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 (8)

Asmik Jasmine Gevorkyan

Asmik Jasmine Gevorkyan

Personal Injury Lawyer - Sherman Oaks, CA
Answered

You should consult with a personal injury attorney ASAP. If your former doctor is hesitant to continue with your treatment your lawyer will find a doctor who would be willing to c

The response given is not intended to create, nor does it create an ongoing duty to respond to questions. The... more
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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 be able to 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
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Paul J. Molinaro, M.D., J.D. ... Attorney at Law, Physician, Broker... Fransen & Molinaro, LLP... 980 Montecito... more
Marc Lazarus

Marc Lazarus

Car / Auto Accident Lawyer - Newport Beach, CA
Answered

That is infuriating to hear. An adjuster is interfering with your medical care in a third party case. Which insurance company is that? There is something seriously wrong with an adjuster calling your PT facility and limiting your treatment. That sounds like a violation of HIPPA, interference with contract, interference with prospective economic advantage, and inconsistent with insurance code 790.03. Call a lawyer!

Marc Lazarus
www.russellandlazarus.com

Michael Shemtoub

Michael Shemtoub

Car / Auto Accident Lawyer - Los Angeles, CA
Answered

With a case like yours it seems like you have some good facts in order to get a high settlement. The most important thing when building your case are: liability (were you at fault); how bad are your injuries to your body and your property; and of course how high is the at fault person's policy. A lot of these things sound like they are not complete yet in your case so its something that is worth hiring an attorney for in order to get a sense of whether you have a case and what the strategy would be for you to build a strong case!

I've handled many of these cases and wouldn't mind speaking to you.

View my website & call for a FREE consultation if you are a California resident 877-427-2752 or you can email me... 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.

Kevin Coluccio

Kevin Coluccio

Car / Auto Accident Lawyer - Seattle, WA
Answered

You need to talk with an attorney.

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

Christopher Steven Hoffmann

Christopher Steven Hoffmann

Car / Auto Accident Lawyer - Saint Louis, MO
Answered

An adjuster canceling a physician order for physical therapy needs to be reported to the department of insurance. This behavior cannot be tolerated in a car accident claim. If you were represented by counsel, I do not think this would happen.

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

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