- Dec 29, 2011
Like many other things in life, it's best to know the (right) answers to the questions before they are asked. Even if you are doing the asking. Insurance campanies are just a giant money maker, and despite spending hundreds of millions of advertising dollars/pounds/etc. telling us how much they are there to take care of us if something bad happens, they really only care about their profit, which involves reducing what they pay out.It may be time to update this a bit though still not resolved .
I elected to file my claim with the insurance company of the driver who hit me . After speaking with their agents - one for medical, one for vehicle damage , I did as requested.
The wonderful state of New Jersey is no fault regarding medical claims - your insurance pays medical bills UNLESS your vehicle coverage does not include medical, in which case it than defers to whatever medical plan you may have . In speaking with the agent of the driver who was at fault I was told to produce proof that my insurance did not include medical coverage , which I promptly did and they acknowledged receipt of it .
At the time of the accident I refused an ambulance ride to the ER as I was examined by the sole responder on the volunteer first aid squad - a wonderful woman about my age ( too old to be doing this
sh_t ) all four rigs were answering other calls at the same time .
I was fortunately ok other than swelling , bruising and road rash so why the hell would I tie up an ambulance when someone else might really need it .
A few days after the accident while changing the dressing on my wound my wife ( a medical professional) and I thought that it might be a good idea to have some of the dead peeled back skin removed so I called my GP . When they were told it was a motor vehicle accident I was informed that they don’t deal with that and to go to an urgent care facility or the ER .
I went to a local urgent care as advised . ( local is misleading - part of a chain based at the other end of the world- North Jersey )
When checking in I had to explain the circumstances of my injury and produce insurance info - motorcycle insurance ( no medical ) ,
medical insurance ( Medicare A & B AND Medicare supplemental plan) . At the time of my visit the police report was not available so I had no idea of who hit me or what insurance she had .
I was eventually led to an exam room and after a considerable time a woman ( nurse ? ) and a man in a lab coat came in and took some information. The man was introduced to me as “ Dr . so and so . “ My hearing is terrible so I couldn’t understand the name .
Dr. so & so asked what brought me in . I explained the accident and I said that I thought I might need the dead skin removed . “ we don’t do that here “ was his response. He then asked if I went to the ER and when I said no I got lectured on how foolish I was . While examining me I also got a lecture on how dangerous motorcycles are . He examined all my injuries including removing the dressing on my wound . Another woman came in who turned out to be an x - ray tech and l was led to the x- ray facilities where she took a number of x - rays as ordered by Dr. so and so . I asked the woman to repeat the name of the physician who examined me as my hearing is terrible. She replied “ Oh - he is a policeman with a number of degrees in this and that “ . My response was “ You mean he is not an MD ? “ No answer and promptly changed the subject . ( My wife later researched his name and it turns out he is a PhD and advanced nurse practitioner) While taking the x - rays she placed my still undressed wound on the table . I resisted and told her I was concerned because it was an open wound . Her response ? “ No worries - I am a type A personality and I clean everything “ .
Back in the exam room while waiting for the x-rays to be read by a radiologist Dr. ( is he a Dr . ??? ) said he looked at my x-rays and saw something he was concerned about . Turns out all was OK and so I was sent on my way . ( So Dr. or whatever you are - it seems I made the right choice about not tying up a rig , eh ? )
So now back to the insurance bit . I submitted my out of pocket costs again for antiseptic, bandages etc. to the medical adjuster . I also forwarded the contact info for the liable insurance company to the urgent care group in order that they get paid .
Some time later I was then told by the medical adjuster that I need to submit my bills to Medicare and my supplement plan and then they would be responsible for the balance . I did so and several weeks later I had no communication from the liable insurer or Medicare and so I reached out to the urgent care group and was told I had a zero balance - all had been paid by Medicare / supplement plan . I contacted the medical adjuster and told her my Medicare paid x and you now owe me y . She agreed And then told me they have to reimburse Medicare ! Why the f_ _ _ didn’t they just pay urgent care bill to begin with ? Unbelievable system we live with these days .
I am tired of typing and so I will update the vehicle damage claim saga in the next installment.
To be continued...
I'm glad your injuries are recoverable. I hope it's speedy and complete.