by perfectlove » Fri Nov 12, 2010 03:07 am
Can I sue the one who hit me on a small claim court without settling the claims on their insurance yet.
Bills are filing up on medical and theraphy and the adjuster won't give me a payment protection which all the billers are asking. This is just a formality that they will really pay if I settle the claims. But the adjuster said they will not do that they have to wait till I settle the claims which there is no date to be settled as I am still doing some healing and waiting if I will go back to work. Accident is 100% at fault of their insurer.
But can I sue the person who hit me and ask them to pay my two theraphist who bill me for more than 5, 000 now. If I can what can I do. how can i start claiming to small court.
Bills are filing up on medical and theraphy and the adjuster won't give me a payment protection which all the billers are asking. This is just a formality that they will really pay if I settle the claims. But the adjuster said they will not do that they have to wait till I settle the claims which there is no date to be settled as I am still doing some healing and waiting if I will go back to work. Accident is 100% at fault of their insurer.
But can I sue the person who hit me and ask them to pay my two theraphist who bill me for more than 5, 000 now. If I can what can I do. how can i start claiming to small court.
Posted: Fri Nov 12, 2010 03:58 am Post Subject:
Can I sue the one who hit me on a small claim court without settling the claims on their insurance yet.
Yes... you would need to go to court before you accept settlement from the carrier as the carrier will have you sign a release.Bills are filing up on medical and theraphy and the adjuster won't give me a payment protection which all the billers are asking
That is because your medical providers don't have a clue. The adjuster is no obligation nor can he/she commit to _anything_. Your medical providers simply need to send the adjuster a written lien on any settlement. This insures that they will be paid out of any settlement. I'm betting your medical providers don't understand that difference between health insurance and a liability claim.I'll be brief... this is how it works.... the other carrier is _only_ going to make a payment in order to settle the claim/protect their insured. They cannot make ongoing payments (which is what that commitment is) as this does not protect their insured. They will require a release be signed before any payment is made toward your injury. This is the way it works.
But can I sue the person who hit me and ask them to pay my two theraphist who bill me for more than 5, 000 now.
Well, no... not the way you out it. Court is the same way. You obtain a _1 time_ judgement. You can't collect any more then the judgement amount. So if you want to make this only two therapist bills... feel free. The other person will be getting off pretty easy.Paying ongoing medical bills is why people have health insurance. It's also why many states have PIP/Med Pay laws.
If your current medical providers won't file a lien and still treat you, switch providers. It's a tough market with very people having medical insurance. I'm betting you can find several providers who are willing to work with you.
Posted: Fri Nov 12, 2010 09:31 am Post Subject:
If you have been "injured" ("damaged") by a third party, and liability is clearly determined, then there is no reason to delay the payment of a claim. With ongoing medical expenses, it can be a bit more complicated since the bills can continue to come in after the insurance company thinks everything has been resolved.
It could just be a matter of wanting to wait until all of the bills have arrived to start writing checks. But that doesn't prevent the insurance company from writing checks at all.
If you think there is a problem with the way your claim is being handled, then file a complaint with your state's Dept of Insurance immediately. If there is a problem, they will probably find it, or their inquiry will change the insurance company's attitude toward your claim.
Paying ongoing medical bills is why people have health insurance.
While this statement is true, it does not really apply to bills that result from the negligence of a third party (or work-related injuries and illnesses, regardless of negligence). If you are injured because of another person's actions (such as in an auto collision), while your insurance may pay the medical bills initially, it's not their responsibility to do so.
As a result, if you later collect "damages" from the third party or their insurance company, you will owe up to 100% of the money to your insurance company that it paid for the same loss. It's called SUBROGATION.
But can I sue the person who hit me and ask them to pay my two theraphist who bill me for more than 5, 000 now. If I can what can I do. how can i start claiming to small court.
Rushing into small claims court, in an attempt to force an insurance company to pay a claim, is not always the best course of action. If your total loss exceeds the maximum amount for which you can sue, you can only sue for that amount, and you will lose the right to collect any other money beyond that point -- in your case, not only the bills of the "two therapists" that are already more than $5000, but all of your other bills as well. I'm sure you don't want to do that.
