QuestionI wanted to know if I can ask my personal health insurance to pay for my medical bills/treatments of my spine after the MVA last April?
I have 2 previous spinal fusions (lumbar in the summer of 2008 and cervical in the spring of 2010). 7 weeks after I was released by my Neurosurgeon to return to work I was almost T-boned. I filed a medical claim with Geico as instructed by my auto insurance Progressive. I have had numerous MRI's, Epidual Streroid Injections and now I am looking at surgery of my Thoracic spine.
Progressive will not pay anything (they sent me a letter saying I do not have medpay coverage). Geico hasn't paid the first bill yet. My personal health insurance will not pay anything.
I am in moderate chronic pain but conintue working because I can afford to not work. At this point I would like to have my bills paid but Geico said they wont pay until this is closed. Am I expected topay the $20,000 is bills I already have. It is bad enought that I am paying out of pocket to see my NS and buy my meds, but to see the bills coming in is very scary. I feel helpless.
Thank you,
Julie
AnswerHello Julie,
Your questions are very complex, but I will try my best to point you in the right direction.
First, the extent of your coverage is determined by the laws of your state and by the terms of your insurance policy.
Your coverage with Progressive apparently does not cover your injuries, at least according to what they have told you. Do you know this for sure? Do you have a copy of your policy, and, more specifically your Declarations Page? The latter is a document which outlines your specific coverage.
Next, most states to my knowledge do require some type of liability insurance. Liability meaning damage done to others. Liability applies to both property damage and injuries.
I am assuming that the GEICO driver has been determined at fault since they have implied to you that will eventually pay.
Has GEICO confirmed that have accepted liability on the part of their driver?
If so, GEICO is responsible to their own policyholder who has paid them for liability coverage, and to you for your injuries. GEICO does not have the option to find reasons to avoid payment of your legitimate claim. I would refute the GEICO's position that they will not pay you until this "is closed". From my understanding of your circumstances, GEICO is responsible for your loss, and has an obligation to offer you fair settlement for your loss. Based on what you have told me, I would say that your payment of $20,000 in the face of liability coverage is nothing short of outrageous.
As to your personal health insurance, that coverage is probably secondary coverage, meaning that they will not extend payment until the primary coverage (in this case GEICO) has paid.
If GEICO does pay, and the coverage is insufficient, you could turn to your personal health insurance as well as uninsured/underinsured motorist (UM) coverage, if you have it and if you are not at fault. Again, you would have to turn to the terms of your coverage with both.
You do not mention if you plan on hiring an attorney. Usually a competent insurance attorney can compel the carrier to issue fair insurance claim settlement if there is liability on the other driver. Of course, a portion of your proceeds will go to that attorney.
If you have not decided on an attorney, at risk of sounding self serving, but as a genuine help to you, I would suggest you go to my website http://SolutionsForYourInsuranceClaim.com and take a specific look at my e book, Power To Profit. The book is written specifically for persons such as yourself who are facing unreasonable circumstances and need professional claims advice concerning a valid insurance claim. Power To Profit costs $19.95.
Hopes this helps.
