Dear Catherine:

Signs here of definitely timing someone out who really needs and deserves
support and care. It would be good to discuss here, although unless someone
raises their hand it is not clear such situations, alas, are confined to
auto accidents. Many pain and other patients get stranded these days.

Because this list needs pruning of those posting spam and other non
pertinent matter, could you please verify that yours is a real situation -

This is not in any way to pick you out individually, but just to start up
the discussions again directly on point.

Best wishes, Mod.


----- Original Message -----
From: "callo66" <catherine@...>
To: <pain-in-the-law@yahoogroups.com>
Sent: Tuesday, June 15, 2004 11:08 AM
Subject: [pain-in-the-law] I have a question about auto insurance law


> Hi -
>
> My name is Catherine Wylie. I live in Denver, Colorado and was in an
> automobile accident almost four years ago. Up until a year ago, I was
> recieving most of the care that was prescribed for me and then as all good
> insurance companies seem to do after a while, they started to deny care
that
> was doctor requested.
>
> For more than six months now, I have been fighting them to even let me go
to
> pain management for chronic pain issues. My primary care doctor finally
gave
> up on me and now I have no primary care physician either. I believe she
got
> tired of fighting the insurance company too for pain management as there
was
> nothing else that could be done about my conditions (Thoracic Outlet
> Syndrome, severe TMJD, and pain that has now spread to other parts of my
> body).
>
> The only person who would help me out with any sort of pain management
> was my psychiatrist and they cut him off recently too and send me a letter
> saying that after reviewing the doctors notes they do not feel that
whatever
> pain I have is related to my accident. This is a complete convoluted lie.
> Actually, the last pain management specialist I went to wrote to them
saying
> that this was due to my accident and that I could benefit by pain
management.
>
> So they write me saying that based on what even she said, they do not feel
I
> can be approved for pain management.
>
> Now, the issue that is troubling me, is that I have been trying to get my
lawyer
> to help me with all this for months as well and while we were in the
litigating
> stage with the unprepared, very stalling adjuster from State Farm, he did
not
> press the issue enough about getting my health care needs straightened
out -
> the fact that they have been denying me care and I myself had brought that
up
> in the deposition and the arbitration meeting.
>
> About a week before having to go to court, they decide to settle out of
court
> and only because I was desperately out of money did I sign the litigation
> agreement that a state farm lawyer wrote up and while I do not have it
with
> me, my lawyer told me that by signing it, I release them from any further
> charges - basically I cannot take them to court for bad faith etc. I knew
I should
> not have signed it and I would rather have had the thing go to court but
my
> attorney assured me that trying to force a bad faith claim is like "trying
to find
> the unicor on the arc" - that it can be impossible to prove.
>
> So now he has his money and I have some of mine that I need to live on and
I
> am expected now to pay out of my pocket for my own care and I have been
for
> alternative things. I cannot afford to pay for pain management and
besides,
> my policy says I have five years of care from the date of the accident
coming
> to me and I still have 21K in medical coverage left.
>
> Due to their behavior towards me for the last year, I have become sicker
and
> need help with pain mangement. I finally went again to my thoracic outlet
> surgeon and he once again wrote a note that I need pain management,
> possibly another surgery, physical therapy, and a psychiatrist. My lawyers
> office sent this to my state farm adjuster, along with a request for them
to just
> settle out my PIP claim (basically give me what is left of my medicals)
and they
> are supposedly going to write me with a decision.
>
> I hate to be negative, but I know what the decision will be since they did
not
> tell the paralegal over the phone that they were going to give me the
money.
>
> I am extemely frustrated and agnry and need help with pain management. I
> refuse to let them off the hook and pay out of my own pocket. I do take
pain
> meds for now and I have already paid plenty for accupuncture and massage
> but nothing fixes me long term and I cannot afford to keep letting my
> settlement money drip out of my hands like this.
>
> I am scared and frustrated and angry as hell. My mother, who is an
attorney
> said that even though I signed that release, it still does not release
them from
> the obligation to provide the care I have paid my premiums for and that
maybe
> I can take them to court on another issue.
>
> As well, I am also planning to write to the insurance commissioner if they
do
> not do either give me the PIP money or the care I need. I am dreading that
as
> well because there is so much paper work that they have lost and stalled
at
> Sloane's Lake Managed care that it will probably be a large undertaking by
> now to explain exactly what they have done to me to the insurance
> commissioner.
>
> And what if for some reason they do not want to see it my way and State
Farm
> gets away with this? I will be really out of luck. But I do not see how
they
> cannot, being that about five doctors have said, this person needs pain
> management for injuries sustained for this specific MVA.
>
> Thanks for any insight into the laws or perhaps another direction I could
go in.
>
> Thanks,
> Catherine
>
>
>
>
>
>
>
>
> Yahoo! Groups Links
>
>
>
>
>