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Old 01-11-2013, 02:18 AM   #1
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complicated issues regarding insurance

Hey everyone,

I'm in a bit of Jam right now, and this totally sucks! I was cut off from no-fault benefits over the summer and my doctor still continued to treat me under them. My doctors office informed me that the bills have reached the maximum that my doctor is willing to cover (apparently he has paid for my bills until he arbitrates the money back). So now, I need to charge my regular insurance - I am now stuck to paying about $60 a week in co-payments! I haven't worked since the accident.

This is crazy - I am not sure what to do. Whats the next step? Has this happened to anyone else? How did you go about getting through it.

I know these are questions for my lawyer, I just don't understand whats going on. Given that my injuries are accident related, shouldn't the other guys insurance be paying for all this - even though their corrupt doctors said I was fine and cut me off. Bunch of ******** this is. About to be poor trying to get in better health from something that wasn't my fault. Please help!!

 
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Old 01-11-2013, 07:10 AM   #2
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Re: complicated issues regarding insurance

I was in the insurance business and its been too many years since I handled no fault insurance.

Why did they cut you off from benefits? Did you call the adjuster handling the no fault thru your insurance carrier.

I would says start off and tell us why they cut you off then maybe we can make some sense out of this.

 
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Old 01-12-2013, 09:36 AM   #3
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Re: complicated issues regarding insurance

Hi pubbies, It seems to me you were cut off because their dr said you were fine, right? When i got hurt I didnt even have a lawyer & I didnt want to see their dr, so i didnt. Why didnt someone tell you not to go, as in your dr or lawyer? If i were you I would find a new lawyer b/c he/she should have it all set up for me to go to dr on consignment or contingency, retainer & I would go to the dr no matter what insurance it got filed on if i was hurt bad enough that i had no choice. What is wrong, like what does your MRI say? Addendum:You have been suffering for a long time, according to your posts, & i am certainly not suggesting that you are not in pain, i just dont understand why you would have this problem now, in my experience lawyers usually arrange with drs so that the patient/client can be treated & the bill paid when the lawyer gets your settlement. If i were you i would start all over with a new lawyer!I really hope that this back problem is "acute", can be fixed & never chronic!

Last edited by gmak; 01-12-2013 at 10:09 AM. Reason: typos, update

 
Old 01-13-2013, 03:11 PM   #4
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Re: complicated issues regarding insurance

hey guys,

I found some answers on line made me understand it more. I was seeing my dr on a contingency, the medical bills reached what my doctor was willing pay without "hope" of any payment. I have two bulging disc, lumbar issues were taken care of nicely with the epidurals+facets, although now its not pain, is a strange feeling in my lower back on the spine but not at all bothersome. My neck, shoulders, and middle back, aren't responding as well with the injections. My main concern to my lawyer in the beginning and now was that my medical was to be covered and that I am not ran into the poor house with unexpected bills. I do remember my lawyer saying something in the beginning about at one point the doctor is going to cut me off, and at that time I would need to use my insurance, and if I didn't have any they would figure out a way.

I've already been through so much with my doctor, and he's doing a great job, he's been right pretty much every time, and I have a vast improvement. The only thing I don't like is sometimes when I tell him some pains that I'm feeling hes telling me it's all normal. To me, it's def not normal, and I feel stupid asking kinda. I would hate to change him and go through the process of seeing a bunch of money hungry apathetic doctors again. As you said though GMak, I just don't know why this is happening now. Acute or chronic, sometimes are hard, sometimes aren't, at times I feel like how I feel now is the best I'm going to get and just live with it - and I try/do. I am Always feeling some type of pain somewhere. I do not want to go down the pain medication route.

The pain is noticeable to family and friends without me even saying anything. The way these insurance companies do business makes you want to sue because they're not giving people much of a choice. Just give me my medical what the freak, that's what I pay my car insurance for (HELLOO). I'm just mad cause I'm strapped for cash, and I'm going to be giving out co-pays like no tomorrow (I'm going to ask my lawyer, if the co-pays can be taken out of the settlement which I think could be possible). Its bad enough I've been paying out-of-pocket for my chiro for months now. I feel like a part of it is my fault, in person I never think of the right questions on the spot - I think of them later and now I can't get the answer lol.

