Disclaimer: This content is for informational purposes only and does not constitute legal advice.
Detailed Answer
After a car accident in South Dakota, your auto insurer must evaluate your medical claims fairly. If the insurance adjuster disputes that your treatment is related to the crash, take these steps:
- Gather Comprehensive Medical Records and Opinions. Obtain all records from emergency care, doctors, therapists, imaging studies and test results. Ask your treating physician to provide a written opinion linking your diagnoses and treatment directly to the crash. Clear medical causation letters strengthen your claim.
- Review Your Policy and Statutory Requirements. Check your policy’s definition of “accidental injury.” Under South Dakota law, insurers must not engage in unfair claim settlement practices (SDCL 58-33-1).
- Send a Detailed Demand Letter. Draft a letter outlining your collision history, your injuries, itemized medical bills and a medical causation statement. Request prompt payment or a specific explanation for denial. Keep delivery records.
- Engage a Third-Party Review. Ask your insurer for an independent medical examination (IME) or peer review. If they deny this, document your request in writing.
- File a Complaint with the South Dakota Division of Insurance. If you believe the insurer acted in bad faith, submit a complaint at the Division of Insurance consumer services portal: dlr.sd.gov/insurance. The DOI can investigate unfair practices.
- Consider Legal Action Before the Statute of Limitations Expires. Under SDCL 15-2-14, you have three years from the accident date to file a personal injury lawsuit. If negotiations fail, a lawsuit in circuit court can compel payment and potentially recover attorney fees and court costs.
Helpful Hints
- Keep a treatment log noting dates, symptoms, and pain levels.
- Preserve all billing statements and insurance correspondence.
- Use certified mail or other trackable methods for important documents.
- Get written confirmation from providers linking care to the accident.
- Seek a second medical opinion if the initial link is unclear.
- Track deadlines: insurance response times and the three-year statute of limitations.
- Consult an attorney early if the insurer questions your causation.