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After an auto accident, my insurer will not pay chiropractic bills, can I get the other drivers insurance to pay?

My sister was recently involved in a rear end collision in which the other driver was at fault. She has been seeing her chiropracter for neck/back pain and her insurance company refuses to pay for it because she didn't have a doctors referal. Can the other drivers insurance company be made to pay these medical bills?

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Attorney answers (3)

Reputation Level 14
If there is a third party injury case, the answer is yes. Her injuries must, however, reach a certain threshold here in Michigan. If not, her fight is still with her own carrier. I am also in Livonia and can help her. Please visit me at www.kliszlaw.com to discuss the matter in detail. Tim Klisz
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Avvo Pro

Reputation Level 12
In a Michigan accident, each person’s No Fault (PIP) insurer is responsible for their own medical expenses. The insured wrongdoer is immune from any medical expenses incurred by your sister as a result of the accident, and vice versa. Therefore, the other person’s insurance company has no responsibility to pay for your sister’s medical expenses.

If your sister has health insurance and her health insurance is in first priority to pay, then she has an obligation to go through the health plan first, before seeking payment from the PIP carrier. In the event there are chiropractors in the health plan, then she must use one of those chiropractors, or the PIP carrier will have no obligation to pay for the treatment. If there are no chiropractors in the health plan, then she should be able to treat with a chiropractor and circumvent the HMO completely, as long as the HMO gives her some documentation that they have no chiropractors in the plan.

If your sister has followed all of the rules regarding which plan pays first and the PIP carrier still refuses to pay, then her recourse is to sue the PIP carrier in a first-party No-Fault lawsuit to recover unpaid benefits. www.michiganautolaw.com.

Reputation Level 10
Most likely * NOT *

I do this work everyday and it even confuses other attorneys. Generally, medical expenses are paid by each person's own auto insurance company. There are exceptions; however, those only apply when one person is uninsured.

The rules as to whether your sister's chiropractic care should be covered by either her auto insurance company or her other health insurance company can be tricky and need to be evaluated by an attorney at this point.

This portion of our web site provides information about this exact issue. Please read http://www.michiganautolaw.com/caraccidents/car...

Good Luck to you and your sister,
/Tom James

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