What is the name of your state (only U.S. law)? Ohio
I was involved in a minor auto accident 8 weeks ago. The other party admitted fault when they gave their statement to my claims rep [no accident report was filed at the time but I filed one the next day]. I contacted my insurer and they opened a file, the other parties insurer contacted me stating in writing "we do no pay medical bills as they occur. We generally settle in exchange for a release of claims". Which basically means they will typically pay the bills after I agree sign a release.
I called my otho but he was booked for 30 days so I made an appointment with a chiropractor to get checked out. The doctor's office called back and I was able to see another ortho in his practice who basically said I was ok [and I was at that point]. The chiro said I suffered a minor concussion and due to the position of my head at the time of the accident that my spine suffered trauma, he scheduled twice a week treatments for three weeks. Condition improved, he scaled back the appointments and then I woke up one morning with a stiff neck and the condition worsened. I called his office made an appointment but felt worse after his treatment, so I sought out a massage therapist to seek relief as the chiro treatment stopped being beneficial. The next week I scheduled another appointment with another ortho [neck / spine specilaist] who took xrays and confirmed that I'd suffered a soft tissue injury, recommended I stop seeing the chiro, continue with massage therapy and scheduled P/T.
The issue here is that I only have a $2000 max for medical with my insurer and I'm already close to my limit. My insurer said that once I reach that limit *I* would be responsible to get the other insurer to pay the remainder of the bills. It seems they will go after them to reimburse for the 1st $2000 but it's on me should I go over that limit. Since my condition has improved quite a bit I'm considering stopping the treatment for P/T and massage until I get some sort of confirmation from the 3rd party insurer on the status of them accepting the doctor's treatment as fair.
My concern is I sign the release and then I run into complications down the road. What is the limit on how long I can seek payment [take them to court] for this accident? At this point we're taking perhaps zero dollars out of my pocket [assuming My auto insurance agrees to all of my treatment] or at worst a couple of $100 bucks if I do not receive any more treatments. While I'm feeling much better I'm still not to the point I was pre-accident, but even the specialist told me this could improve on its own.
The massage group I went to didn't request payment up front. They took my claim information from MY auto insurer.
I do have a copy of the 'script for the P/T and another of massage therapy from the specialist that I'll fax to both claim reps. I had 7 treatments with the chiro, 4 with the massage therapist and 4 with P/T. The treatment plan was twice a week for 4 weeks.- so, I've completed half of the treatments already. The fact a MD specialist wrote me two 'scripts for P/T and massage therapy is it customery to expect the 3rd party insurer to honor those treatments?
If claims are paid after max medical improvement, which could last months, then I would be billed after I reach my $2000 MAX? To avoid a negative effect on my credit rating I'd have to pay the bills and then have the other insurer reimburse me? If I were to file a claim against them to seek payment would I do so in small claims court [assuming the limit I'm seeking is handled by that court]? I've represented myself in small claims court in addition to a custody case, so I'm not unfamiliar.
I appreciate the education on this process.
I wanted to add, a couple of weeks ago my claim was transferred to another claims rep to "handle till conclusion". When I asked the original agent why she said "company policy".
I was involved in a minor auto accident 8 weeks ago. The other party admitted fault when they gave their statement to my claims rep [no accident report was filed at the time but I filed one the next day]. I contacted my insurer and they opened a file, the other parties insurer contacted me stating in writing "we do no pay medical bills as they occur. We generally settle in exchange for a release of claims". Which basically means they will typically pay the bills after I agree sign a release.
I called my otho but he was booked for 30 days so I made an appointment with a chiropractor to get checked out. The doctor's office called back and I was able to see another ortho in his practice who basically said I was ok [and I was at that point]. The chiro said I suffered a minor concussion and due to the position of my head at the time of the accident that my spine suffered trauma, he scheduled twice a week treatments for three weeks. Condition improved, he scaled back the appointments and then I woke up one morning with a stiff neck and the condition worsened. I called his office made an appointment but felt worse after his treatment, so I sought out a massage therapist to seek relief as the chiro treatment stopped being beneficial. The next week I scheduled another appointment with another ortho [neck / spine specilaist] who took xrays and confirmed that I'd suffered a soft tissue injury, recommended I stop seeing the chiro, continue with massage therapy and scheduled P/T.
The issue here is that I only have a $2000 max for medical with my insurer and I'm already close to my limit. My insurer said that once I reach that limit *I* would be responsible to get the other insurer to pay the remainder of the bills. It seems they will go after them to reimburse for the 1st $2000 but it's on me should I go over that limit. Since my condition has improved quite a bit I'm considering stopping the treatment for P/T and massage until I get some sort of confirmation from the 3rd party insurer on the status of them accepting the doctor's treatment as fair.
My concern is I sign the release and then I run into complications down the road. What is the limit on how long I can seek payment [take them to court] for this accident? At this point we're taking perhaps zero dollars out of my pocket [assuming My auto insurance agrees to all of my treatment] or at worst a couple of $100 bucks if I do not receive any more treatments. While I'm feeling much better I'm still not to the point I was pre-accident, but even the specialist told me this could improve on its own.
The massage group I went to didn't request payment up front. They took my claim information from MY auto insurer.
I do have a copy of the 'script for the P/T and another of massage therapy from the specialist that I'll fax to both claim reps. I had 7 treatments with the chiro, 4 with the massage therapist and 4 with P/T. The treatment plan was twice a week for 4 weeks.- so, I've completed half of the treatments already. The fact a MD specialist wrote me two 'scripts for P/T and massage therapy is it customery to expect the 3rd party insurer to honor those treatments?
If claims are paid after max medical improvement, which could last months, then I would be billed after I reach my $2000 MAX? To avoid a negative effect on my credit rating I'd have to pay the bills and then have the other insurer reimburse me? If I were to file a claim against them to seek payment would I do so in small claims court [assuming the limit I'm seeking is handled by that court]? I've represented myself in small claims court in addition to a custody case, so I'm not unfamiliar.
I appreciate the education on this process.
I wanted to add, a couple of weeks ago my claim was transferred to another claims rep to "handle till conclusion". When I asked the original agent why she said "company policy".
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