Disclaimer: This article provides general information about Minnesota law. It is not legal advice. Consult a qualified attorney for advice on your specific case.
Detailed Answer
When an insurance adjuster denies that your medical treatment relates to a car accident, you should act quickly and methodically. Minnesota drivers carry Personal Injury Protection (PIP) benefits under the no-fault system. These benefits cover your reasonable medical expenses, regardless of fault, per Minn. Stat. § 65B.42 and § 65B.44.
1. Review Your Policy and Coverage. Confirm your PIP limits and any medical provider network requirements. Note deadlines for submitting bills and medical records.
2. Gather Strong Medical Evidence. Ask your treating doctor to prepare a written statement linking your treatment to the collision. Include diagnostic reports (X-rays, MRIs) and treatment plans.
3. Send a Written Rebuttal. Within 30 days of denial, submit a letter of reconsideration to the insurer. Attach your doctor’s opinion and all supporting medical records. Reference the policy language and relevant statutes.
4. Use Internal Dispute Resolution. If reconsideration fails, file a formal appeal with the insurer’s dispute resolution department. Maintain records of all communications and deadlines.
5. File a Complaint with the Minnesota Department of Commerce. If the insurer still denies coverage, you can file a first-party complaint online. The Department reviews unfair claim practices and can order the insurer to pay legitimate PIP claims.
6. Explore Third-Party Claims. If another driver caused the crash, you may have a third-party claim. Send a demand letter with your medical evidence. If they still deny liability, consider filing a lawsuit. Minnesota’s general statute of limitations for personal injury claims is six years (Minn. Stat. § 541.05).
7. Consult an Attorney. If internal appeals and administrative complaints do not resolve your claim, an experienced personal injury attorney can negotiate with insurers, prepare your lawsuit, and represent you at mediation or trial.
Helpful Hints
- Track all medical appointments, bills and correspondence with the insurance company.
- Request copies of your complete medical file and billing statements from providers.
- Obtain a second medical opinion or an independent medical examination if your treating doctor won’t provide a causation letter.
- Keep a pain diary to document daily symptoms and functional limitations.
- Send all letters via certified mail and keep delivery receipts.
- Note deadlines carefully to preserve your rights under the PIP statute and civil court rules.
- Consider mediation or appraisal clauses in your policy before filing suit.
- Make sure any attorney you consult has experience handling Minnesota car-accident cases.