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Denial after I did not settle for $10,000.
#1
I received a denial from the insurance company. Says the internal medicine doctor I saw at their clinic for 5 minutes said my depression was not industrial. They asked me to settle for $10,000., I did not think the amount was appropriate and now I get a denial- now that they have denied am I still to go to their doctors? I have an attorney who is going to set me up with a psyciatrist, but hasn't done so yet and I have an appt with their psyciatrist. How can they deny after I refused to settle? Sad
 
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#2
They can deny a claim at any time.

You will most likely be sent to a QME or AME to determine causation.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#3
Your situation is all to common. The carrier didn't get the deal they wanted, and now they will make you pay for standing up to them.
Timothy D. Belt
DISCLAIMER: This post is intended as general information applicable only to the state of Pennsylvania. The answer given is based only on the facts provided. This post is not intended to create an attorney client relationship, or to provide any specific guarantee of confidentiality.
 
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#4
they can deny a claim any time they have information that the condition is not covered by comp insurance.
they can settle any time there is a dispute.
you should put your state/location in your profile or in your post so responders know what laws apply.
........Each state has their own comp system; POST YOUR STATE to get accurate information.........
 
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#5
(06-01-2014, 02:08 PM)1171 Wrote: they can deny a claim any time they have information that the condition is not covered by comp insurance.
they can settle any time there is a dispute.
you should put your state/location in your profile or in your post so responders know what laws apply.



I am in Northern California. Thank you.

 
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#6
You didn't take their deal so they are going to make it hard on you in hopes you will give up and go away. Talk with your lawyer because you will need him for sure now. Don't give up just because they deny you.
 
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#7
I suspect the denial was in the works as soon as they got the doctor's opinion.
you shouldn't take any settlement until you've had enough treatment to stabilize your condition.
until then no one knows the long term effects and how much that is worth in benefits.
........Each state has their own comp system; POST YOUR STATE to get accurate information.........
 
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