How to I go about a denturists who illegally charged me$990 for dentures when there provider is medicaid which is my provider: My denturist made me a set of dentures back in 07 there was nothing wrong with them except my gums shrunken they became to loose he wrote to my insurance company saying there was no problem with the old ones so they denied my case well every 5 yes you are entitled to a new set of dentures and there was a problem with the top ones they where to loose due to my gums shrinking so he charges me $ 990 out of pocket for the top ones and did a good job but just should have billed my provider now the bottom ones the state approved of but he made them to big and I told him right away they where to loose he said I had to use glue to keep them in place I tried the clue for 5 months went back to him and he refused to do a enlinement or even try to fix the issue so I called my insurance provider about this and they are investigating my case I want to know what other action I can take and who would I contact about his negligent behavior he refuses to fix my dentures and I need teeth to eat with my gums are getting all ate up because of this
Brian’s answer: What a frustrating situation! From the information provided, it is unclear if you have claims, but contacting your insurance company was a good first step. You may consider following back with the insurance company to see their investigation results. You may also wish to consult a dental malpractice attorney if you are concerned that the doctor's care was negligent or deceiving in getting your consent. It is important to not delay, as the medical malpractice rules on statutes of limitations can bar a claim.
A contractor nearby dug into power lines and caused a surge & outage., $2300 in damage (furnace, ice maker, tv's) Who pays?: We had a recent power outage where it was not wind or storms. It was a contractor working on a new home up the street and dug into the underground utilities. The type of outage fried our furnace circuit boards, scottsman ice maker and 2 tv's. The power company disavowed any liability (it wasn't their fault so i understand that) but is the contractor or their insurance company liable for damages? The dig-in was not on our property, it was up the street.
Brian’s answer: They may very well be liable for damages if the contractor or their subs were negligent, and that negligence was the cause of your damages. Evidence they caused the problem will be very helpful, if not necessary, in court. To start, you could document the losses and present all the costs to the contractor and ask that they pay that amount. If they refuse, and you are unable to reasonably resolve the matter, small claims court (with a max of $10,000 in WA) may be a good venue for you. This is often an inexpensive and judicially enforceable way to get a just result. Check your local court's website as attorneys are often not permitted to participate in small claims actions. You may also wish to consult with an attorney to advise you further (including in how to properly go about small claims court proceedings).
How can I go about opening a PIP claim that was closed but I experienced pain that got worse after the initial treatments? : I was in an accident fall of 2019, got chiro, massage and PT for a dew months after. Then when mid 2020 hit the pain got worse and worse, but I didn't know there was an option to open it back up so I pushed through. Fast forward to recently, I've been in excruciating pain that has me laid flat out at times. I contacted the old insurance adjuster for the PIP claim and he referred me to a third part chiro to evaluate me. The chiro "concluded" that there was no evidence to show that this was due to the accident. I know that I am still within the window of time. I am also having to seek specialized care that would be an enormous out of pocket expense.
Brian’s answer:
In Washington, your PIP coverage includes up to $10,000 (or more if you paid for a larger policy) of treatment that is reasonable, necessary, related to the crash, and was incurred within three years of the auto crash. If you have been cut off from treatment, you can ask them for the basis for cutting you off, and for a copy of any examination report or medical record review that was done.
One option, if you believe your treatment fits the four criteria (reasonable, necessary, related to the crash, and within three years of the crash), and your medical provider agrees, you can ask the provider that is being cut off write a letter to the insurance company "rebutting" the cut-off decision. With insurance companies, my experience has been that they generally give more weight to M.D. and M.D. specialists. You may want to talk to your specialist about writing a rebuttal to the PIP cut off. If you have been improperly cut off, you may have legal remedies. Washington's Office of the Insurance Commissioner has a good website on point:
https://www.insurance.wa.gov/personal-injury-pr...
Because every case is unique, and your letter does not contain all the relevant facts to your specific situation, a conversation with a lawyer would probably be helpful for you to further understand the specifics of your claim and give more thorough and individualized advice. You may also want to seek a free consultation and/or hire a personal injury lawyer to assist you in the claim process.