How to Handle an Insurance Adjuster Who Disputes Your Medical Treatment After a Car Accident in West Virginia
Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult an attorney licensed in West Virginia for guidance regarding your specific situation.
Detailed Answer
After a car accident, you have the right to recover medical expenses from the at-fault driver’s insurer. If the insurance adjuster disputes whether your treatment is related to the crash, follow these steps to protect your claim under West Virginia law.
1. Gather and Organize Medical Records
Obtain all documents from every healthcare provider who evaluated you post-accident. This includes hospital records, x-rays, doctor’s notes, therapy reports, and billing statements. A complete chronology strengthens your position.
2. Secure an Expert Medical Opinion
Ask your primary treating physician or a specialist to provide a written statement or affidavit linking your treatment to the collision. Courts in West Virginia give weight to expert testimony on causation.
3. Send a Demand Letter
Draft a formal demand letter to the insurance company. Include:
- Summary of the accident and fault determination.
- List of injuries and treatments with dates.
- Copies of medical records and expert letter.
- A clear demand for payment of medical bills and related expenses.
Under West Virginia Code Title 33, insurers must investigate and respond to claims in good faith.
4. Consider an Independent Medical Examination (IME)
If the insurer still denies causation, they may request an IME. Attend the exam and provide honest, consistent information. An unbiased evaluation can confirm your injuries are crash-related.
5. File a Complaint for Bad Faith (If Necessary)
If the insurer unreasonably denies your claim, you may pursue a bad faith action. Under W. Va. Code § 33-11-4, an insurer that fails to settle a claim without a reasonable basis can face penalties. Consult an attorney to discuss filing suit in circuit court.
Helpful Hints
- Act promptly: West Virginia has a two-year statute of limitations for personal injury claims (W. Va. Code § 55-2-12).
- Keep a treatment diary: Record pain levels, activities you cannot perform, and how injuries affect daily life.
- Photograph injuries and accident scene: Visual evidence can bolster causation arguments.
- Do not sign broad releases: Review documents before signing; some may waive future claims.
- Stay consistent: Discrepancies between your medical history and statements to insurers can undermine credibility.