Legal Question in Personal Injury in New York
Insurance Company No Fault Denial
Got into accident with father's vehicle and was injured.After several months,the insurance company has me go to about 4 of their IME doctors,who all say that I am able to work.
My father has uninsured/underinsured and PIP.The insurance company is now denying EVERY bill to Any doctor I go to because they said that their doctors say I am fine.these doctors see me for 1 to 3 minutes and make an opinion,while I have physicians who have been treating me for a year(along with x rays and MRI's)that know there is no way that I could work.My attorney says that they do this to approximately 90% of their customers and leave it at that.
I went to the NYS Insurance Department and all they sent me was a copy of the insurance's doctors evaluations.What are my further courses of action to take,as it seems that my attorney is not going to budge to see that I can get a possible reversal of their original decisions?
3 Answers from Attorneys
Re: Insurance Company No Fault Denial
The proper way to handle this is to file a request for arbitration to contest the no-fault denials under the insurance law. When you received the denials they should have informed you of this. I am presently handling one of these for someone else, but it is a very complex one. The American Arbitration Association reviews no-fault denials for tthe NY State Insurance department. It costs a $45 application fee, but you must have your own doctors reports that say something differernt than the insurance company reports.
If you wish to follow up, go to the web site of the AAA or NYS Ins Dept. Or contact an attorney immediately.
Re: Insurance Company No Fault Denial
If your lawyer and doctors were confident that their treatment is related to your motor vehicle accident then why are they not pursuing arbitration on that issue. Has your lawyer discussed that with you? In the NYC area doctors do the arbitration themselves. Not so elsewhere generally. There is difficulty with lawyer doing it and his client has to be the medical providor for arbitration only.
Re: Insurance Company No Fault Denial
It is surprising that your attorney will not help you pursue this. In New York you have the right to appeal the no-fault denial by filing for no-fault arbitration. There are clear procedural rules and forms covering this. In fact, the denial forms used by the no-fault carrier contain information on them as to how you can appeal those denials. Additionally, the doctors themselves can pursue recovery of their bills through arbitration against the no-fault carrier. Hope this helps. Please let me know if I can be of further assistance.
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