My car insurance and health insurance are denying my accident coverage and now the doctors offices are all calling me

[theprincess97]

Just a vent but it’s really stressing me out. I was rear ended at a red light on 11/28. It was a bad accident, both cars totaled, the other driver was taken to the hospital in an ambulance and I have 3 broken ribs and 12 herniated discs. For the past 4 months I’ve had tons of drs appts, PT, Chiro, and 6 pain management procedures with 4 or 5 to go. It’s been a lot.

Here’s the problem. My husband got new health insurance on 11/1 but it doesn’t cover car accidents. Our auto policy is under his name so I kept telling him he needed to call our car insurance and change the policy. I wrote it on our to-do board in the kitchen. I reminded him atleast 4 times and he didn’t do it. So when I was hit on 11/28, I technically had no medical coverage because I am in a no fault state.

I got a lawyer and he said just have everything go through my health insurance and he would fight to have my car insurance covers our policy to go retro back to 11/1 and cover the accident. So we did that, and none of the medical providers I have been seeing have said anything about their being any issues. All of a sudden I got a bunch of EOB’s in the mail basically saying they aren’t paying for the treatment I’ve been receiving because it wasn’t approved ahead of time. Shouldn’t the drs office know it needed prior approval? I trust the drs offices to not just give me a treatment that isn’t approved or am I wrong here?

Anyway, now I’m getting bills for THOUSANDS. The MRI place and surgery center keep calling me about outstanding bills. I had a convo with my lawyer a few days ago and he did NOT calm my fears at all, he just said he was trying to negotiate with each side and that I need to reach out to each medical provider and find out what approvals I need for any treatment moving forward. I’m exhausted just from trying to get better. I might need surgery in my thoracic spine to get my legs to work normally again which is a dangerous scary surgery. I may need one of my ribs rebroken and a plate put in.

None of this is my fault. I was going to work and stopped at a red light. Why do I have to deal with all this bllsht? Thanks for listen to my rant.

ETA: just to clarify since it came up a few times, I did file a claim with my car insurance. I’ve been in contact with them the whole time. My car was totaled (as was the other drivers) so I’ve already received a payout for my car and the other drivers insurance sent me a check to cover the extra cost for the rental that my car insurance didn’t cover. Also I am on my husbands insurance, he just hadn’t called to change our medical over to the car insurance since the insurance we were on did cover auto.

 

[creature3]

@theprincess97 Being in a "no-fault" state means that your auto policy has no fault or personal injury coverage that pays for medical expenses regardless of who is at fault. As the wife, you are automatically a named insured and do not have to be added to the policy to have coverage, although your husband should add you. Call your insurance company and report the claim. The 1st level of coverage is "no-fault/personal injury" coverage, then the other driver's liability coverage. Also, time to get a new lawyer who understands insurance.

 

[johnerica]

@creature3 OP is in NJ where you can elect to have health insurance primary over PIP.

Agreed OP needs a new attorney, or maybe none at all, considering I’ve never seen a carrier backdate coverage, especially to cover a loss. It’s not like the carrier made a mistake. Luckily it seems like even if OP has limited tort they won’t be screwed that way given injuries.

 

[theprincess97]

@johnerica Yea both the lawyer and my dr said I have plenty of injuries to qualify under limited tort (I think that’s the thing that there are 6 things that qualify to sue for damages). I’ve honestly considered changing lawyers but I signed an agreement with this lawyer and I have no idea how that works to change lawyers at this point.

 

[jhjeppe]

@theprincess97 Basically you go to another lawyer and they do some paperwork to change representation. Sometimes they need to speak to your previous attorney, sometimes there are other obligations, but the attorney you're switching to can advise on those specifics.

Edit: I should specifically mention that those other obligations, in the personal injury field, can often include that the previous attorney still gets a chunk of your settlement.