Question-------------------------
Followup To
Question -
I was in a car accident about a year ago. It was a pretty bad accident, my car was tottaled and I was in the hospt. for 3 days. Being that I have never been in an accident before, i had NO idea how the "clims process" worked, and pretty much beleived everything the insurance adjuster (it was the other drivers fault, 100%). Now I am finding out that she really pulled the wool over me! My question is, is it to late for me to fix it? First off, she had me (told me I HAD to) sign an authorization to release medical records. she said it is only to authorize the release of records from the accident. I even had my boyfrined with me when she was going over it. Also, the way the form reads is: I am releasing all health information and related insurance claims and policies, including, but not limited to those containing ......between how she explained it, and how the form reads, I had no reason to beleive I was releasing anthing else. It reads...all health information and realated insurance claims...including, but not limited to THOSE...those meaning the health information related to the claim. Then she put a real nice cover on the form and sent it whereever she wanted to, and got my ENTIRE health records from every ER and Dr. office. When I foudn out, I withdrew the autho. right away. When i brought it to the hospt and dr office attn. both of the ladies in records got fired becaus I guess they were not supposed to release my entire medical reacords. (I hope that makes sence) I just want to know if it is legal on anyones part? I also wanted to know if I had to sign,print, and date the authorization to be legal. The reason i am asking that is because she rushed me to sign it so fast, she just said "you just sign it here, and I will print your name and date it for you". She has also told me some things throughout that I am now questioning. She told me that because I withdrw the autho. she can not evalute my claim now. I aksed her if I could but some dates on it, and limitations on who it could go to, and she said NO. Out of frustration, I told her to just come up with an offer for me...so she did! Without anything more from me. I just don't get it. She tried to tell me that from the records that she did get, it does not say I have any injuries from the accident (Whcih is not true, it clearly states on the ER report that I have soft tissue injuries and other things). I also asked her if they could just tell I was injuried in the accident based on how my truck looks, and she told me NO. I know I need to get a lawyer, but I want to know about these questions first, because I know a lawyer is going to say don't worry about what she did in the past. But the whole point is, I did not get a lwyer from day one because I did not want all of my medical records looked at, I have some very personal things happen to me the past 2 years that even my own mother does not know about. I feel like the adjuster has lied to me, mislead me, and misinformed me from day one. One other thing, the few times I did tell her i was thinking about getting a lawyer, she would magically show up with some money for me. She called them "advancements". She gave me 3 so far. One was supposed to be for a medication reibrsmnt, but then when she came up with the offer for me, she said it is minus the "advancemts" she gave me. Its almost like she used the money to try to not get me to go to a lawyer.
She came up with the offer last December, and I never even found out what it was because I knew she is scaming me. She has intimidated me so bad, I can not even talk to her on the phone. Can someone please help me..please? The car accident has runied my entire life. Everyone around me is suffering because of it. I have a torn rotery cuff ,permant injury to my sterno clavicular joint , and neck and back injuries from the accident, and she is telling me I only have brusing? Ohave about $35,000-$40,000 in hospt/doc bills. And there are many other things she has done and told me that i just don't beleive.
Thank you in advance for your help.
Lindsay
P.S. sorry for all the spelling type-o's, this just makes me so mad, it is hard to type.
Answer -
Dear Lindsay,
I am sorry to hear that the impacts of the car accident have carried on this long with continued pain and suffering, together with an uneven relationship with the insurance adjuster. But wait! Help is on the way: don't you know that this woman is "like a good neighbor" and with her help "you are in good hands"?
Oh well, if we had one-tenth of the money the insurance industry spends on propaganda devoted instead to paying injured persons, there would be a lot more equity in the country. I know of your frustration, and your fears: my business is to help people like you—either through my website or for free on this forum. DO NOT DISPAIR: YOU WILL HAVE HELP AND MUCH CAN STILL BE DONE BY YOU WITHOUT HAVING TO SPEAK WITH THIS ADJUSTER.
You have asked a good many questions, and it will take a long time to go through each of them, but I promise to give as much time to you as you need. You just have to read everything I write, and look at the free pages of my website on certain topics to help inform you. If your boyfriend can have access to this answer with you, it may help for both of you to take notes.
I will address each issue you raised, in exactly the order you raised them. I will number each topic you raised and put your comments or questions in ALL CAPS so it is distinguished from my answers. OK? But I am also going to interject some of my own issues into your claim.
