Detailed Answer
Disclaimer: This article is for informational purposes and does not constitute legal advice. Consult an attorney to discuss your specific circumstances.
When an insurance adjuster in Oregon disputes whether your medical treatment stems from your car accident, follow these steps to strengthen your claim and protect your rights under Oregon law.
1. Compile Comprehensive Medical Records
Obtain all treatment records, imaging reports and physician notes. Document your symptoms, the date you first sought care and any referrals. Accurate records help show a treatment link to the crash.
2. Get a Physician’s Opinion
Ask your treating doctor for a detailed letter tying your injuries and treatment directly to the car accident. A clear medical opinion often persuades adjusters by explaining the causal connection in plain terms.
3. Exercise Your Rights Under Oregon Statutes
Oregon law prohibits unfair claim settlement practices. An adjuster who wrongfully denies valid medical bills may violate ORS 742.016. You can cite this statute when you appeal the decision.
4. Request an Independent Medical Examination (IME)
If the insurer remains unconvinced, they may require an IME by a neutral physician. This exam can confirm whether your treatment relates to the accident and strengthen your position.
5. File a Complaint with the Oregon Division of Financial Regulation
If you suspect bad faith or unfair handling, file a complaint online. The Division can investigate allegations of improper denials or delays.
6. Consider Legal Remedies
Under ORS 36.200, you must file a personal injury lawsuit within two years of the accident. Consult a personal injury attorney before the deadline to discuss filing suit or a bad faith insurance claim.
Helpful Hints
- Keep a personal injury journal to track pain levels and treatment progress.
- Send medical bills and records to the insurer by certified mail and keep proof of delivery.
- Follow your doctor’s recommendations precisely to avoid insurer claims of noncompliance.
- Obtain photos of vehicle damage and the accident scene as supporting evidence.
- Review your auto policy limits and consider underinsured/uninsured motorist benefits if applicable.
- Be proactive: call your adjuster for status updates and document each conversation.