Doctor Explaining Insurance Company Denial for Surgery

So much has changed about your life since your car accident. Your only goal is to get better and to continue living your life on your terms.

To achieve this goal, your doctor has recommended surgery, but the insurance company that is responsible for paying your accident damages is refusing to pay for your surgery. The insurance company may try to claim that you waited too long to get medical care, that the surgery is not necessary to your recovery, or that you require surgery for an injury or illness that was not caused by the car accident.

It is incredibly frustrating when an insurance company refuses to pay for a surgery that your doctor recommends. Insurance companies should not make medical decisions. However, insurance companies often deny expensive treatments or claims so that they can maximize their profits. The insurance adjusters hope that you will simply accept the denial, but there are things that you can do to get your surgical costs covered. 

Fight for the Car Accident Surgery You Need

The insurance company’s initial denial of your surgery claim may not be its final answer on this matter. You may get the insurance company to pay for your reasonable and necessary surgery by having your car accident lawyer:

  • Convince the insurance company that its refusal to pay is wrong. Sometimes a car accident attorney can present strong evidence in a clear and convincing way. If the insurance adjuster is convinced that you will be successful on appeal or in court and that you will pursue an appeal or lawsuit, then it is less costly for the insurance adjuster to agree to cover your surgery now. 
  • Appeal the insurance company’s initial decision. Each insurance company has an appeals process. When you receive notice that your claim is denied, you should be notified of how the appeals process works. Your lawyer can make sure that all deadlines are met, documentation is provided, and steps are taken to protect your rights during an appeal.
  • Go to court to protect your rights. You can refuse the insurance company’s proposed settlement and go to court. However, it is critical that you do not accept any money from the insurance company before going to court. Once you accept a settlement, the terms of that settlement will likely be payment in full for your accident injuries and prevent you from taking further legal action.

Do not delay surgery while you fight with a car insurance company. Instead, let your health insurance company cover the costs of surgery. The health insurance company will file a subrogation claim and claim reimbursement from the car insurance company when your claim is settled or decided in court.

Insurance Companies Know Our Illinois Car Accident Lawyers Mean Business

Hupy and Abraham has recovered more than $1 billion for our clients. Insurance companies know that we go above and beyond the call of duty for every one of our clients, that we provide tough, aggressive, and compassionate representation, and that we will not hesitate to go to court to get our personal injury clients the full and fair recoveries that they deserve. This makes insurance companies more likely to negotiate with us.

If you’ve been hurt in a car accident case, then we will do everything we can to make sure that the insurance company pays for the surgery and other medical treatments recommended by your doctor. We will also fight for your recovery of lost income, out of pocket costs, physical pain, emotional suffering, and other car accident damages.

You should not be financially worse off than you were before your accident. Call the experienced car accident attorneys of Hupy and Abraham today to schedule a free consultation about your rights. We would be pleased to welcome you in our Bloomington, Gurnee, or Rockford, Illinois offices or to come to your home or hospital room if that is more convenient for you.

Jason F. Abraham
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Managing Partner, Hupy and Abraham