Detailed Answer
After a Nevada car accident, your Personal Injury Protection (PIP) insurer must cover reasonable and necessary medical treatment. If the adjuster disputes that your therapy, diagnostics or bills relate to the crash, follow these steps.
1. Gather Comprehensive Medical Documentation
Collect all medical records, itemized bills and receipts. Show the dates of service, providers’ names and specific treatments. Nevada law requires insurers to pay for “reasonable and necessary” care up to policy limits (NRS 41A.070).
2. Obtain a Physician’s Nexus Statement
Ask your doctor to explain how each treatment links to your car accident. A clear nexus letter strengthens your claim and meets the insurer’s “reasonable and necessary” burden.
3. Request a Written Explanation of the Denial
Under Nevada law, the insurer must accept or deny your PIP claim within 21 days of proof of loss and include written reasons for any denial (NRS 41A.150). Use this notice to understand their objections.
4. File a Complaint with the Nevada Division of Insurance
If you cannot resolve the dispute directly, file a complaint online at the Nevada Division of Insurance (doi.nv.gov). The Division can investigate unfair practices.
5. Consider Legal Action
You may demand appraisal or mediation if your policy allows. If the insurer still refuses, you can file suit for breach of contract or unfair claim settlement practices under NRS 686A.310.
6. Consult a Personal Injury Attorney
An attorney can help gather evidence, navigate Nevada’s no-fault system, and protect your rights in litigation.
Helpful Hints
- Keep a treatment log with dates, providers and services.
- Obtain a detailed nexus letter from your physician.
- Send records and bills via certified mail for proof of delivery.
- Note your insurer’s 21-day response deadline.
- Review your PIP policy for coverage limits and exclusions.
- Use the Nevada DOI complaint portal for unresolved disputes.
- Explore arbitration or mediation if your policy permits.
Disclaimer: This article is for educational purposes only and does not constitute legal advice. Consult a qualified attorney to address your specific situation.