1. YOU HAVE A VERY SERIOUS SET OF INJURIES AND THUS A LARGE CLAIM—A SIGNIFICANT AMOUNT OF MONEY. PLEASE DO NOT SETTLE ANYTHING AND DO NOT GROW WEARY OF THE PROCESS. USE MY SITE FOR HELP AS NEED BE. YOU MAY BE ABLE TO WORK THIS ALONG PRETTY FAR ON YOUR OWN: ALL YOU NEED IS SOME INSTRUCTIONS AND EXAMPLES. There is a lot of money at stake here, Lindsay, so give yourself some time to work with this on the knowledge that everything you do will bring you that much closer to a successful personal injury insurance claims settlement.
2. THE VERY VERY FIRST THING I WANT FOR YOU TO DO IS TO KNOW WHEN YOUR STATUTE OF LIMITATIONS EXPIRES. If you do not take care of this issue, you can lose your entire claim, which is going to make you really unhappy! Go to my site and review this free Directory of Legal Information on Statute of Limitations for Personal Injury Insurance Claims for Motor Vehicle Accidents http://www.settlementcentral.com/page0452.htm
If you are going to have a problem running up against the statute of limitations, you have my permission to use my site contact format to send me an e-mail. Mention who you are and how we met so I will remember you. I will then try to get you some immediate help from an attorney if it is required.
3. DON'T BLAME YOURSELF FOR SIGNING THE MEDICAL RELEASE. THE ADJUSTERS PLAY THAT TRICK ON MOST ALL CLAIMANTS. YOU WERE RIGHT TO WITHDRAW THE MEDICAL RELEASE.
Take a look at one of our newsletter articles on this topic and you can see that you did the right thing: Should I Sign the "Authorization for Release of Medical Records" Sent by the Insurance Adjuster?http://www.settlementcentral.com/newsletter0309.htm
4. WHAT ABOUT HER HAVING ME LEAVE THE DATE BLANK?
Ahh, yet another little adjuster trick. Some doctors and hospitals got wise to adjusters sending in authorizations that they obtained six months before and thus refused to honor stale authorizations. In response, the adjusters get signatures on undated originals, and they will make photocopies of your original and then whenever they want records they will fill in the date so it always looks like a "fresh" authorization. Neat, huh?
The solution to this is to send her a letter in which you officially rescind any and all authority to get any of your medical records. More on this below.
Meantime, since this adjuster is deep into her bag of tricks, you better bone up on some of the other Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm
5. CAN SHE REFUSE TO EVALUATE MY CLAIM IF I PUT RESTRICTIONS ON THE NAMES OF THE DOCTORS (all unrelated to the accident injuries) FROM WHOM I WILL ALLOW RELEASE OF MY RECORDS?
No, she cannot! And that sounds like a potential bad faith adjusting practice. I am recommending that you make a complaint to your state insurance commissioner about this woman's abusive practices. First thing is to gather all of the information in a logical and well prepared list, and then get the complaint form from your state insurance commissioner http://www.settlementcentral.com/links.php
Why file a complaint? Because she has been abusive and even if you do not get relief directly from the insurance commissioner, you WILL GET HER ATTENTION since her boss will be less than happy when HIS supervisor hands him a complaint inquiry from the state insurance commissioner. You will no longer be intimidated by her once you file the complaint.
6. WHAT SHOULD YOU DO ABOUT SENDING REPLACEMENT MEDICAL RECORDS TO HER—I.E. ONE'S THAT ARE LIMITED IN SCOPE?
First, you compile your own set of medical records that are relevant to your medical condition and all accident-related injuries. You have to satisfy her curiosity as to what it is you are trying to hide. So we have a way to provide assurances she needs whilst still preserving your secrets. Thus you will next use a slick little technique that we have reserved for our members on my website, but which I will share with you at no cost to you. I am just not going to post it here for everyone else. Send me an e-mail as instructed above and mention this in particular and I will divulge some of the technique to you so you can do it yourself.
7. WITH THE INJURIES YOU DESCRIBE AND THE DOCTOR AND HOSPITAL BILLS BEING AS LARGE AS THEY ARE, YOU MAY HAVE A POLICY LIMITS CLAIM. PLEASE KNOW WHAT YOUR OWN UNDERINSURED MOTORIST (UIM) COVERAGE IS. ALSO CHECK ON YOUR HEALTH INSURANCE.
This is potentially a very large personal injury claim. You may or may not need an attorney just now, depending upon the tortfeasor's policy limits. For example, what if the tortfeasor has just the minimum limits for your state? That entire limits should be paid to you upon presentation of a well organized and documented demand letter. More about insurance claim demand letters below. But if a well presented demand package will deliver you those limits, why would you have to pay an attorney one-third of that total to do what you can do yourself?