So start with the Dept of Insurance and see if that doesn't help. If it doesn't, then you may find that you'll have to pay an attorney to assist you (no money up front, but they'll take 30%-40% of whatever settlement you agree to).
Posted: Fri Nov 12, 2010 09:40 am Post Subject:
But that doesn't prevent the insurance company from writing checks at all.
Sure it does... this is a BI claim... there is only going to be one check.. a settlement check. If the OP is not done treating then is it right for the carrier to low ball him/her because of this? They can make an offer but if it were me, my offer would be based on the OP being pretty much done with treatment. This might not be the case.While this statement is true, it does not really apply to bills that result from the negligence of a third party (or work-related injuries and illnesses, regardless of negligence).
It most certainly applies. Heath insurance pays bills as they are uncured... which is what the OP wants. A BI payment is not made until the full extend of the person's injury and treatment is known. It's a one time, settlement payment. So certainly people have their own health care insurance to pay the bills as they are uncured.Based on what the OP mentioned, I see the other carrier as not only not doing anything wrong but rather as doing everything right. They could just make a low ball offer based on the OP's current status. Instead they are waiting to understand the OP's situation in order to make a fair and reasonable offer.
Regardless, they still won't/can't pay for expenses as they are insured.
Posted: Fri Nov 12, 2010 11:19 am Post Subject:
If you are injured because of another person's actions (such as in an auto collision), while your insurance may pay the medical bills initially, it's not their responsibility to do so.
tcope . . . you took my statement out of context by failing to include the remainder of the statement (above).
There is nothing to prevent an auto insurance company from paying actual medical expenses of a claimant as they are incurred. It may be simpler to wait until all of the expenses have been compiled, and it may also be unreasonable to do so.
Delaying payment of a claim can also cause a person to have to resort to their own medical insurance to pay the claims and not realize that SUBROGATION applies to the medical insurance. When they later accept a settlement (often with the needless aid of an attorney -- a situation we both loathe), they may end up with virtually nothing as a result.
To "lowball" a claim deliberately, in order to (1) force a claimant to accept a payment or (2) force a claimant to litigate in order to obtain the same amount of money they would ordinarily be entitled to collect -- both are violations of Unfair Claims Settlement Practices laws.
But you're also correct, that the insurance company is probably doing everything correctly. I did not make any judgment along that line other than to say, "If you think there is a problem with the way your claim is being handled . . ."
Posted: Fri Nov 12, 2010 04:50 pm Post Subject:
There is nothing to prevent an auto insurance company from paying actual medical expenses of a claimant as they are incurred. It may be simpler to wait until all of the expenses have been compiled, and it may also be unreasonable to do so.
It's about the quickest way I know of to get to a Bad Faith claim. I've _never_ heard of a situation where this has been done.If the insured were to pay medical bills to the third party it reduces the amount they have to settle claim as their insured has policy limits. Then if at any time the claimant files suit (as we see in this post) an excess verdict can be the result. The insured then files a Bad Faith claim for a whole lot more with the contention if the insured had obtained a release prior to making any payment there would have never been an excess verdict. It's pretty much a slam dunk Bad Faith claim. This is why medical bills are never paid on an ongoing bases. It's always one settlement payment with a release.
All of this is also the whole reason why so may states have PIP and Med Pay. It's also the reason why I stated this is one reason why people have health insurance. So that they can be treated while waiting for the BI settlement (which might be week, which might be years, which might not be enough to cover everything).
When they later accept a settlement (often with the needless aid of an attorney -- a situation we both loathe), they may end up with virtually nothing as a result.