So this hasn't happened to anyone else? You all got treated all the way to the end without using/paying with your insurance? How long did you receive PT for?

Last edited by pubbies; 01-13-2013 at 03:57 PM.

 
Old 01-13-2013, 03:31 PM   #5
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Re: complicated issues regarding insurance

Dear pubbies, I can certainly understand your pain & frustration. If i were you i would write the questions down but I wouldnt want to have to go to talk to a lawyer,or feel like a beggar, or not have enough money, or feel like a victim. Im so sorry that this "happened" to you! I think that this is the problem that no one understands... that this "happened" to us. I certainly hope everything works out!

Last edited by gmak; 01-13-2013 at 03:37 PM. Reason: wording

 
Old 01-14-2013, 01:59 PM   #6
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Re: complicated issues regarding insurance

Pebbe,

I can tell you stories about insurances and what I went through with them; hard to imagine that in this country its OK to play ill patients like they do, very heartless.
When lady didn't stop ona Stop sign in a very rainy day on a highway, she hit my car. My Brand New Infinity was total and my new life starts. I didn't feel any pain at first and refused to go to ER, although policeman and ER car took me there anyway saying it may be shock only and I may not feel pain.
They were right. My spinal/neck/knee damages were pretty bad. Long story short. Even this lady's insurance company Doctors addmited I need very big, serious spinal surgery. OK?
We scheduled surgery at first in November. I get ready at work, prepare all documentations, my HR worked hard to find an assistant while I will be out, another words, I have 3 days before major surgery and I get phone call from her insurance company: no, they say you can't have surgery now, we need to collect more information. We need to send you to so an so. I was shocked... We did what we had,
another surgery was scheduled on March 10. Mine you, I can hardly walk, I am in so much pain. I lost balance due to spinal issues, falied and broke my knee cup... You would think they would harry?
Again, 3 days before my surgery, they say they will not pay.

My lawyer was furious but said this is very common, they play games with us, they want me to use my own BCBS, although they had to pay for this 10 hour surgery.

Yes, we had no choice but to use my BCBS for surgery and than my lawyer fought with them to get every penny back. But still they won, they were able to keep their $$$ for some time; forget about me, who cares when it comes to money?

When it comes to your Dr expenses, usually lawyer gives your Dr letter or protection and it suppose to guarantee the payment. My both doctors didn't complained, I didn't have to pay anything but my regular co-pay. I believe co-pays are your responsibility.

Best of luck to you, hope they will not play with you games, like they did with me,
Moldova

 
Old 01-14-2013, 02:55 PM   #7
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Re: complicated issues regarding insurance

Hey guys,

These insurance companies are ruthless. Make you lose faith in the system we have. I understand people may be abusing the system for their own selfish reasons but for the people who actually need it they get treated as if they're one of those people abusing it. Incredible.

The last time I went to a doctor was when my parents used to take me. After that I probably went about twice for blood work lol. I am very ignorant to how the system works because everything was always just taken care of for me. I made an appointment with my lawyer to chat about everything. Let's see how it goes - tonight need to get a list of questions together so I go in prepared.

I guess I am seeing things one way, my way. I don't see how people don't care about people and in the end its all about the money. I know when I see someone who is need of help, I do it without any questions. These people see people who need help and refuse to even look their way. Cut them off and throw them to the wolves. I am sorry you went through that Moldova, at least I do not feel alone!! Thank you everyone for your love and support. It's been a rough battle, but the wars not over yet

 
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Old 01-16-2013, 08:30 AM   #8
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Re: complicated issues regarding insurance

Pubbies!!!, how are you?

Please, don't go to any chiropractors and don't let them even touch your neck!
They can cause further damage to your neck.
I wouldn't even let them touch your back. They are not doctors and can cause your permanent damage.

Something I didn't understand. Does your neck hurt you also? I am confused.

Second thing, you can go to the free health clinic. If you don't have a job, you can tell them and it should be free. Perhaps they have free meds there(though you don't want to go the medication route?...sometimes we have to).

One last question. How long have you been suffering from pain? (I forgot...).
My doctor told me that if pain persists more than 6 months than it's called chronic pain.

OK, hope to hear from you.

Last edited by nochange; 01-16-2013 at 08:31 AM.

 
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