Re-victimization after accident

[Gail]

I was in an automobile accident almost a year ago.  While stopping for traffic, I was hit hard from behind by a woman in a truck with a grid in front of it.  I knew my neck had been injured and was taken by ambulance to the emergency room.  Over the next several weeks, my pain got worse, I had a course of PT (only a few months since that's all my health insurance would cover), and an MRI that showed herniation and possible tearing of two discs.  I have not improved for quite some time and have a fair amount of pain.  The other driver was ticketed and clearly at fault, and her insurance company paid to have my van repaired and told me they would pay my medical bills and also I would get some additional compensation.

Nice words, but now an adjustor is giving me a very bad time, basically insinuating that I'm lying about the pain I have and that I can't prove the herniation and possible torn discs are due to the accident.  She gave me a big lecture about my medical records not showing objective evidence of injury and said she sent my MRI films to have their own doc read.  I learned that she does not even have most of my medical records, which clearly document injury, and has not even requested my MRI films. 

The frustrating thing is she's basically keeps changing her story and twisting everything I say to make me look bad.  She said two weeks ago that they probably will not authorize paying for any more treatment, then today denied saying that, and questioned why I even called her when I told her I wanted her to have my medical records when making a decision like that. They haven't paid for anything so far anyway and I am several thousand dollars out of pocket. Today, when I called her to let her know that I knew she hadn't even requested my MRI films, she said I told her I would get them for her.  Hunh?  Then, she said I didn't need to tell her how to do her job, that she knew how to get medical records.  But, that's the whole point!  She hasn't gotten them, yet told me she was evaluating them!  AARRGGHH!!! Crazy making behavior.

I didn't want to use an attorney, but now have an appointment with one next week.  It's bad enough to have an injury like this, that affects so much of my life, but to be accused of lying about it makes it that much worse.  I'm thinking of talking to her superviser and asking to be assigned to a different adjustor, but will check with an attorney about that before I have any more contact with that company.

October, your example of standing up to the doctor has helped.  I'm not going to deny what I know to be true.  I was injured and I still am experiencing pain.

Gail

[Sallying Forth]

Hi Gail,
I've been in your situation with an auto accident. I had to get an attorney to get the insurance company to give me what I needed and deserved. I didn't want to go to the attorney but it turned out to be the best thing I ever did.

I wouldn't worry about the adjuster. If the attorney is good and you have the medical records, the adjuster will probably be history!

[Marta]

Hi Gail,

SF is probably right. Without an attorney, your chances of getting any additional compensation may be negligible, and the mount may be lower as well. If you get a contingency attorney, it may be worth it. Her take on this is very clear, so the sooner you get an attorney, the better off you'll be. It IS crazymaking behavior, and in all likelihood, supported and encouraged by her supervisors and her company. Hnag in there.....

Marta

[David P]

The adjustor's behavior toward you is SOP for insurance companies. It is NOT personally aimed at you. It is the adjustor's job to minimise payouts and the game that they play,and the way that they play it, is wellknown. The tactics that they employ are reprehensible but legal(barely) .These tactics include befuddling your story, endless challenges to the details and facts in yur claim,losing documentation, subtle intimidation and covert bullying. All designed to weaken your posture and make you accept a lower payout than your are entitled too.

 Insurance companies are barracoudas whose first loyalties are to profits and their stockholders. You are a claimant and therefor you are regarded as a pest who is about to reduce their bottom line.
The way to succeed is to resist their tactics strenuously and tell them what you want in the amount of your payout and stick to your guns. Is is pointless complaining to the supervisor because the supervisor has been though the same training program as the adjustor and the supervisor works( and is paid by) the company, not you! That means that the supervisor's loyalty will be to the company and company profits not a complaining customer.

They work like this - Of every 100 (say) claims,the adjustor will be successful in intimidating a percentage of these who will drop their claim entirely (YEP!). Lets say that is 10% of claims.
Instant profits!
Then the adjustor will screw the remainer around and a further 30% will readily accept a lower instant  -Woopee! More profits!
That leaves 6o% who are willing to go head to head with the company.Of these a further 20% wiil get tired of the fight and accept a lower payment to make it all go away.
That leaves about 40% who will be paid in full EVENTUALLY if they push hard enough and are willing to tough it out.These folk are either veterans of this 'game' or have hired attorneys to do the fighting.
Too bad attorneys are kinda greedy too!

Good hunting !
David P in Tx.

[mum]

So sorry, Gail.  Everyone here is right on, at least it's been my experience. The insurance adjuster's job IS to make you crazy so you give up.....
I am not a huge fan of attorneys (although I have put several of my attorney's children through college by now) but in this case, you, as an unrepresented party, are just what the insurance companies count on...
I hope you feel better soon, in many ways....

[Gail]

Thank you everyone, for your advice.  I have an appointment with an attorney next week and also talked to a woman who used to own an independent insurance agency who gave me some good pointers.  I need to make a decision about further treatment.  The neck specialist suggested a steroid injection into the cervical area of my spine and I'm trying to sort that all out. 

Gail

[genuine]

I'm sorry to hear about your accident. I hope you get everything worked out and that you feel better real soon. God Speed! Love genuine

(((((((((((( Gail ))))))))))))

[Plucky]

Hi Gail,
as others have said, it's all about the benjamins.   So get thee to an attorney, and when you get recommendations or estimates for treatments, make sure the doctor knows it's being paid by insurance, so spare no expense.  You can always cut back later if need be.  If anything, be a wimp about your pain, and a barracuda about your money.  For example, if you need extra childcare to go to the many doctor appointments you will need, that is a medical expense.   So is mileage.  If you buy anything such as a heating pad or arnica, that is reimburseable.  Get it?
Plucky