Insurance Company Not Paying Medical Bills...

by Tammie
(Collins, MS)

I was driving and got hit from behind in February 2011. The insurance company still hasn't settled for my hospital bills, lost wages or prescription costs. I haven't been back to the doctor even though I still have problems because I don't want the medical bills to keep piling up.

What can I do?

Visitor Question:
Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter. Our response does NOT create an attorney-client relationship. Always get a formal case review from a licensed attorney in your area.

ANSWER for "Insurance Company Not Paying Medical Bills...":

Tammie (Collins, MS):

Call the Claims Adjuster you've been dealing with. Make sure you use the claim number so your claim can be accessed quickly. Tell the Adjuster exactly what your concerns are. You stated them quite clearly in your question.

The Adjuster should be honest with you. By now you must know if the insurance company has accepted liability. If they have and you're still having pain and discomfort the Adjuster should not object to you continuing your treatment.

While speaking with the Adjuster ask her when she will be in a position to discuss the settlement of your case. If you haven’t already made a settlement demand upon the insurance company, you should do it now.

It is possible the Adjuster is “sitting” on the case because you haven’t made a demand for settlement. Once you do she will be bound to accept it or make a counter-offer.

You settlement demand should include the total amount of your medical bills, out of pocket expenses, and any lost wages. With those amounts in mind you should consider what amount you think would be fair compensation for your Pain and Suffering.

If you do not know how to incorporate an amount for pain and suffering, here's a suggestion...

Take the total of just your medical bills, called “Hard Costs”. Multiply the hard costs by a multiple of 1.5x-5x. The length and severity of your injuries and treatment should determine what multiple to use.

The number 3 is often used as a multiple for many cases. But if your injuries and duration of your pain and suffering was lengthy, you can use a higher amount.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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