First, let's learn a couple of things about policy limits claims.
CAR ACCIDENT INSURANCE POLICY LIMITS Directory of Legal Information.
www.SettlementCentral.Com, has created a FREE legal directory of information regarding the INSURANCE POLICY LIMITS CLAIM. Why don't you go over and check it out?
8. PAYMENT OF MEDICAL BILLS VIA MEDICAL INSURANCE AND YOUR OWN PIP/MEDPAY
If you have a policy limits claim, why not get your own PIP and medical insurance involved so that you do not use up all of the tortfeasor's limits on medical costs, but direct it instead to your own pocket as general damages (pain and suffering; interference with enjoyment of life)? You then fight subrogation with a letter to your medical insurer or your auto insurer. Sound complicated? It isn't really, but it does take some effort. Then, again, your rewards at the end are a lot sweeter.
9. HOW DO I GO ABOUT ASKING FOR A SETTLEMENT FROM HER SINCE I AM ALREADY INTIMIDATED TO TALK WITH HER?
In the first place, you do NOT ASK, for a settlement, YOU DEMAND A FAIR AND REASONABLE SETTLEMENT. This is something you will do in writing. It is not that hard, but it will require you to put together a history of your prior injuries and treatments and any claims made before this one.
You will include your medical care and treatment to date and expected in the future (possible rotator cuff surgery, for example).
Then you will describe the ways in which your injuries interfere with your life. If you are employed, then your lost wages will also come in.
10. WHEN SHOULD I SEND IN MY DEMAND LETTER—NOW OR AFTER I HAVE REACHED MAMIMUM MEDICAL IMPROVEMENT?
OK, Lindsay, here is another page from my website that shows in detail why you should never make an early settlement of personal injury insurance claims http://www.settlementcentral.com/page0211.htm
See this page for information on when to send in your personal injury insurance claim demand letter http://www.settlementcentral.com/page8015.htm
Finally, here is a general page of information on auto accident insurance demand letters http://www.settlementcentral.com/page0170.htm
11. HERE IS THE CONTENT OF THE LETTER YOU CAN WRITE NOW. MAKE SURE TO TELL THE ADJSUTER THAT SHE CAN CONTACT YOU VIA SNAIL MAIL OR E-MAIL, BUT NOT BY TELEPHONE.
Letter to do the following:
• rescind all authorizations she obtained from you;
• provide copies of all authorizations she obtained from you
• request copies of all records she has obtained to date;
• request list of doctors, hospitals, and any others to whom she has sent your authorizations or with whom she has made contact, including the nature of the contact (i.e., by phone, mail, or in person) and the content of the contact (i.e. any discussion of your medical condition or of this claim);
• request list of any providers from whom she has NOT obtained records, but for whom she feels records would be needed to evaluate my claim;
• request list of all medical expenses that she is aware of to date;
• request list of all medical expenses she has paid to date;
• request list of all general damages award advancements she has made to you to date;
• request that she communicate with you in writing via snail mail or e-mail ONLY inasmuch as you feel she has misrepresented and deceived you in her verbal communications, and thus you would like a written record of her processing of your claim.
12. WATCH YOUR ERRORS IN COMMUNICATIONS WITH INSURANCE ADJUSTER AND INSURANCE COMMISSIONER.
Errors in communications show that the writer does not give attention to detail. They show that the writer does not care enough about the topic to take the time to be accurate. Thus, ERRORS IN WRITING WILL HAVE AN ADVERSE IMPACT ON VALUATION OF YOUR CLAIM.
Why should writing errors impact the value of one's claim? It is simply this: Almost every doctor's record is based upon a clinical examination of the patient, at the beginning, for progress notes, and at the end of treatment.
This clinical examination INCLUDES A MAJOR COMPONENT OF INFORMATION DRAWN DIRECTLY FROM THE PATIENT. Thus, the doctor's opinion is often no better than the quality of the information she receives from the patient. If the claimant reveals through her communications with the insurance adjuster that she does not give attention to detail, or that she is sloppy, or that she is in a hurry to get this over with, or that she is greedy for her money, WHAT KIND CONCLUSIONS is the adjuster to draw about the communications the claimant had with her doctor?
And, thus, the adjuster is not going to put as much weight on the doctor's clinical examination notes if it can be seen that they rely upon the reporting of the claimant as to historical pain and problems from the injury. That is just human nature, and the adjusters DO PAY ATTENTION to errors in communications as being relevant to whether or not the claimant can be trusted to make an accurate AND thorough report to the doctor.
