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Jmatic1

Fee Arbitration for Auto Insurance to pay medical bills

6 posts in this topic

Hello:

 

I've been dealing with a lower back injury since 2016 and until recently I had an IME stating that I have reached Maximum Medical Improvement for Pain Management which then resulted in Geico stopping payment of my medical bills (I'm in New Jersey by the way). My doctor suggested that we continue treatment and then do Arbitration against Geico in order for him to get paid. My question is, if they lose in Arbitration and Geico says they're not paying anything, will I then be stuck with all the bills from my doctor's office?

 

Thanks in advance!

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54 minutes ago, Jmatic1 said:

My question is, if they lose in Arbitration and Geico says they're not paying anything, will I then be stuck with all the bills from my doctor's office?

Who are "they"?  Who is GEICO insuring?  You need to indicate the cause of your injury and who you believe may be liable for your medical bills.

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Just now, RetiredinVA said:

Who are "they"?  Who is GEICO insuring?  You need to indicate the cause of your injury and who you believe may be liable for your medical bills.

"They" is the Doctor's offices legal team. Geico is my insurance company. The cause of the injury was an automobile accident in 2016 which I was declared at fault. Geico has been paying my medical bills up until November 2018 and then Geico stopped when Geico said I reached maximum medical improvement after I completed an Independent Medical Examination.

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So, you are asking: if the doctor takes his claim to arbitration and loses the arbitation, are you liable for the doctor's bill that accrued after you were determined to have reached maximum medical improvement.  I assume the issue in arbitration is whether you have, in fact, reached MMI.  If it is determined that you have, it is essentially a determination that further medical treatment was not medically necessary or appropriate.  If that is the case, it would tend to excuse you from paying the bill.   

 

BTW, in my practice, this has usually involved chiropractors who continue treatment until the patient or the chiropractor dies.  Is there a chiropractor involved here?

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1 minute ago, RetiredinVA said:

So, you are asking: if the doctor takes his claim to arbitration and loses the arbitation, are you liable for the doctor's bill that accrued after you were determined to have reached maximum medical improvement.  I assume the issue in arbitration is whether you have, in fact, reached MMI.  If it is determined that you have, it is essentially a determination that further medical treatment was not medically necessary or appropriate.  If that is the case, it would tend to excuse you from paying the bill.   

 

BTW, in my practice, this has usually involved chiropractors who continue treatment until the patient or the chiropractor dies.  Is there a chiropractor involved here?

 

Oh okay I think I understand. So in other words if I am to determined to have reached MMI, then I don't have to pay anything because it was the doctor's choice at the end of the day to choose to continue treatment?

 

Also, no there is no Chiropractor and my doctor hasn't recommended that I get one. I have went to see a spinal surgeon for a second opinion and he told me that even if he was to do surgery, the injury would either stay the same or get worse.

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1 hour ago, Jmatic1 said:

So in other words if I am to determined to have reached MMI, then I don't have to pay anything because it was the doctor's choice at the end of the day to choose to continue treatment?

 

Don't count on it.

 

If you accept additional treatment and lose the arbitration you can bet that your doctor will hold you responsible for the bills.

 

If you want to challenge the IME, I suggest you go to arbitration now, before you incur any more medical bills.

 

If you don't believe me ask your doctor to put it in writing that he will waive any future bills if you lose the arbitration. Also bear in mind that any agreement your doctor makes won't be binding on any other provider of medical services.

 

By the way, your doctor's "legal team" is not your "legal team" and sure as heck isn't looking out for your best interests. They are there to protect the doctor.

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