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Ins. Company Responsibility?

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SET

Junior Member
Texas - My situation: :confused:
I was rear ended in 1/06 and they at fault's insurance company accepted responsibility
I have been experiencing back complications ever since.
I had scoliosis corrective surgery in 2001 and have had no back problems since surgery.
I continue physical therapy and am about to see a doctor about injections.

QUESTION:
1. I am being told that the insurance company is not going to cover anymore of my medical expenses based on the vehicle damages and their statistics showing I should be better right now. If I have Doctors disagreeing with this, then how can they get away with continuing to pay me medical expenses???

2. I am being told that I should just settle (even though I am not better and don't know how long it will be until I am fully recovered), and that I probably will barely get enough money out of the settlement to cover the medical expenses I have already accrued. How do insurance companies get away with that, or am I being fed a bunch of balonie?
3. I am being told that if I try to take this to court I will probably loose because in the last few months the only thing awarded in these cases if anything is medical expenses. Is this right? And where do I begin to look to find these records?

I am confused and frusfrated. If someone could help answer these questions, or at least point me in the right direction I would appriciate it.

Thank You,
SET:(What is the name of your state?
 


ecmst12

Senior Member
Right direction - hire an attorney.

Someone who had no history of back problems might indeed be better by now. But you have a history of back surgery, and you are the one they hit. The at-fault party has to accept you "as you were" at the time of the accident and make you whole again, regardless of whether you were prone to more severe injury due to previous conditions.

(Is that an accurate explanation of what I have been told of the "eggshell clause"?)

You can contest this decision, but on your own without representation it will be an uphill battle. Definitely get yourself a decent lawyer and go from there.
 

Scary

Junior Member
Hi,

Sorry I cant help you as I posted questions myself. I am curious as to who is telling you to settle and being from So. Texas and in a simialar situation, I am wondering what company you are dealing with. I dont know the rules here but it doesnt sound like you can name the company.

Good luck
 

SET

Junior Member
Re:

I don't want to disclose the name of the insurance company, but let's just say it is one of the shotty ones. (Nationwide, A-Affordable, etc..) I am starting to believe that all insurance companies are crooks
 

moburkes

Senior Member
SET said:
Texas - My situation: :confused:
I was rear ended in 1/06 and they at fault's insurance company accepted responsibility
I have been experiencing back complications ever since.
I had scoliosis corrective surgery in 2001 and have had no back problems since surgery.
I continue physical therapy and am about to see a doctor about injections.

QUESTION:
1. I am being told that the insurance company is not going to cover anymore of my medical expenses based on the vehicle damages and their statistics showing I should be better right now. If I have Doctors disagreeing with this, then how can they get away with continuing to pay me medical expenses???

2. I am being told that I should just settle (even though I am not better and don't know how long it will be until I am fully recovered), and that I probably will barely get enough money out of the settlement to cover the medical expenses I have already accrued. How do insurance companies get away with that, or am I being fed a bunch of balonie?
3. I am being told that if I try to take this to court I will probably loose because in the last few months the only thing awarded in these cases if anything is medical expenses. Is this right? And where do I begin to look to find these records?

I am confused and frusfrated. If someone could help answer these questions, or at least point me in the right direction I would appriciate it.

Thank You,
SET:(What is the name of your state?
Do you have PIP or medical payments on your own policy?
What are the liability limits of the at fault party?
 

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