This has been a load to read and take in all at once, Lindsay. Take your time, but DO pursue a lot of this on your own inasmuch as you do stand to see some significant remuneration for all the troubles you have endured.
I have devoted a lot of time to your claim, and I trust that my efforts have been of value to you. And thus I would respectfully request that you find the feedback form on this website and leave me some feedback.
Best Wishes,
Dr. Settlement, J.D.
www.SettlementCentral.Com
Hi again!
Thank you again SO much for ALL of your help!!
I do have just a few other (easier) quick questions. I wanted to know that could I have had the option to provid the insurance adjuster my medical records myself?, or is the only way she can get them (At all) via the Authorization to rels. medical information? Also, I wanted to ask you what you know about a "naritive"? That is another thing she keeps talking about. She told me what it was, but again told me she could not request the naritive from the doctor because I withdrew the authorization for medical records. She told me without ALL (My ENTIRE medical records) she could not get the naritive. So that is where is was left last time I sp0ke to her (DEC, 2005) and why I just told her to come up with an offer (Out of frustration) because she was telling me I could not put any limitations on the authorization (she said it "Is a legal for and can not be tampered with" and without the authorization, no naritive). Thinking back on it now, I think it was jsut another one of her tricks. My accident was on May 1st, 2005 and I did not find out that she was getting ALL of my records until Oct 2005 so she did get 6 months of after accident reports. On one of the cover letter to the doctor she said I approved the release from my 1ST OFFICE VISIT!!! And I have been going to that doc. for 5-6 years. So I am thinkning she had MORE than enough to go off of. Could my doctor just right his own nartive?
What about the Police report? I thought it was really strage that she mailed me a copy of it (without even asking) It was only one page and does not mention anything about any tickets given. That also makes me think she is hiding something there? Its almost like SHE wanted to fill my curiosity and jsut mail it to me, so i would not ask. ?
Thank You Thank YOU THANK YOU Again for ALL of your help. I was really ready to just give up with this. I really could not have moved on without all of your help.
THANK YOU X's 1,000,0000,000,00!!!
AnswerHello again, Lindsay,
There is nothing at all wrong with your gathering all of the records for the adjuster, EXCEPT THAT YOU HAVE NOW AROUSED HER SUSPICIONS that you are hiding something. The way around that is for you to go ahead and gather all of the records, but use the letter I am going to send to you for your doctors to tell this adjuster that you have not had any prior problems of this nature.
Medical authorizations are usually "blanket" forms, meaning that the adjuster gets to go "fishing" through all of your life's records. That is why we do not like to give blanket medical authorizations to the insurance claims adjuster.
At http://www.SettlementCentral.Com, we teach our members to limit the forms in both scope and time. We then have a way to get the doctors to acknowledge that no prior problems of this nature appeared before. I am e-mailing you some private materials on that topic soon.
Some adjusters think you are a terrorist if you don't do what their office procedure tells them to do. They want a recorded statement and blanket authorizations or else then can then get VERY upset, as you discovered. Nasty is another word, and on-guard or suspicious is also how they can act if you make any changes in their documents.
By the way, it is inane to suggest that one cannot change an authorization. We tell our members to line through what they do not want, and to interlineate (write your changes with pen and ink) to add what they want added, right on the original authorization. So far, no police have come out to claim it is a problem! So maybe the adjuster is wrong: the world will not collapse if she does not get her pretty little. Authorization back all signed.
As for the narrative report, it is a written letter that can be prepared by the doctor to summarize her diagnosis, treatment history, closing exam, and prognosis. You DO NOT NEED HER TO SUBMIT A REQUEST FOR SUCH A REPORT.
You can easily ask your own doctors to submit narrative reports. Usually one first should find out just what kind of information the adjuster is looking for. But in this case, if you let her dictate what it is she wants the doctor to address, then you can allay some of her fears that you are trying to sneak something by her.
So, you can do that by asking her to draft the letter that would be sent out to your doctors, and then make SURE THAT SHE, AS THE REQUESTING PARTY, agrees to pay for the reports, NOT YOU. I would have her prepare the letter to the doctors from whom she desires reports. Then you sign them and send them back, RESERVING TO YOURSELF THE RIGHT TO A FREE COPY OF WHATEVER SHE RECEIVES FROM YOUR DOCTORS.
Giving you a copy of the police report is no big deal. Shows she is making free copies already for you. Also, on the topic of the narrative report
I trust that this information has been of value to you, Lindsay.
Best Wishes,
Dr. Settlement, J.D.
http://www.SettlementCentral.Com
