NO Fault Denial
May 29, 2014
I was involved in a auto accident in November of 2012.(Not my fault) The injury I received was a serious herniated c6/7 disc, also 2 other disc were herniated they did not bother me. So after doing conservative treatment,PT,pain management, nerve blocks in the spine, my condition got worse. The pain and tingling feeling in my hand was now traveling down my legs when I would look down. scared I had surgery for fusion of the C6/7 October 2013. Due to complications of the surgery I've had on going treatment with my Ortho and now Pain management, which consist of medicine,chiropractic manipulation and supposed to try another nerve block in 2 weeks. I received a denial from my insurance carrier stating they will no longer pay for other medical procedures,medicine or pt. because their dr says soThe thing that I do not understand is why my own insurance carrier is screwing me knowing I am going to have to pay for treatment.. Should I dispute the denial with the AAA or departmental of financial services. By the way I have never missed an appointment nor have I ever missed an IME appointment.
Usually, a medical provider will have you sign an "assignment of benefits" which gives them the right to pursue arbitration against the insurance company when they (and they almost always) deny no-fault benefits. It's not something the insurance companies say in their TV ads, that's for sure. My question is why you don't have a personal injury attorney already pursuing your bodily injury claim. With fusion surgery and the other party's fault for causing the accident, it seems to me you would have a viable bodily injury claim, and that attorney should advise you also about the no-fault benefits. Maybe you reached the limits of coverage, I don't know. You really ought to consider a B.I. claim for this accident. There's a 3 year statute of limitiations, so don't delay.
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