Having health insurance does not create this situation. If the person did not have a health carrier waiting for payment then they would have the medical provider. The difference is that the state may allow double dipping (the health carrier cannot surrogate) or, and this happens all of the time, the health carrier either does not collect or takes a greatly reduced amount as full subro.To "lowball" a claim deliberately,
No one mentioned anything about "lowballing" the payment for any reason. To not pay medical bills as they are insured has always, will always, be the right thing to do. The insurance companies _main_ responsibility is to protect their insured... period. Find me a place in the Unfair Claims Practices that states an insured should pay medical bills as they are incurred or that an insured needs to make a BI offer before the full extent of the claimants injury is known. To use your own argument, wouldn't an offer being made before the full extend of an injury/treatment is known be "unfair" (as it would not take into account the full extent of the injury)?If a person has health insurance then their health carrier acts like PIP/Med Pay and pays the person's medical expenses on an on-going basis until a BI settlement is reached.
Posted: Fri Nov 12, 2010 10:36 pm Post Subject:
No one mentioned anything about "lowballing" the payment for any reason.
Maybe I misread the following:
If the OP is not done treating then is it right for the carrier to low ball him/her because of this? They can make an offer but if it were me, my offer would be based on the OP being pretty much done with treatment. This might not be the case.
To use your own argument, wouldn't an offer being made before the full extend of an injury/treatment is known be "unfair" (as it would not take into account the full extent of the injury)?
No, it wouldn't -- if it's understood and agreed not to be the full and final offer. Just payment for things that would have to be paid for anyway. Not any different than a property loss in a replacement cost policy, where the initial claim is paid ACV and the difference will be paid if the actual cost to complete the repairs or replace the property is higher, based on actual receipts.
In a BI case, the "specific" damages will not really be argued, it's the intangible "pain and suffering" that gets everyone crossways. Too many people think they have a $1,000,000 case when they have a minor injury or broken bone, when all they have are medical bills and some inconvenience to compensate.
Let's say I had third-party injuries that would leave me hospitalized for several weeks (like broken legs in traction). Following that, I will need physical therapy to restore my ability to get around. If I had no medical insurance, and without an attorney who's going to rob me of 30%-40% of my eventual settlement, if I don't know how to negotiate my way through the maze I'm about to enter, I might not get all of the care I require since I have little or no ability to pay up front.
But knowing they are on the hook for my injuries, there's nothing to prevent the other party's insurance company from agreeing to pay my medical expenses as they occur and negotiating a final settlement for my "general damages" (which necessarily includes all money paid for medical expenses along the way). If I've been injured by a person with minimum limits, and my bills are going to far exceed that amount, they can write a check long before my care is complete, since they are not going to write a check for more than that at any later point in time.
Nothing at all to do with BAD FAITH.
That claims aren't handled this way on a routine basis, which they are not, is not to say the insurer cannot agree to anything that makes sense.
Based on the eventual outcome of a personal experience involving a family member many years ago, I might sound very reasonable to an insurance company by saying, following a collision resulting in serious injuries and hospitalization, "Just pay my medical bills as they are submitted and after the last bill comes in, put the balance of the policy limits in my bank account, and we'll be done. No lawyers, no lawsuits." If they want to negotiate a lesser amount, I might be willing to listen.
Posted: Mon Apr 23, 2012 08:27 pm Post Subject:
I was involved in an car accident I got me an lawyer to help me get what is fair. The other party won't pay all of my medical bills, can I take the driver to court and sue them for the rest of my medical bills before settling my case
Posted: Tue Apr 24, 2012 02:07 am Post Subject:
can I take the driver to court and sue them for the rest of my medical bills before settling my case
First, if you are paying an attorney 33% of your settlement.... why don't you ask him/her? If you were to sue, the attorney would be doing all of the work.
Second, you can't sue only to address your medical bills... you'd sue to settle everything at the same time. What you describe is prohibited by something called double jeopardy.
Again, this type of information is why you are paying your attorney.
Posted: Tue Apr 24, 2012 02:53 am Post Subject:
A couple of questions here. First, if you have a lawyer, why are you asking any questions here? What has your lawyer told you?
Second, have you even filed a claim against the other party's insurance company? What have they told you?
Usually, we don't advise anyone to go to an attorney until you have reached an impasse with the insurance company, Now you're going to give up 30%-40% of your settlement to an attorney, which probably means less in your pocket than you would have had on your own. So ask your attorney these things, not us.
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