Medical ins. not paying for accident claims

[Masthera]

i live in maryland but have health insurance in pennsylvania. i was involved in an accident in august of 2001 in pa. i used my own auto insurance for claims and once that was exhaused i used my medical insurance. the woman who hit my car was found to have the majority of the fault of the accident. i settled with her auto insurance company. my health insurance company paid for about one month worth of medical bills. there is still 2 months of physical therapy, 2 mri's, and all the bills from a neurologist. the insurance company has not paid anything for about 3 months and has also not denied any claims. i have asked everyone to rebill their claims. i received a letter wanted information on the accident about 6 months after the bills started to go to the insurance company and they also sent a letter wanting me to sign saying that they would be paid for monies that they paid out if i won any settlement. i received this letter after i settled and the attorney told me that the insurance company can not hold my claims and that i will not owe them any money because i settled before they sent the forms. i had to call the insurance company 5 times to get the claims that were paid, paid. the kept feeding me the usual excuses. but now it is getting ridiculous. i contacted the attorney he wrote a letter to the insurance company expaining the accident and to contact him with further questions. i never hid the fact that the claims were from an accident i told the company point blank that they were. So they were aware of the accident early on. also all the providers mail in exhaustion letters from my auto insurance co.

How much longer do I have to wait for payment?! is the attorney i used correct in what he says? Is there any legal action i can take?
I would appreciate any opinions please.

Thanks (sorry so long)

 

[ALawyer]

This is something tht your attorney should have explained to you BEFORE accepting a settlement.

Health Plans often have specific provisions entitling the company to recover what they pay from any third party -- such as another driver's insurance company.

I would tell the attorney that you need him to do more than simply write a letter to the insurance company if you are being dunned by doctors and others.

As lots depends on the Health Plan, its exact language, the terms of the settlement, and local state laws -- and I am NOT from PA or MD - I really can't advise you further.

 

[Masthera]

Thanks for the advise. I will contact the attorney again and ask him to do more.

 

[bowler87]

By settling your liability claim with other driver, your attorney can not avoid the obligation spelled out in your health coverage.

"attorney told me that the insurance company can not hold my claims and that i will not owe them any money because i settled before they sent the forms."

If he said this, I believe he is in error.

Why did he settle if you were still having treatment?

 

[Masthera]

good question. he had told me that the offer was the best i would get even if i went to court and he advised me to settle. he contacted me a few weeks ago and said that the insurance company agreed to pay my claims within the next 30 days (yeah right) and that if they do not pay then we will sue the health insurance company. I have coverage for the treatments that i received within my policy and there is no subrogation clause in my policy so i guess sueing is the only option if they do not pay.

thanks