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HELP-any experience with how PIP or auto personal injury claim work

Started 10 months ago by photogirl
Latest reply from photogirl

photogirl
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So a few weeks ago, I was rear-ended by another driver. I received a neck strain from the incident and been having issues with my neck/upper back. I've been seeing a chiropractor and massage therapist to help with this. Luckily we have PIP insurance, so I basically have not had to pay anything out of pocket.

Anyway, it was my understanding that my insurance will then deal with the other driver's insurance in getting reimbursed. However, the other person's insurance adjustor has been calling me and want to meet in person to "talk" about the injury claim.

This makes me feel uneasy. I am not sure why he can't just talk to me over the phone. When I asked my own insurance company, they said they can't offer me any legal advice, which I'm not really looking for. I am just CONFUSED.

Is this typical behavior for a third party insurance adjustor? Do they normally call to check up on you and then ask to meet to discuss stuff but won't tell you what exactly it is they want to discuss other than the "injury claim?" My concern is that they are trying to get out of paying for my medical bills, which I then will need to involve a lawyer. I really would like not to do that but I may not have a choice. Any suggestions, experiences, or advice would be greatly appreciated.

Posted 10 months ago #
sna
Member Profile

PIP is no fault so your insurance will pay that. The other company's adjuster likely wants to know if there is a bodily injury claim above and beyond the PIP.

Yes, its normal for them to call and want to discuss.

Posted 10 months ago #
JanS
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I'm a massage therapist, and bill insurance companies for services. I am thinking that the other guy's insurance will do what they can to get out of paying...that's cynical me - lol. I'm not sure what being "in person" has to do with anything, unless he's trying to see if you are really injured in any way. I've only dealt with questions over the phone when I have been involved in an accident where the other guy was responsible. I would say it's not typical behavior..just remember...that insurance company represents the third party, works for the third party. Above all, don't sign anything. Sometimes those neck injuries can come back and bite you in the future. If they try to get out if it, contact your insurance carrier and let them go after the other guy.

Posted 10 months ago #
m3bodyworks
Member Profile

Photogirl -

I'm a massage therapist as well and we deal with PIP and 3rd party all the time. The other insurance company want's to minimize their cliam and usually will push to get you to settle quickly.

I agree with Jan - do not sign anything and personally, I wouldn't meet up with him. If you want to borrow one of our books on PIP insurance and the "Navigating your personal Injury claim" please contact me directly and we can loan you one of our books.

Michael @ M3bodyworks.com

Posted 10 months ago #
photogirl
Member Profile

Jans- that is my concern as well. I can understand wanting to talk to me about the injury claim on the phone, but he was insistent about meeting me in person and going over documents. I then asked the adjustor to email me the documents he wanted me to fill out. The only document he emailed was basically a medical authorization form to give them access to ALL of my medical history. That really set off an alarm bell for me. It's one thing if they wanted my medical history pertaining to the accident but ALL of it?! He must really think I am naive to sign away my private medical information like that.

Posted 10 months ago #
photogirl
Member Profile

So I guess the question is, am I obligated to deal with the third party insurance adjustor or can I just let my own insurance deal with them in getting reimbursed? I guess I am just confused about what the process is for auto personal injury claim.

Posted 10 months ago #
jissy
Member Profile

photogirl -- I'm a healthcare provider from a previous life dealing with LOTS of PI clients... here's my take (and sorry, really as I would expect your healthcare providers to be able to offer this clarification or any info. you'd obtain from the book that M3 is offering):

I too would not recommend meeting in person, likely the adjustor is going to offer to write you a check for your "inconvenience" and then have you sign a form (in order to receive said check) which is called a Hold Harmless agreement that says you can never try to claim benefits, payment, injuries etc... in the future, that one check will make things done.

Depending on the Third party claims adjustor and how full their case load or desk is, some will call weekly, some monthly but likely they are recording you on any given conversation so even a harmless, "So, how are you feeling today?" and if you're having a particularly good day and say something to the effect of "Not too bad", they are going to look to use that against you later to say that by that date you should have been fine and no further trmt needed. What I used to advise my patients (while letting them know that my advise was NOT legal counsel) was to just tell the Third Party adjustor, "Hey, I'm focusing on getting better and I'LL CALL YOU!" (when you're ready to talk settlement).

As to the records release to access your medical records, again I'd suggest to my clients to go ahead and sign it if you want, but somewhere in the language of said document to write in, * or whatever, that you authorize records to be released from the DATE OF INJURY forward ONLY b/c really that's all they are entitled to, nothing else.

And ultimately, yes you are obligated to deal with the Third Party Adjustor to settle your claim unless you hire an Atty and they will deal with everything for you including any communication or issues with your own PIP which I tell you I've seen plenty of those, too! Your PIP will deal with them to be reimbursed and made whole (which is the whole idea of PIP and why your rates won't go up b/c you weren't at fault), but they won't necessarily be looking out for you beyond that. If you are interested in the help of an atty I can suggest a GREAT one, but your health care providers can as well and the Atty's I worked with always offered a complimentary consultation to any of my clients to just chat about the case, ask questions etc... and then decide if you did or didn't want to hire them. I bet your chiro's have a few they could recommend that would do the same.

Anyway, hope that helps. And GOOD LUCK!!

Posted 10 months ago #
elikapeka
Member Profile

Photogirl, all the above info is spot on. This is not that unusual. They are trying to settle the claim quickly and keep any payout to the smallest possible amount. They are looking for your past medical records because they are looking for anything that ever happened to you in your entire life that could possibly, remotely, be related to your current symptoms as a pre-existing condition so they can avoid paying you. They will also make a note of your physical appearance - did you appear to be in any discomfort, or did you bring a heavy backpack with you without any trouble?

Despite how nice and concerned they may appear to be, the other parties' insurance adjustor is not your friend. Their job is to minimize the payout to you. I'm not saying some of them are not fair-minded, but your well-being is not their primary interest.

Anytime someone has an actual injury from an accident, I would suggest seeing a personal injury attorney - most of them will give you a free consultation, and if you retain them they work on a contingency basis, only collecting a percentage of what you settle for. You don't have to use them, but at least they can tell you what to do and what to avoid and what your obligations are.

Posted 10 months ago #
JanS
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initial consultation free:

quite a few people use these attorneys..they are very knowledgeable in Auto Accident claims

http://www.adlergiersch.com/

Posted 10 months ago #
sacatosh
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Call Jim Hailey. http://www.sgb-law.com/attorneys/jim-hailey/ He's the very best, and will likely at least give you some first steps and pointers.

Posted 10 months ago #
Irukandji
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Because you do not know the extent of the ongoing treatment for your injuries, it is in your best interest to consult an attorney. Whether or not you have a CASE, a good attorney will help you upon initial meeting by giving you a better perspective on your ongoing treatment needs (as evaluated by YOUR physician and treatment provider), and will help you negotiate the often-crappy process of dealing with multiple insurance companies.
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If I were to guess, the other party's insurance company wants to have you sign off on documents that end their liability for your ongoing care/treatment. If you refuse, they may want to have you evaluated by THEIR preferred medical providers, and then the fights begin.
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Focus on your care and recovery, and let a good attorney deal with the administrative and contentious minutiae. Their 'cut' pays them to deal with the fight and paperwork while protecting you and your healing needs so you can get back, as close as you can, to your daily life pre-incident.

Posted 10 months ago #
photogirl
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Thanks everyone for your feedback! I really appreciate it.

Posted 10 months ago #