by smith123 » Tue Nov 03, 2009 11:09 pm
I was involved with a no fault accident. The other person rear ended me. I had my car totalled. I went to doctor after a week or so, as the day of accident was friday and could not get doctor appointment. I just went to chiro. The final bills run to 3K or so. I still need to pursue treatment for 2 more months. Now, I wanted to know what can I include in the claims in order to get the claims settled? Can I include future claims, loss of wages, hardship? For loss of wages, I did not miss a day at work, but I had to adjust timings during the work to get the treatment. The chiro said that it's normal after the treatment, although I do experience some pain in neck and back, but it's mild now. Do I need to visit any specific doctor now?
Posted: Tue Jan 12, 2010 08:42 pm Post Subject: BI Claim...
Hi tscope...
Thanks again. Here's the thing. The appraiser wrote the estimate. Then when I went to Body shop, it was determined that there is more repair work. The same appraiser came back to repair shop and then they revised the estimate/claim amount and then gave me the check.
What they are arguing is that the total PD paid, whether it was related to the same accident or not? To do that they are requesting the person who rear-ended to provide pictures of the car at the time of accident. I am not sure how to handle this issue.
Regarding BI Claim, I paid doctors bills and the doctor gave a medical report that I need further treatments. I filed a BI claim, and I included the future claims as well, since I need money for the same. They are declining future claims, but worst part is that they are going back and forth on PD claim, and are not starting the BI claim process until the investigation is done.
Posted: Tue Jan 12, 2010 09:23 pm Post Subject:
I'm not understanding the PD... was their prior damage to the same area of your vehicle? Even if so, they should have thought about this 4 months ago. What started them looking at it now?
If you need future meds paid before the are incurred, ask your doctor to write up his evaluation and state this. Otherwise you can wait until you have that treatment and then add it in. I'm betting if you pressed the issue the adjuster would include something for future meds.
Your BI settlement is completely different then the PD settlement. They have no right to hold up one because of the other.
Posted: Tue Jan 12, 2010 09:34 pm Post Subject: BI Claim..
Well tscope, thanks for the response.
reg:
"I'm not understanding the PD... was their prior damage to the same area of your vehicle? Even if so, they should have thought about this 4 months ago. What started them looking at it now?"
Whatever my vehicle had before the accident is not considered. they are currently going by the photographs of the vehicle that rear-ended me to determine the extent of the damage. They are in process of investigation now. I am not sure what brought them to investigation now after 4 months. Is it just to stall the BI payments? I can file a complaint as you have said. But I am not aware of the legalities. I just wanted to know whether they have a right to demand the PD claim back, after 4 months? If they do not have a right, then I can go ahead and file a complaint, but I need to be sure that everything I do is in compliance with the law
Posted: Tue Jan 12, 2010 11:50 pm Post Subject:
Do they have a right could only be determined by a judge. Your view is that they told you how much the damage would cost to repair and they paid you for your loss. If they want some of that money back because now they think it's too much... well, that is their problem. I can tell you that they are not going to file a claim in court and pay some attorney to collect what the _voluntarily_ paid... and that is key.. _they_ came up with the amount and made the payment. If it's wrong, this is their problem not yours. They made the error. But they'd also need to prove it's an error. All in all, it's really not your problem. It's theres. I suspect that this is really some type of stupid 1/2 truth.
The PD is separate then the injury claim. You file a complaint stating that you sent a demand and that there is no reason for it not to be paid. You can complain about anything you want, the color of the sky, the phase of the moon... you don't have to be right about anything. It's just a complaint. The DOI will investigate. Your reason for doing this is so the claim will be seen my some higher up management person and special attention will be given to it. Insurance companies _do not_ like DOI complaints. They can be fined if they did something wrong. Get to many and the DOI might audit more files. It's not a good thing for the carrier.
Posted: Tue Jan 12, 2010 11:58 pm Post Subject: BI Claim...
Hi tscope:
Thanks again. I appreciate you helping a lot. I'm glad that you brought up the issue regarding the error and the right. I can understand that the DOI will investigate and will have an impact on the carrier's reputation and standing. However, will the DOI come to conclusion that it was overpaid and will require me to refund? just to let you know that the estimate was made by carrier's appraiser and he did quiet extensive review. Now, they state that they do not find much impact on the car that rear-ended mine. Also they are going by photographs. But they should have evaluated with mechanics who might be able to find something underneath.
Thanks again, have a good day
Posted: Wed Jan 13, 2010 12:32 pm Post Subject:
I think there HAS to be some misunderstanding...and I'm betting they are not considering that they 'overpaid' the p.d. as much as they want to see their insured's vehicle (they should've already done that!)...to determine the force of impact, as it relates to your injury...
It's not uncommon to look at both vehicles especially if there is a large injury claimed but low impact accident...again, this should've been done months ago.
How much damage was done to your vehicle and what kind of vehicle was it? and what kind of vehicle was the one that hit you?
It's not uncommon for the frt end of a vehicle (strongest part of the vehicle) to not have much damage while the rear end of the other vehicle (weakest part) is distroyed...especially if you've got an older vehicle rearending a newer one, also it depends on 'where' exactly each vehicle hits...say a 1976 F150 rear ends a 2004 camry...the bumper of the truck goes over the rear cover of the camry totally wasting the decklid and rear body panel of the camry and more..the truck might have a scratch on it's bumper...
Yep, they are looking for low impact with a large injury...again...should've been done immediately...
Posted: Wed Jan 13, 2010 04:55 pm Post Subject: BI Claim
well, mine was 2000 Sedan Honda and their was 2008 sedan Nissan. The BI claim was just a whiplash claim somewhere around 3K or so. Already bills are submitted. They ran thru medical records which I believe indicate non existance of injury before accident. Also the doctors reports specifies everything in detail. Now, I have complained to DOI
Posted: Wed Jan 13, 2010 11:35 pm Post Subject:
Smith, did your vehicle have some prior damage in the area of impact? What exactly do they think they overpaid for?
Posted: Wed Jan 13, 2010 11:40 pm Post Subject: BI Claim
No prior damage. That's what I am trying to figure what exactly they are doing? Whether they want to stall the BI claim for some reasons?
Posted: Wed Jan 13, 2010 11:41 pm Post Subject: BI Claim
From what I was told, they are looking at the impact of the vehicle that hit mine. They are only going by photographs I believe, since it's 4 months past now. I am not sure what else they would look at?
Add your comment