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Can insurance company just close my case without me knowing.
10-01-2011, 04:29 PM
Post: #1
Question Can insurance company just close my case without me knowing.
Hello if i was released from doctor to go back to work full duty does that mean my case was closed? I was still having complications from work injury after released from doctor and my injury got worse and decided to contant a lawyer after i told ithe company doctor of my worsening condition after release for full duty and he told me to just stretch my leg and gave me more medication and gave me a new appointment in the next 2 weeks. i never showed up to the appointment and went to a different doctor for my injury and was doing physical therapy there for 4 months and now i was told yesterday that my case was closed a month after my injury because of full duty release can they decide when the case is closed?
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10-01-2011, 04:39 PM
Post: #2
RE: Can insurance company just close my case without me knowing.
You seem to have a serious set of complicated circumstances. You might be better off calling your Attorney Monday and getting this all sorted out.

DISCLAIMER: I am not an attorney. While drawing from my professional training and experience in law enforcement and as a former Paralegal, no comments offered should be considered as legal advice.
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10-01-2011, 05:51 PM (This post was last modified: 10-01-2011 05:52 PM by 1171.)
Post: #3
RE: Can insurance company just close my case without me knowing.
state work comp laws control the provision of benefits including medical.
without knowing your state I cannot offer an explanation.
many states put restrictions on the employers liability for medical care, if you ignored the rules they may not be required to cover treatment.
you can update your profile with your state location to make it easier to respond.
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10-01-2011, 06:30 PM
Post: #4
RE: Can insurance company just close my case without me knowing.
(10-01-2011 05:51 PM)1171 Wrote:  state work comp laws control the provision of benefits including medical.
without knowing your state I cannot offer an explanation.
many states put restrictions on the employers liability for medical care, if you ignored the rules they may not be required to cover treatment.
you can update your profile with your state location to make it easier to respond.

IM from Los angeles ,california
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10-01-2011, 06:46 PM
Post: #5
RE: Can insurance company just close my case without me knowing.
(10-01-2011 06:30 PM)lizdawiz82 Wrote:  IM from Los angeles ,california

Update your profile to include your State - that will help others respond more appropriately.

DISCLAIMER: I am not an attorney. While drawing from my professional training and experience in law enforcement and as a former Paralegal, no comments offered should be considered as legal advice.
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10-01-2011, 06:53 PM (This post was last modified: 10-01-2011 06:53 PM by 1171.)
Post: #6
RE: Can insurance company just close my case without me knowing.
california requires that comp treatment be provided thru an authorized medical provider network.
if your new doctor is not part of the network, it likely won't be covered.

unless someone notified the carrier you were seeking additional treatment elsewhere, they would not normally keep a file open especially after a "no show".
closing their file is not decision on your entitlement to benefits.
it doesn't sound like your atty has notified them of your representation.

more information on use of Medical Provider Networks is here:
http://www.dir.ca.gov/dwc/mpn/dwc_mpn_faq.html
and here
http://www.dir.ca.gov/dwc/MPN/DWC_MPN_Main.html
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10-01-2011, 10:38 PM
Post: #7
RE: Can insurance company just close my case without me knowing.
(10-01-2011 06:53 PM)1171 Wrote:  california requires that comp treatment be provided thru an authorized medical provider network.
if your new doctor is not part of the network, it likely won't be covered.

unless someone notified the carrier you were seeking additional treatment elsewhere, they would not normally keep a file open especially after a "no show".
closing their file is not decision on your entitlement to benefits.
it doesn't sound like your atty has notified them of your representation.

more information on use of Medical Provider Networks is here:
http://www.dir.ca.gov/dwc/mpn/dwc_mpn_faq.html
and here
http://www.dir.ca.gov/dwc/MPN/DWC_MPN_Main.html

The insurance company was notified that i was represented by a workers comp lawyer and they know im treating with a doctor of my choice not in the MPN but they still paid for phsyical therapy for me with my doctor and now they want to act like they dont know nothing. the no show was because i chose my own doctor after the 30 days of being stuck with insurance doctor he did nothing 4 me , he just drugged me up and hid info about me having a fractured spine well thats beside the point but this whole workers comp thing is full of corruption.
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10-01-2011, 11:14 PM (This post was last modified: 10-01-2011 11:16 PM by 1171.)
Post: #8
RE: Can insurance company just close my case without me knowing.
must be lots of lawyers, doctors and judges involved?
maybe politicians?
how are you going to stop it?
when everyone around you is part of it, how can you win?
there is no one you can turn to.
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10-01-2011, 11:48 PM
Post: #9
RE: Can insurance company just close my case without me knowing.
(10-01-2011 11:14 PM)1171 Wrote:  must be lots of lawyers, doctors and judges involved?
maybe politicians?
how are you going to stop it?
when everyone around you is part of it, how can you win?
there is no one you can turn to.

Aint that the truth.
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