Legal Question in Workers Comp in Maryland
Who is liable for battery operated wheel chair and van?
The doctor ordered the insurer to purchase a battery operated wheel chair with hand controls and a van to transport chair and lifting apperatus. Is the insurer liable for these items? If so where is that law located, or case located where it was paid for? The insurer is saying yes to chair but no to van. Doctor says I am totaly disabled, and isurers doctor says I am totaly disabled and agrees with my doctor. Is this a battle I will have? Thank you Donna
1 Answer from Attorneys
Re: Who is liable for battery operated wheel chair and van?
Welcome to the world of "managed care". Insurance companies will do anything possible to avoid paying a claim, no matter how strongly justified it is. And unfortunately, they ofter get away with it because most people don't have the resources to fight them.
First of all, you should read your policy carefully to determine the process for challenging an adverse decision denying a claim. Your policy should contain a review process in-house. While that's unlikely to bring about a decision in your favor, it may be a prerequisite for a further proceeding, such as before the Maryland Insurance Administration. Once your insurer has rendered a final decision, you can file a claim with the MIA and they will investigate it to determine if your insurer's actions are justified or not. If they rule against you, you can request a hearing before an administrative judge assigned by MIA. Of course, these matters are complicated and you should probably engage legal counsel.