One of the most complicated aspects of a car accident case is ensuring that you will receive the treatment that you need and deserve for your injuries. While your insurance company may provide coverage, the policy provisions can be complex, and when multiple insurers are involved, disputes can arise regarding which insurer must provide reimbursement to your doctors for your treatments. If the parties are unable to reach a resolution regarding payment, you may find yourself receiving a hefty bill. As seasoned Boston car accident lawyers, we have assisted many victims with ensuring that their insurance coverage is applied fairly and appropriately to their claim and that they receive the reimbursement that they deserve.
In a recent appellate opinion, the court discussed a dispute between insurance companies regarding payment for treatments that a car accident victim received in 2010. The victim had a Massachusetts auto insurance policy and a health insurance policy from two different insurers. From the period of the accident until 2011, the victim received treatment from the plaintiff’s office, which offered chiropractic treatment. During each treatment, the plaintiff was billed for multiple treatments, including a hot and cold pack treatment. The parties did not dispute that the treatments that the plaintiff received were medically necessary.
The auto insurer paid the first $2,000 of the medical expenses that the victim suffered, and thereafter the auto insurer instructed the plaintiff to provide the medical treatment payments to the health insurance provider for payment. The health insurance provider made partial payments to the plaintiff but denied reimbursement for all of the hot and cold pack treatments. According to the health insurer’s payment policy, these were expressly excluded from coverage. The plaintiff did not object to the health insurer’s decision in this regard.