Detailed Answer
When an insurance adjuster challenges whether your medical treatment relates to a Mississippi car accident, take proactive steps. You can protect your rights, gather evidence, and involve regulatory authorities if necessary.
1. Review Your Policy and Adjuster Duties
Start by reading your auto insurance policy. Note deadlines and coverage limits. Under Mississippi Code §83-11-155, insurers must investigate claims fairly and promptly. You can read the statute here: https://law.justia.com/codes/mississippi/2014/title-83/chapter-11/section-83-11-155/.
2. Compile Comprehensive Medical Records
Request copies of all medical records, diagnostic tests, treatment notes, and billing statements. Organize them chronologically. Ensure each entry identifies your accident date and treating physician’s opinion on causation.
3. Obtain a Nexus Letter from Your Doctor
Ask your treating doctor or a specialist for a written “nexus letter.” This letter should explain why your injuries and treatment relate to the collision. A clear, signed medical opinion strengthens your position.
4. Submit a Supplementary Demand Packet
Send the adjuster a detailed demand packet that includes:
- Accident report and policy declarations.
- Chronological medical records with dates and provider names.
- Doctor’s nexus letter.
- Itemized bills and explanation of benefits (EOBs).
- A cover letter summarizing why the treatment is accident-related.
5. Follow Up and Maintain Communication
After you submit the packet, follow up in writing or email within 10–14 days. Politely ask for an update on the claim status and any additional information the insurer needs.
6. File a Complaint with the Mississippi Insurance Department
If the insurer still denies or undervalues your claim, you can file a complaint with the Mississippi Insurance Department. Visit https://www.mid.ms.gov/insurance-complaint.aspx to learn how to submit a grievance online.
7. Consider Legal Action
If negotiations stall, you may need to pursue a personal injury lawsuit. In Mississippi, you typically have three years from the accident date to file a suit under Miss. Code §15-1-49 (https://law.justia.com/codes/mississippi/2014/title-15/chapter-1/section-15-1-49/). Consulting a qualified attorney can help you assess next steps.
Disclaimer: This article provides general information about Mississippi law. It does not constitute legal advice. Always consult a licensed attorney about your specific situation.
Helpful Hints
- Keep a dedicated file for all accident-related documents.
- Send all correspondence via certified mail or email with read receipts.
- Track deadlines—Mississippi’s statute of limitations is strict.
- Get second opinions if you doubt medical causation.
- Document pain levels and daily limitations in a journal.