Insurance companies are in business to make money. They take insurance premiums paid by all of us, invest them, and do their best to make sure that the amount of paid claims is minimum. These are simple business strategies that many people overlook.
Your initial contact with insurance claims representatives may frequently be pleasant. Their goal is to make you comfortable and gain your trust. However, when dealing with your own insurance company or the insurance company of the individual that caused the accident, this friendly attitude will inevitably change.
There are many aspects to a personal injury claim that you probably don’t fully understand. For example, your initial medical payments are made under your own policy pursuant to your PIP coverage. When your treatment is completed your insurance company then makes a claim to the insurance company of the at-fault driver for reimbursement of the money they paid. Logically you might conclude that your insurance company is going to pay all of your bills because they’re going to be reimbursed. This is not so. In fact, your insurance company will most probably scrutinize your bills carefully, make reductions and pay your doctor parts of the bill. Frequently your insurance company will send you to an insurance doctor for an examination. Most of these doctors work closely with the insurance companies and consistently render opinions that enable your insurance company to stop paying for the care you need. Your perception will be that you have been “cut off” for medical treatment and that you have no further rights to treat. That is not true.
Your insurance policy is a contract between you and your insurance company. The policy allows your insurance company to schedule an exam with a doctor of their choice provided they give you reasonable notice. You have a right to decline to attend that exam. However, if you refuse the exam your insurance company is no longer required to pay for any of your medical treatment. If you attend the exam and the insurance company denies payment you would have a right to challenge the insurance doctor’s opinion. The Oregon laws allow injured persons to file suit against their insurance company following a denial of payment. The attorneys at Gatti & Gatti have a long history of prevailing in those lawsuits and getting your medical bills paid by your insurance company.
Similarly, the insurance claim representative for the other driver may well seem friendly and accommodating at first. That attitude will most definitely change at some point along the way.
Remember that insurance claims people are evaluated, receive pay increases, and receive promotions based upon the amounts that they do not pay. It is in their interest to not pay you everything you are entitled to receive.
If you’re in a motor vehicle accident that was caused by the negligence of another person your best interests are served by contacting a competent plaintiff’s attorney shortly after the accident to discuss your legal rights. The attorneys at Gatti & Gatti have been representing injured victims for over 30 years and we are eager to assist anyone who has a personal injury claim. We will fight for all of your rights and be certain that the insurance company pays what they contractually obligated to pay and that you are compensated fairly for your injuries.