Detailed Answer
When an insurance adjuster denies that your medical treatment relates to your Indiana car accident, take these steps to protect your rights and maximize your recovery.
1. Review Your Policy and Coverage
First, check your auto insurance declarations and policy. Indiana Code § 9-26-1-1 requires carriers to offer Personal Injury Protection (PIP) or Medical Payments (MedPay) benefits. Indiana Code § 9-26-1-1 outlines these coverages. Confirm the limits and scope of your medical benefits.
2. Gather Thorough Medical Documentation
Compile all records, including:
- Emergency room and hospital reports
- Doctor’s notes, diagnoses, and treatment plans
- Physical therapy and specialist reports
- Medication records
Link each treatment date to the accident date. Highlight continuity of care from the collision forward.
3. Obtain a Causation Opinion from Your Physician
Ask your treating doctor to provide a written statement linking your injuries and treatments to the crash. A clear causation letter carries weight with adjusters and in court.
4. Send a Formal Demand Letter
Submit a demand letter to the insurer that details:
- Your accident date, location, and circumstances
- List of injuries and treatments
- Medical bills and outstanding balances
- Physician’s causation statement
Demand full payment of covered benefits by a specific date. Sending the letter via certified mail creates a record of your request.
5. File a Complaint with the Indiana Department of Insurance (IDOI)
If the adjuster still refuses payments, file a consumer complaint online at the IDOI website. The department can investigate bad-faith practices and force the insurer to respond.
6. Consider Appraisal or Arbitration
Your policy may include an appraisal or dispute-resolution clause. If so, demand appraisal in writing. An independent appraiser can determine reasonable medical costs, and an umpire can resolve conflicts.
7. Protect Your Right to Sue
Under Indiana Code § 34-11-2-4, you generally have two years from the accident date to file a personal injury lawsuit. Indiana Code § 34-11-2-4 sets this deadline. Acting promptly preserves your legal options.
If you decide to sue, gather all evidence—police reports, witness statements, medical records—and follow Indiana Rules of Trial Procedure. Consult with an attorney early to navigate court procedures.
Disclaimer: This article is for educational purposes only and does not constitute legal advice. Consult a qualified attorney to address your specific situation.
Helpful Hints
- Document every phone call and email with the insurer.
- Keep a detailed medical treatment journal, noting symptoms and dates.
- Obtain all billing statements and payment histories from medical providers.
- Request an itemized explanation if the insurer denies part of your bills.
- File your IDOI complaint as soon as unreasonable delay occurs.
- Act before the two-year statute of limitations expires (IC § 34-11-2-4).
- Consider hiring counsel if denials continue or your injuries are severe.