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Demand letter.

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Walk3r1

Member
What is the name of your state? North Carolina

So I am preparing my demand letter to send to the insurance company.
So here is my accidnet and medical.

I was side swiped by a dump truck on the high going about 35 mph.

I went to the emergency room got xrays on leg and wrist and no fractures, but was referred to an orthopedic, I went and he advised I had soft tissue damage in my wrist and put me on a brace for 6 to 8 weeks, no follow up. I will be billed for these two appointment.

I went to a chiropractor, and was diagnosed with about 6 different type of injuries that requires 20 sessions of physical therapy. 3 a week the first four weeks then once or twice the following weeks. They direct bill the insurance company.

They have already totaled the car and given the money for that which was reasonable.

I owe a carpet cleaning company, and do that part time making around 3 to 4 hundred a week. That I can not do at all for about a month now and will not be doing for 2 months.

I have read how things are calculated but with the direct billing by the chiropractor how am not sure how that plays into it and how much compensation I should put in the demand letter for pain and suffering.
 


adjusterjack

Senior Member
I went to a chiropractor, and was diagnosed with about 6 different type of injuries that requires 20 sessions of physical therapy. 3 a week the first four weeks then once or twice the following weeks. They direct bill the insurance company.
Insurance companies routinely balk at paying for quackopractic bulls--t. Count on having most of it disallowed.

I owe a carpet cleaning company, and do that part time making around 3 to 4 hundred a week. That I can not do at all for about a month now and will not be doing for 2 months.
Do you mean you "own" the company? ;)

Make sure you submit your tax returns for 2017 and 2018 plus copies of your billings from 1/1/19 to the date of the accident.

The insurance company will want documentation (not just sayso) of your loss of earnings.
 

Walk3r1

Member
The chiropractic is very good been in the buiness for 30 years. We was hit by a dump truck and I have had days I can hardly move.

They are already paying the Bill's he sends.

Yes I have all of that prepared already.

So the question was and still is, what would be the suggested amount to put in the demand letter.

Thanks for the respone but this is not a money grab. This is a legit claim. I was re ended before slightly. I was referred to a quack, who put me in a neck brack back brace and stupied stuff. I called the insurance company told them, that in no way was I hurt that bad, and that this guy is BS.

I settled with them within a month of the accident.
 

adjusterjack

Senior Member
So the question was and still is, what would be the suggested amount to put in the demand letter.
Any amount that you feel would adequately compensate you. I couldn't even begin to estimate a personal injury claim and I'm the retired claim rep. Each one is based on it's own merits.

There are probably websites out there that might help you quantify your claim. Some of them might still subscribe to the ancient pain and suffering formula of 3 x specials. That has pretty much gone the way of the buggy whip but you can start there for want of anything else and see what kind of response you get.

There are also sites that will help you draft your demand letter.

If you are still under treatment I suggest you wait until you are completely recovered plus a couple of months to make sure you have no residual issues cropping up. Understand that once you sign the release you don't get another trip to the well.

I may have been facetiously dismissive of chiropractic but it's a serious issue in the insurance industry because of all the scamming that occurs even by supposedly reputable chiropractors who have been in business for decades.

You wrote:

I went to a chiropractor, and was diagnosed with about 6 different type of injuries that requires 20 sessions of physical therapy.
So your chiropractor knows, in advance, that after exactly 20 sessions you'll be cured and need no further treatment. Not 19 sessions, not 21 sessions, exactly 20 sessions at X dollars per session billed directly to the insurance company. It's exactly that kind of thing that puts claim reps in fight mode. :)
 

Walk3r1

Member
Any amount that you feel would adequately compensate you. I couldn't even begin to estimate a personal injury claim and I'm the retired claim rep. Each one is based on it's own merits.

There are probably websites out there that might help you quantify your claim. Some of them might still subscribe to the ancient pain and suffering formula of 3 x specials. That has pretty much gone the way of the buggy whip but you can start there for want of anything else and see what kind of response you get.

There are also sites that will help you draft your demand letter.

If you are still under treatment I suggest you wait until you are completely recovered plus a couple of months to make sure you have no residual issues cropping up. Understand that once you sign the release you don't get another trip to the well.

I may have been facetiously dismissive of chiropractic but it's a serious issue in the insurance industry because of all the scamming that occurs even by supposedly reputable chiropractors who have been in business for decades.

You wrote:



So your chiropractor knows, in advance, that after exactly 20 sessions you'll be cured and need no further treatment. Not 19 sessions, not 21 sessions, exactly 20 sessions at X dollars per session billed directly to the insurance company. It's exactly that kind of thing that puts claim reps in fight mode. :)
No not at all, started at 4 weeks, was reavulated, which I advised that there was still pain and issues. (Thou improvement) He has now set a schedule of twice a week instead of 3, and if there is improvement, then down to once a week, to ensure I am good. He said 20 sessions as a guideline.

I think someone that has been in the buiness for 30 years, would have an idea have what type of treatment plan is needed. When you break your hand, there is a plan in place and timeline of cast, and therapy to build back the strength.

I do not in anyway feel an estimate of sessions, is a sign of being shady. I think a plan is put in place.... when you workout d you plan? Or just got to the gym and hope.
 

adjusterjack

Senior Member
No not at all, started at 4 weeks, was reavulated, which I advised that there was still pain and issues. (Thou improvement) He has now set a schedule of twice a week instead of 3, and if there is improvement, then down to once a week, to ensure I am good. He said 20 sessions as a guideline.
That's better.

Do you know how much he is billing per visit? Have you compared his charges to charges for a physical therapist from a medical provider?

Who is he billing? Your medical insurance or the other driver's liability insurance? If the latter, he's not going to get paid anything until you settle. And then it's likely that you will have to pay him out of your settlement.
 

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