Legal Question in Personal Injury in California

No -Fault refuses to pay claim deemed medically necessary by physicians

My auto accident case was settled nearly 30 years ago in N.H. My N.J. no-fault insurance has continued to pay for on-going medical problems related to the original injuries. The head injury has caused difficulty with organization and my doctors agree that due to the injury to my brain at the time of the accident, it is medically necessary to have an Occupational Therapist work with a Prof. Organizer & her exp. team, come into my extremely cluttered, unsafe & unhealthy home and help clear it out and organize it while teaching me the skills to maintain it. My insurance co. from the accident has denied the claim. How shall I proceed? Thank you so much!


Asked on 2/29/08, 2:02 pm

2 Answers from Attorneys

Mitchell Roth MW Roth, Professional Law Corporation

Re: No -Fault refuses to pay claim deemed medically necessary by physicians

YOu can sue the carrier for bad faith and breach of contract. Some lawyers are willing to sue for bad faith and breach of contract on contingency. Most, not. You'll have to shop around. YOu can initiate a complaint with the Department of Insurance on your own. That may get you some results.

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Answered on 3/04/08, 12:27 am
Robert L. Bennett Law offices of Robert L. Bennett

Re: No -Fault refuses to pay claim deemed medically necessary by physicians

Mr. Roth has given you excellent advice. Follow his instructions and Good Luck!

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Answered on 3/05/08, 7:35 pm


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