Legal Question in Personal Injury in California
insurance company refusal to pay
I was in an auto accident in 2001 and received chiropractic care. The accident was deemed the other person�s fault. I informed her insurance company that I was seeking medical care. My chiropractor told me that he would submit a bill on my behalf. I never heard a word or received anything from either the chiropractor or the insurance company. In 2004, I received a call from an outside agency that the chiropractor hired stating that I owe over $2000 and threatening to send me to a collection agency if I don�t pay. I contacted the insurance company and they refuse to pay because the statute of limitation has passed. Since I never received any notification that my claim was never paid, am I responsible and can they send me to a collect agency?
4 Answers from Attorneys
Re: insurance company refusal to pay
I agree with
Stone.
Re: insurance company refusal to pay
Already answered.
Re: insurance company refusal to pay
I respectfully disagree with the responses provided by my colleagues. In my opinion you still can pursue this matter.
Its an Administrative Regulation; here's the law:
[14:74] Warning re statute of limitations: Unless the claimant is represented by counsel, the insurer must give written notice of any statute of limitations or other time period requirement upon which the insurer may rely to deny the claim as untimely. Such notice must be given at least 60 days (30 days, for claims under uninsured motorist coverage) before expiration of such time period. For claims first received within that period, the notice must be given "immediately." [10 Ca Adc � 2695.7(f)]
(1) [14:75] Estoppel against limitations defense based on failure to warn: The insurer's failure to give the requisite warning is ground for estopping the insurer to assert the statute of limitations or contractual time period for commencing suit:
-- "(I)t is simply unacceptable for an insurer to take advantage of its own misconduct and thereby succeed in defeating an otherwise legitimate claim because the insured did not comply with a policy time limit of which it was not actually aware due to the insurer's failure to provide the required notice." [> Spray, Gould & Bowers v. Associated Int'l Ins. Co. (1999) 71 Cal.App.4th 1260, 1271, 84 Cal.Rptr.2d 552, 558 (emphasis in original); > Neufeld v. Balboa Ins. Co. (2000) 84 Cal.App.4th 759, 762-765, 101 Cal.Rptr.2d 151, 153-155; see also > �6:158]
Caution: This issue is presently before the California Supreme Court in Northwest Airlines, Inc. v. Ontario Aircraft Services, Inc., Case No. S113305.
Re: insurance company refusal to pay
You Are An Idiot. You let the statute of limitations (2 years) run out, so you no longer have the right to file a lawsuit which is what you would have had to do to get the insurance company to pay for your chiropractic bills and other damages. Yes, you do owe the chiropractor for the care you received and he has every right to sue you. Next time, consult a lawyer the same day you have the accident, not 3 years later.
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