Detailed Answer
When an insurance adjuster in Wyoming denies that your medical treatment relates to a car accident, you face a common dispute over causation. Here’s how to respond effectively:
1. Review Your Policy and the Denial Letter
Examine your automobile liability policy (Wyo. Stat. § 26-7-101 et seq.; see https://wyoleg.gov/Statutes/StatutesByTitle?title=26&chapter=7). Note coverage limits, required notice deadlines, and any conditions for medical benefits or Personal Injury Protection (PIP), if you purchased it.
2. Gather Strong Medical Evidence
Collect all relevant medical records, treatment notes, imaging (X-rays, MRIs), and diagnostic reports. Ask your treating physician to prepare a detailed written opinion or affidavit explaining how the accident caused your injuries and why each treatment is necessary.
3. Submit a Supplementary Demand
Prepare a demand package that includes: medical records, a causation letter from your doctor, billing statements, and any accident reports. Send it by certified mail and retain proof of delivery.
4. Invoke Policy Remedies
Your policy may offer appraisal, independent medical examination (IME), or peer review. If provided, request these processes in writing. Appraisal can help resolve disputes about reasonable and necessary treatment costs.
5. Consider Mediation or Small Claims
Wyoming courts encourage mediation before trial. You can also file a claim in Small Claims Court (up to $12,000 as of 2023) to recover documented medical expenses. Check local rules for procedures and fees.
6. Prepare for Litigation
If the insurer still refuses to pay, consider suing for breach of contract and bad faith. Wyoming’s four-year statute of limitations for contract claims applies (Wyo. Stat. § 1-3-105; see https://wyoleg.gov/Statutes/StatutesByTitle?title=1&chapter=3).
7. Hire a Wyoming Personal Injury Attorney
An attorney can help you navigate discovery, depositions, and trial. They know local court rules, including the Wyoming Rules of Civil Procedure, and can pursue claims for medical bills, pain and suffering, and attorney fees.
Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a licensed Wyoming attorney to discuss your specific situation.
Helpful Hints
- Document everything: Keep a detailed treatment journal including dates, symptoms, and doctors’ names.
- Photograph injuries: Take pictures at regular intervals to show healing or ongoing issues.
- Track deadlines: Note notice requirements in your policy and the statute of limitations.
- Maintain communication records: Save emails, letters, and voicemails with the adjuster.
- Get second opinions: If your primary doctor’s causation letter is questioned, seek another qualified provider.
- Understand your bills: Ask providers to code treatments clearly to reflect accident-related care.
- Explore PIP: If available, PIP coverage can pay medical bills regardless of fault.