Disclaimer: This article provides general information on Connecticut law and does not constitute legal advice or create an attorney-client relationship. For guidance specific to your situation, consult a qualified attorney.
Detailed Answer
1. Understand Connecticut’s No-Fault PIP Coverage
Connecticut requires all drivers to carry Personal Injury Protection (PIP) coverage. PIP pays up to $25,000 in medical expenses per person without regard to fault. Review your policy declarations page to confirm your limits. Insurers must evaluate treatment links to the crash under Conn. Gen. Stat. § 38a-363c. Conn. Gen. Stat. § 38a-363c.
2. Gather and Submit Comprehensive Documentation
Compile all relevant records: doctor notes, imaging reports, bills and receipts. Ask your treating physician to provide a letter explaining how the accident caused your injuries and why each treatment is necessary. Organize the records chronologically. Send them to the adjuster via certified mail and keep copies.
3. Request an Independent Medical Examination
If the adjuster denies causation, request an Independent Medical Examination (IME). Connecticut law allows the insurer to require an IME at its expense. Choose a licensed physician experienced in crash injuries. An IME can clarify disputed medical issues and strengthen your claim.
4. Initiate PIP Arbitration Under Connecticut Law
If your insurer still disputes coverage or medical necessity, you can demand arbitration. Pursue arbitration under Conn. Gen. Stat. § 38a-364 to resolve disputes over PIP benefits. Conn. Gen. Stat. § 38a-364. Send a written demand to the insurer and include copies of all medical records, bills, and correspondence. An impartial arbitrator reviews your evidence and issues a binding decision.
5. File a Complaint or Seek Legal Action
If arbitration does not resolve the dispute or you face unfair delay tactics, file a complaint with the Connecticut Insurance Department. You can submit a no-fault PIP dispute complaint online at ct.gov/cid. As a last resort, you may file a lawsuit in Connecticut Superior Court to enforce your benefits. An attorney can guide you through court procedures and deadlines.
Helpful Hints
- Keep all correspondence and proof of delivery for insurer communications.
- Review the “Declarations” and “Exclusions” sections of your PIP policy.
- Maintain a daily pain and treatment journal to document your recovery.
- Meet all statutory deadlines when demanding arbitration to preserve your rights.
- Consider consulting a personal injury attorney if the dispute involves significant medical bills or complex causation issues.