Q: In regard of a car accident
I was involved in a car accident on October 2020. I did not hire an attorney because the insurance company said they would take full responsibility, the report said we were both at fault even though the driver cut me off on the opposite side and hit my driver side, I was injured. Upon taking days off from work the insurance company deny compensation because when I went to the doctor for treatment I did not have out of pocket. I provided my primary I insurance, they say they cannot pay unless they are billed and doctor provide note for treatment, even though my Doctor provide note for each day out of work for my visits. What are my options, and can they legally do that since they are causing financial stress? Thank you.
Unfortunately, you are 1 1/2 years late for getting the assistance you need if you are in NY. You really needed an attorney at the outset. I can only comment on New York Law, so if this is another state this response might not apply. In NY, you would not use your primary health insurance for medical payments and treatment resulting from a motor vehicle accident. In NY you would file for No-Fault benefits within 30 days of the accident and the insurer for the vehicle you occupied would pay all of your medical bills for a period of time, up to 3 years. They would also pay 80% of your lost earnings up to $2,000 per month (or more depending on the policy endorsement).
While insurance companies for the other vehicle involved in the accident might initially tell you that they will take care of everything, they generally end up taking the side of their insured and so they often change their position.
At this point, if you want to get compensated for the days out of work, and assuming that you never applied for No-Fault benefits, you might have to turn to litigation against the other party, which may be tricky and costly, depending upon whether you also have a viable personal injury claim. You should consult a personal injury attorney in NY for the best advice particular to your case.
Tim Akpinar and Jonathan R. Ratchik agree with this answer
Your question is a bit confusing. Can the insurance company deny paying you for your time out of work? Yes, especially if you haven't established that your time out of work was due to the injuries you sustained as a result of the motor vehicle crash or did not submit the appropriate paperwork. Following the incident, you should have filed an application for no-fault insurance benefits with your own insurance company. Your doctors should have submitted their bills to the no-fault carrier for payment, not your private health insurance. Your doctor should also have filled out a Verification of Treatment by Attending Physician form while your employer needs to fill out the Employer's Wage Verification Report.
The only way to get the other car's insurance to pay you $ would be to file a lawsuit which may or may not be possible depending on the extent of your injuries. In New York, you need to have sustained a "serious injury" in order to bring a lawsuit for damages not covered by no-fault insurance.
Tim Akpinar agrees with this answer
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.