QuestionHi,
A guy rear ended me, my car damaged and I am getting medical treatment.
Lets say:
My insurance company is InsA
The guy(who rear ended me)'s insurance company is InsB
I am Mr A, that guy is Mr B.
Now what are all the coverages that Mr A gets from InsA and InsB?
I (Mr A) got the MedPay of $5K and a very good insurance coverage including the best UIM coverage too,
I dont know the coverage details of Mr B by InsB.
With whom do I need to file a claim? Ins A or Ins B?
If I am using my group medical insurance for each and every payments now, at the end, who will be responsible for my PD(Property Damage, rental car etc?) BI(Medical bills, Lost wages, pain and suffering etc)?
Right now, I filed a claim with InsA and B reported to InsB and they filed a Claim.
InsA is asking me to give the medical authorization etc so that they want to start paying my medical bills(from my MedPay with them). But I am already using my group health coverage.
Here is what I am thingking.
I will ask InsA and InsB to not to pay anything but they can have my medical records to verify the treatment process.
At the end of the medical treatment, I will supply them my expences report so that they can pay me the settlement money. But who will pay my settlement money? InsA or InsB? or Both?
Also note that I need to payback my medical bills due to this accident to my group medical insurance at a later point.
What is the right direction for me?
Shall I go through my insurance company InsA and they will work with the at fault InsB company or do I need to directly and seperately handle both of them?
Thanks in advance
Abe
AnswerHi Abe,
First question: why did you include "no fault" in your title? Are you in an official no-fault state?
You covered the ground pretty well, although I have no idea whether or not this is truly a no-fault state, and if so, whether you have a monetary or verbal threshold for the right to sue a third party, and, further, whether you would likely exceed that threshold so that you could file against the third party.
I think you get the picture of what is missing by my question. If your state is no-fault, then we go one way. If you simply meant to tell me that you were not at fault, but your state favors injured persons instead of the insurance industry (i.e. enacting no-fault legislation), then we go another way.
To simplify things, let's take your medical treatment costs first. If you are in a normal tort state, we recommend the procedure you have decided upon: use health insurance first. At the least there is the possibility of some savings on a partial defense against their subrogation claim.
Here are two pages that deal with those topics. First, take a look at the topic of which company to choose for medical care payments by health insurance or using auto insurance first party payments http://www.settlementcentral.com/page0201.htm
Next, here is an introduction to insurance subrogation http://www.settlementcentral.com/page0459.htm
Next, you asked which company would be paying your general damages, i.e. which company you should submit a claim to "at the end of the medical treatment." In the first place, try to submit your letter BEFORE your treatment ends so that you do have some threat of continued care that will incite the adjuster to move quickly to secure a settlement rather than risk continued and expanding care costs.
If you are in a normal state, wherein the legislators listened to trial attorneys instead of the insurance industry, then you would submit your claim to the tortfeasor's company (B). If your claim exceeds his policy limits, then you claim against your own UIM coverage.
By the way, here is a page of background on UIM policy limits claims http://www.settlementcentral.com/page0451.htm
On the other hand, if you live in a state where your legislators dined and wined with the insurance industry, then you are stuck with the pig called No-Fault. You will not have any tort claim until you exceed that threshold I mentioned earlier.
A monetary threshold is set in terms of dollars spent on medical costs. So, if it is $5,000, you cannot recover for your pain and suffering unless your medical bills exceed $5K.
Worse is the verbal threshold, which is something along the lines of "permanent disabling injury", or some other hard to satisfy threshold. Unless your doctors clearly indicate that they believe your case is more severe than the threshold, you get NOTHING above your medical costs.
I also agree on your handling of the medical records, so long as you remain accurate in giving all relevant records, INCLUDING ANY OF TREATMENT FOR A PRIOR ACCIDENT. If you are discovered trying to hide anything, then your credibility is shot.
Best wishes,
Dr. Settlement, J.D. (Juris Doctor)
www.SettlementCentral.Com
