QuestionQUESTION: I was in an accident last month. i was at a light and the other driver fell asleep at the wheel and crossed over traffic and hit me on the drivers side fender/ mirror.
the other insurance company says it is their policy holders fault completely.
i did not go to the hospital at the scene. i feel i did not need to. later that day and the following day i went to the chiropractor. and had xrays done. the xrays showed i had structural damage and soft tissue damage.
my chiropractor suggested a 6 week treatment plan 2-3 times a week. I sent the insurance company my chiropractor bills for the 6 weeks... which all came out to 1200. the insurance company is only willing to pay 500. that isnt even half of my chiropractors cost to treat me.
i was really sore after the accident and felt i needed to go to the chiropractor. i was really swollen in the neck and my right arm.
i know i will not accept the 500 .. but how can i get them to settle for at least the amount of my chiropractic care?
ANSWER: Hello Rachel,
Let's make certain we are actually talking about Bodily Injury coverage, BI.
In Texas you have the option of Personal Injury Protection, PIP. PIP covers your injuries in an accident regardless of fault. It is not mandatory. However, if you did not select PIP when you purchased your policy, you had to actually sign a rejection. Do you know if you did that?
If you do have PIP, your medical bills would be covered by your own PIP.
If you rejected PIP, you are at the mercy of the at fault carrier. From your description, it appears that they are offering you what is called a "cashout". Carriers are anxious to settle minor BI claims as soon as possible. To do this, they will offer a small sum of money to cover incidental expenses. If you agree, you relinquish all rights to future claims for injury.
I suggest you first determine if your injuries are permanent. In other words, could there be something more serious than the first diagnosis? What if, after 6 weeks, your injuries are not resolved? If you sign a release now, you will not be eligible for any further benefits from the at fault carrier.
First, confirm whether or not you have PIP. If your only concern is to have your bills paid, then PIP should cover that - up to your limits of course. If, on the other hand, you rejected PIP, than I would suggest you hold off until you know the full extent of your injuries before you agree to a BI settlement. Speak to your chiropractor. He might be agreeable to payment options considering the other insurance carrier has admitted fault.
It would certainly seem to me that you should be entitled to your actual short term doctor bills, assuming you do not have PIP. But unless your injuries are permanent, and unless they have a significant impact on your life, you will not be able to proceed with damages for "pain and suffering". That would require a full BI claim - beyond a cashout - and would likely require an attorney.
Sorry for your loss. Good luck.
Jane Pytel
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QUESTION: Yes. I do have pip thru my insurance company. Up to 2500. I was told I couldn't use my pip as welll as receive medical reimburstment from his insurance company due to double dipping? So I don't know if I should just tell his insurance company to close the claim and do everythimg thru my insurance company . It seems it would be easier that way?
Answer Hello again Rachel,
It is not double dipping because the at fault carrier is trying to settle a potential BI claim. They are attempting to cash you out with a minimal payment, hence the $500 offer. In return they are going to require that you sign a release. If you are certain that your injuries are short term and are resolving, then go ahead and agree to and negotiate a cashout BI settlement from that insurance company.
In the meantime, yes - file a PIP claim with your carrier. You have paid for the benefits and you are entitled to them. Up to $2500 will be paid directly for your medical treatment.
Whoever told you this is double dipping was confused or ill informed.
Hope this clear things up.
Jane
