QUESTION

What can I do if State farm is refusing to pay my claim?

Asked on Jul 29th, 2013 on Personal Injury - Michigan
More details to this question:
My wife got in an auto accident with an uninsured motorist. It was definitely the other persons fault as she was cited (rear ended at 40-45 mph while almost completely stopped at a light). We immediately informed State Farm that my wife was injured but we figured it was more sore and would wait a few days. After it did not go away, she did seek medical attention per State Farms request. The Dr. sent her a referral to a physical therapist which we then sent State Farm. She then proceeded to go to the physical therapist. We are now 2 months post accident. While she was visiting a physical therapist regularly and improving, State Farm sent us a notice that we needed to go see their physician. We did as they suggested. After asking a few questions and hitting her to test nerves, she was finished. Total appt. time was 5 minutes. We were then informed by State Farm that they were not going to pay her bill based on that appt. I carry PIP to 10 K and 100k of uninsured motorist coverage. We paid a $500 deductible and the truck was fixed but other than that, her medical has not been paid at all. If it was not for the accident, she would have never injured herself and we would not be in this mess. Any suggestions?
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11 ANSWERS

Personal Injury Attorney serving Kansas City, MO at Nash & Franciskato Law Firm
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In Missouri, State Farm can be liable for breach of contract in failing to pay the medical payments and UIM pursuant to your policy. They can also be liable for a separate cause of action, pursuant to Missouri insurance statues, for vexatious refusal to pay (which if you prevail, entitles you to an award of attorneys fees).
Answered on Aug 02nd, 2013 at 8:07 PM

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Medical Malpractice Attorney serving Highland, IN
Partner at Padove Law
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Clearly, to coin a phrase, they are not treating you like a good neighbor. My suggestion is that you hire counsel to pursue this matter as State Farm is at a great advantage-they litigate claims on a 365 day a year basis, some years 366 days. You need to level the playing field.
Answered on Aug 02nd, 2013 at 8:07 PM

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Plaintiffs Personal Injury Attorney serving New Orleans, LA at David A. Easson
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File suit against State Farm. You are dealing with an adjuster with limited settlement authority. If you file suit you will most likely get a litigation adjuster with higher settlement authority.
Answered on Aug 02nd, 2013 at 8:07 PM

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Personal Injury Attorney serving Charlotte, NC at Paul Whitfield and Associates P.A.
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2 months. That is no time at all for a serious injury. I sense you don't have a serious injury, but see a Personal Injury lawyer for complete review.
Answered on Aug 02nd, 2013 at 8:06 PM

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Car Accidents Attorney serving Warwick, RI
State Farm is known as "Snake Farm" to plaintiff lawyers. You will only get adequate compensation after you hire a lawyer.
Answered on Aug 02nd, 2013 at 8:06 PM

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James Eugene Hasser
Sounds like a visit to your local personal injury lawyer is in order.
Answered on Aug 02nd, 2013 at 8:06 PM

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Thomas Edward Gates
You need to retain your own attorney to assist you. You can go to another doctor for an evaluation.
Answered on Aug 02nd, 2013 at 8:06 PM

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Auto Attorney serving Bloomfield Hills, MI at Gregory M. Janks, P.C.
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In Michigan your car insurer MUST pay all wage loss, medical treatment expenses and replacement services under your PIP coverage. If they refuse to pay, you may hire counsel and sue them. However, the problem becomes one of economics. It is only economical to pay the expense of litigation, and a fee to your lawyer, if the amount of outstanding benefits warrants the cost of suit. You would need to explore this with local Michigan counsel who regularly handles insurance litigation. As to any uninsured motorists claim, you'll need to prove the fault of the other driver, the uninsured status of the other driver and that your wife's injuries were a serious impairment of a body function to collect under the UM coverage. Again there are economic considerations that will need to be discussed with local Michigan counsel. You can also file a complaint with the State Insurance Commissioner re: the denial of the claim, which may, or may not, lead to any resolution/payment of benefits.
Answered on Aug 02nd, 2013 at 8:06 PM

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Insurance Defense Attorney serving San Bernardino, CA at Ricks & Wear, PLC
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Get an attorney as soon as possible. I understand this is probably the most common response you're getting but it is true. As long as State Farm knows you are not represented they will push you and your wife; the whole examination by insurance doctor is ridiculous. If you haven't served a notice of intent to arbitrate then they have no right to compel your wife's examination by their doctor but of course they are not going to tell you that. Any respectable attorney should have an easy time with your claim which is "first-party" requiring your insurance company to treat you/your wife differently (better) than any third-party claimant. Don't waste any more time and get a good attorney.
Answered on Aug 02nd, 2013 at 8:06 PM

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NA richard@jandjlaw.com
Well, you have two things going on with S.F. PIP the insurance policy says S.F. can ask for an exam under the PIP (and also under the UM/UIM) coverage by a doctor of its choice, at its expense. Under PIP, you do not have to attend, but if you don't you are not cooperating so you get cut off. Damned if you do, damned if you don't. S.F. wants to cut off PIP payments, so it goes out and buys an exam to paper its file to try to say cutting you off on PIP was not bad faith. You don't have to take that. You can give Notice of Intent to Arbitrate the cutting off of the PIP payments. Your doctors and therapists will back you on that. S.F. has to pay for the PIP arb. I have never seen a PIP insured loose a PIP arbitration. UM/UIM. This is the coverage where S.F. steps in to the shoes of the at fault uninsured driver. This pays you for pain, suffering and disability. IF you can't settle with S.F. on the UM/UIM, I always do Notice of Intent to Arbitrate under the UM/UIM. I ask the adjuster to respond to that, in writing. The S.F. adjuster will write you back refusing to arbitrate, citing their policy provision that S.F. must agree to arbitrate under the U and you have to SUE S.F. AND the at-fault driver. We have had to do this many times. Bottom line = you need to get with a lawyer who handles injury cases, because you are getting jerked around big time by S.F. Then, keep in mind, too, that you may have an IF CA (Insurance Fair Conduct Act) / bad faith claim against S.F. YOUR first party insurer who you have been paying premiums to to have this coverage protection for how many years (and this is probably your first claim) S.F. is bound to coverage on this MVA you are talking about. BUT you do not have to continue to be insured by S.F. if you don't want to be. You can now switch to another auto insurer, such as PEMCO or Safeco / Liberty N.W. even before the pending claims with S.F. are concluded. [Do NOT, though, ever under any circumstances allow yourself to be insured by Allstate.
Answered on Aug 02nd, 2013 at 8:06 PM

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Ronald A. Steinberg
You deal with State Farm, Allstate, Liberty Mutual, and a whole host of "hard nosed" companies by suing them. Talking, negotiating, begging just doesn't "cut it." You get an attorney and you sue them. If they do not negotiate, you can eventually present your case to a jury. State Farm had some very bad media play over the years. They were (and probably still are) guilty of using "whore" doctors specifically who would find that you were not disabled, no matter what your treating doctors would say. I can't recall if it was 20/20 or 60 Minutes that did an expose' on them about 10-15 years ago on national TV. Most recently, State Farm was hit with an 8 million dollar judgment in, I believe, St. Louis, because they refused to pay a claim for a stolen car, and then they hassled the local prosecuting attorney to file criminal charges against the woman who had made the claim. The jury acquitted her, and so she sued State Farm for abuse of process or malicious prosecution, and nailed State Farm. 3 cheers for the good guys.
Answered on Jul 31st, 2013 at 10:51 AM

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