Question about Medpay from the other party’s insurance
I’m in Virginia, and the other driver was found completely at fault for my car accident.
I’ve finished physical therapy and submitted all the necessary paperwork to their insurance. However, I was informed today that my claim is still under review due to a “gap in treatment.” The accident occurred in mid-November, and I attended two orthopedic appointments before starting physical therapy in January. The insurance company claims this gap raises questions, even though I attended all my appointments as scheduled.
What are my options?
It sounds like you’re in a frustrating situation, but there are steps you can take to address the issue with the other party’s insurance regarding the “gap in treatment.”
Document Everything: Make sure you have comprehensive documentation of all your medical visits, treatments, and the timeline of your recovery. This includes any notes from your orthopedist, physical therapist, and other healthcare providers.
Clarify the Gap: If you believe there is no gap in treatment due to the scheduling of appointments, consider gathering your documentation to provide evidence of when and how treatment was provided. You could request a copy of your medical records to present a clear timeline.
Contact the Insurance Company: Reach out to the claims adjuster and explain your situation. Provide them with any additional documentation that can help clarify your treatment timeline. Be persistent and patient, as insurance claims can take time.
Ask for Clarification: Inquire about their specific concerns regarding the gap in treatment. Understanding their perspective may help you address their concerns more effectively.
Request a Review: If necessary, ask for a supervisor to review your case, especially if you feel the claims adjuster is not fully understanding your situation. Sometimes a fresh set of eyes can make a difference.
Consider Legal Advice: If you find that the insurance company is unresponsive or continues to delay payment without valid reasons, it may be beneficial to consult with an attorney who specializes in personal injury or car accident claims. They can provide guidance tailored to your situation.
Stay Informed: Keep a record of all communications with the insurance company, including dates, who you spoke with, and what was discussed. This could be helpful later in the process.
Stay proactive and don’t hesitate to seek legal assistance if the matter isn’t resolved to your satisfaction. Good luck!