Can my insurance adjuster cancel my Physical Therapy?

I was in a car accident in November 2012. I have already received about 10 weeks of physical therapy. Upon returning to my doctor for an examination, she determined that I was at about 80% range of motion, and wrote me a prescription for more physical therapy, to return me to 100%. My insurance adjuster called my Physical Therapy office and told them she wasn't going to pay for the second round of treatment, and now the office won't even let me make an appointment. The longer I go without Physical Therapy, the more the pain slowly starts returning. Is this legal? Don't they have to pay for all of my treatments that are prescribed by a doctor?

Long Beach, CA -

Attorney Answers (5)

Paul J Molinaro

Paul J Molinaro

Car / Auto Accident Lawyer - Corona, CA
Answered

In general (there are exceptions but these are quite technical and uncommon) Insurance companies do not direct medical care but instead decide which services they will pay for... that means they deny payment not deny care. This is an issue with liability insurers as well as health insurers... and one that has caused a battle for decades now. Fortunately, the patient being denied coverage should easily find a local lawyer who can look for available sources of coverage and use the laws to obtain what his or her client is entitled to receive.

Fortunately, most of us personal injury types offer free consultations and take such cases on contingency, so there is nothing to fear in calling us.

- Paul

Paul J. Molinaro, M.D., J.D.
Attorney at Law, Physician, Broker
Fransen & Molinaro, LLP
980 Montecito Drive, Suite 206
Corona, CA 92879
(951)520-9684
www.fransenandmolinaro.com / www.888MDJDLAW.com

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Paul J. Molinaro, M.D., J.D. ... Attorney at Law, Physician, Broker... Fransen & Molinaro, LLP... 980 Montecito... more
Christian K. Lassen II

Christian K. Lassen II

Car / Auto Accident Lawyer - Philadelphia, PA
Answered

Unfortunately, most insurance companies only cover so many pt visits per year. For example, blue cross only covers about 20 visits for my injured clients per year. Have your lawyer send the pt place a letter of protection.

Richard Andrew Harting

Richard Andrew Harting

Car / Auto Accident Lawyer - Long Beach, CA
Answered

You need to hire an attorney. Auto insurance claims are handled on a reimbursement basis. With the help of an attorney you can get your necessary medical treatment. Our office in Long Beach is available for a free in person consultation. 562-981-1010

Andrew Daniel Myers

Andrew Daniel Myers

Personal Injury Lawyer - North Andover, MA
Answered

Insurance companies trying to save a few pennies often find themselves making foolish mistakes. I'd need a bit more info before concluding a trouble shoot here. Retain an attorney to have a convo with this adjuster. I am not a fan of letters of protection because there are cases that correctly point out that they can present a conflict of interest. Bringing in an attorney always raises claim value: that's not my opinion, that's from statistics kept by the insurance industry itself. See link below:

Law Offices of Andrew D. Myers, North Andover, MA & Derry, NH provide answers for informational purposes only.... more
Christopher Steven Hoffmann

Christopher Steven Hoffmann

Car / Auto Accident Lawyer - Saint Louis, MO
Answered

Coverage, not care, can be determined by the insurer after a car accident. An insurance adjuster cancelling physician orders needs to be reported to the attorney general and the department of insurance for practicing medicine without a license. Thank God you were not on life support!

24 Hour Attorney Call Center (314) 361-4242 or visit us on the Web at http://www.hoffmannpersonalinjury.com.

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