipts and records of doctors visits also. He also missed work and school and is still taking medication.

--Is there anything we can do about the adjuster?
--When we do get a hold of her- what kind of things should we say?
-Are there risks involved with signing the lien? (They always say "don't sign anything!")


And most important: Do you think we have a case and should get a lawyer?


I would appreciate any help-- this has become such a hassle I am eager to get it over with. (Sorry for so many questions)


Frustrated in South Carolina,

Alisha

 

[tigger22472]

Physical Therapist can only go by what the insurance co. tells her. I realize it's a pain but the only options you have is 1. pay the full bill for PT and fight it out with insurance co. or 2. wait until the matter is cleared up before receiving PT. I know it doesn't sound good but those are your options. The PT is doing what she has to to guarentee she gets paid for her services.

 

[JETX]

"Is there anything we can do about the adjuster?"
*** Yes.
First, did you ever think that you might be confused or in error. You are two steps removed from this entire situation and, as such, are just that more out-of the-loop.
Second, your own post says that your boyfriend (the 19 year old with the 'family'!!) is hard to get in touch with and seem to be complaining that the adjuster doesn't work his schedule to fit yours. Have you considered that in your condemnation??
Third, have you tried to contact anyone else in the insurance office??
Fourth, have yo tried to contact the adjuster by mail, FAX or even email??
See, there are lots of things.

"When we do get a hold of her- what kind of things should we say?"
*** First off, unless you two are married, there isn't much that YOU can say. However, the claimant can say things like:
- Could you advise the status of this claim?
- Is there a particular reason why this is being held up?
- Do you know any reason why the PT is being held up?
Or any of 100 other things.

"-Are there risks involved with signing the lien? (They always say "don't sign anything!")"
*** Depends on what you mean by 'risks'. If you mean a risk that the PT will not be successful, of course. And you always, always have the risk that the PT is eventually going to want to be paid by someone.

"And most important: Do you think we have a case and should get a lawyer?"
*** Again, there is no 'we'. If your boyfriend feels that he will not be able to successfully resolve this claim without the benefit of an attorney (as it sounds it might be), then by all means, have him talk with an attorney.

And before you respond in anger, no I am NOT an insurance adjuster, nor am I involved in the insurance business in any way. I am only trying to point out that as a 'newbie' to this game of insurance claims, these things never, ever move as fast as you think that they should.

 

[tigger22472]

Good point JETX I never even thought about the fact they aren't married and I should of. Especially with the new HIPPA laws. I remember when my husband was in the hospital after his accident I couldn't do or say anything so as soon as I could I got a POA. Before I got that though I called one of the dr. offices to give them his insurance number. They were going to refuse to take even that from me and said until they saw a copy of the POA they would discuss nothing. The lady finally took it when I told her I didnt' give a rats ass about anything but them getting their money.

OP... YOUR boyfriend has to do all this no body will let you do anything.

 

[alisha]

***Hi JETX,

First off I want to say thank you for your information, although I feel like you were more condenscending than helpful.

To begin with, the whole reason why I posted to this site was because I needed information. (And please read the first sentence of my original post again.)

You ask:
"Second, your own post says that your boyfriend (the 19 year old with the 'family'!!) is hard to get in touch with and seem to be complaining that the adjuster doesn't work his schedule to fit yours. Have you considered that in your condemnation??
Third, have you tried to contact anyone else in the insurance office??
Fourth, have yo tried to contact the adjuster by mail, FAX or even email??"


---Well no, he hasn't done any of those things because he didn't know where to start- SO I got on the internet looking for exactly those answers, yet I feel like your response was more so an accusation of immaturity than instructive.

I also do not appreciate your condescending tone with the "(the 19 year old with the 'family'!!), which seems unconstructive.

Second, yes; you are right, I am not his wife so I am two steps removed from the process, so please excuse all "We's" and turn them into 'he' because I am only serving as a supporter trying to find information for my companion. I am mildly surprised by your consistent reminder throughout the post that I cannot do anything, only the claimant-- and although its expected for an automatic assumption that I'm ignorant; thank you for reminding me of something I already realized when I started out to help my boyfriend in this case, and simply forgot to correct myself in the post.

And no, I am not responding out of anger- I am just responding to the mild irritation and disappointment I recieved after reading your response which taught me that when I ask for help here on the forum, scrutiny will be included with help.

However, the latter half of your post is more instructive, and I thank you for that-- it was a dull sun after the rain after reading your first half of the post.

Am I being too emotional and should stick to the point of the case? Probably. But I feel like it should be like the saying: "Ask and you shall receive," not "Ask and you shall be mildy insulted and then recieve."

Hope I wasn't too offensive, JETX, because I am grateful for your information-- just after reading this post and noticing a few of your other replies in posts I was looking through, I suggest that perhaps you could use a little more tact and quit assuming everyone's an ignorant baby.

If anyone else feels sincere to post more information regarding the my original post, I will be more than happy to accept.

Alisha

 

[JETX]

"I feel like you were more condenscending than helpful"
*** And is that a problem??

"I also do not appreciate your condescending tone"
*** See below.

"I am mildly surprised by your consistent reminder throughout the post that I cannot do anything, only the claimant"
*** And it is correct.... you can't!!

"I am just responding to the mild irritation and disappointment I recieved after reading your response which taught me that when I ask for help here on the forum, scrutiny will be included with help. "
*** Yep, welcome to the real world. Experience has taught me that posters on this forum, are often 'skewed' to put the writer in the best possible light.... even to the point of failing to tell sufficient facts needed to respond. So, yes, your post is scrutinized..... to try to figure out what the real story may be. Accept it... thats life!

"it was a dull sun after the rain after reading your first half of the post."
*** Damn, woman, you sure have a pretty way with words!!!

I take no offense to your post... but if you think I was harsh, you haven't seen me on a good day!! You sure have a thin skin and seem pretty damn whiney to me.

So, you felt 'uncomfortable' reading my post. Who cares?? This is not the 'Oprah, give me a hug' website. The information I provided to you was free, accurate and maybe a little harsh. But teh bottom line is.... you seem to have gotten the point and maybe even learned a little something. If you feel I stepped on your toes in helping you.... go out and buy some steel-toed boots. The real world is pretty tough!!

As my dear ole 'granpappy' used to say, "Sometimes you have to hit the mule in the head with a 2x4, just to get his attention to show him where the food is".