While my client, a 76-year-old man, was driving he unfortunately lost control of the car and hit a guardrail. He suffered severe trauma to his head and chest and after a hospital stay, began treating with his doctors and following their plan of care.
My client suffered a traumatic brain injury, and his doctors determined he would need assistance with his daily activities for the rest of his life.
Unfortunately, his auto insurance company decided, with no supporting evidence or reason, that they would not pay for the care his doctors prescribed – some of his medical bills, and a No-Fault Benefit called attendant care.
Instead of paying the benefits my client was entitled to (after faithfully paying his insurance premiums to ensure he is covered in an accident like this), the insurance carrier decided to send him to an “Independent Medical Examination.” Even their doctor determined my client was severely injured in the accident, suffered a traumatic brain injury, and required attendant care services.
One would think this would be enough to make the insurance company pay. Unfortunately the insurance company decided to send my client to a different doctor, hoping for a different opinion – one that would indicate they could deny payment for the treatment my client needed.
I fought the insurance company and was able to obtain $230,000 for my client, which covers his outstanding medical bills and attendant care benefits he was wrongfully denied.