Disclaimer: This article provides general information and does not constitute legal advice. Always consult a licensed attorney about your specific circumstances.
Detailed Answer
In Indiana, there is no “Rule 414” governing insurance adjusters’ handling of medical bills. Rule 414 is part of North Carolina’s evidence code, and it has no effect in Indiana. Instead, Indiana law and your insurance policy control how an adjuster may review, negotiate, or pay medical expenses after an accident.
Key legal frameworks:
- Indiana Code §27-8-2 defines auto insurance terms, including Personal Injury Protection (PIP).
- Indiana Code §27-8-13 requires insurers to pay reasonable and customary medical charges under PIP.
- Indiana Code §34-29-1 governs medical-provider liens against third-party recoveries.
Negotiation vs. Unilateral Reduction: An adjuster may:
- Verify that bills are reasonable and customary under your policy.
- Apply network discounts if your policy uses a preferred provider organization (PPO).
- Negotiate payment directly with providers who have agreed to discounted rates.
An adjuster may not:
- Invoke a non-existent “Rule 414” to cut your bills.
- Arbitrarily refuse to pay a legitimate, policy-covered medical expense.
- Ignore Indiana’s statutory requirements on liens and PIP payment timelines.
If you disagree with an adjuster’s decision, you can request an itemized explanation of reductions and cite Indiana Code §27-8-13 to ensure your bills meet the “reasonable and customary” standard.
Helpful Hints
- Review your auto policy’s PIP coverage limits and network requirements.
- Ask your medical provider for a detailed, itemized bill before an adjuster negotiates.
- Check if your provider has agreed to a lien under IC 34-29-1 to secure payment.
- Keep records of all medical invoices, correspondence, and payment offers.
- Consult an Indiana-licensed attorney if an adjuster denies or underpays covered expenses.