I got into a car accident while i was on a bike 2 months ago (4/28/13). While riding my bike on a side-walk (slowly), a car runs into me hitting me sideways (He tried to get into a parking lot). Ambulance came, was rushed to the ER for a minor ankle injury. I filed and submitted a claim with the other parties insurance company within 2 weeks. After waiting a month, i was scheduled to meet with one of their health examiners to follow up on my injury. A week later i get a mail from the insurance company, them denying ALL of my no-fault claims.
I dont know all of the details, but it sounds like its time to get a lawyer. Many personal injury attorneys, such as myself, work on a contingency basis (you dont pay unless you win or settle) and offer free 30 minute consultations. Dont try handling this yourself without an attorney as the insurance company is likely trying to gather evidence to use against you. Do not delay.
Did you see the insurance company doctor? You should have received a denial form explaining the reason for the denial and you are entitled to get a copy of the doctor's report. These exams are generally a scam as the doctors usually say the claimant is fine whether it's true or not.
It appears that you notified the vehicle's insurer of your accident, but did you provide the carrier with a fully signed and completed application for no fault benefits within 30 days of the collision?
Assuming that you did submit the no fault application, the carrier may well have denied the claim, but in doing so, has to explain to you in writing what the basis is for the denial. It could be that you filed with the wrong insurance company. It could be that the policy was cancelled prior to the collision. In any event, you really need to contact an experienced personal injury lawyer in your community and have that attorney review the correspondence from the carrier. Only then can you determine what happened and why the carrier is denying your claim
Unfortunately, the insurer has the right to have you examined to determine if you still require treatment. Even more unfortunately, a no-fault Independent Medical Examination ("IME") is rarely a fair assessment of your condition, and the doctors will perform a cursory examination, tell you you're fine, and then recommend the insurer deny any future benefits.
If you want to continue treatment, you will either have to pay out of pocket and then sue the insurance company for breach of contract in order to get reimbursed, or (a much better idea and the way this is commonly done) find health care providers who will allow you to assign them your no-fault benefits, and let them fight with the insurance company instead of you.
First of all, if your injury required surgery it is not a "minor ankle injury." You need to speak to a NYC attorney with experience in automobile accidents. Most attorneys who practice in auto liability offer free consultations. Your injury is serious and you stand to collect a substantial award by starting a lawsuit. Your no fault situation is merely a small part of the equation. Further, if your health care providers "accepted assignment if benefits," they are the ones who have to fight with no fault, not you. Look up some profiles of personal injury lawyers on Avvo. You need to bring a suit against the hitter and hope there is adequate insurance coverage. Your lawyer will determine the answer to this question.
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