#9 The PIP carrier keeps calling me and asking about my treatment, should I talk to them?

QUESTION: The PIP carrier keeps calling me and asking me questions about my treatments from my car accident, should I talk with them?

ANSWER: Yes, cooperate with your PIP carrier’s inquiries about your car accident treatments, but be cautious when communicating with the adjuster. Provide brief and to the point answers about how your recovery is progressing. Avoid giving specific daily details, as the insurance company is looking for reasons to limit payments on your personal injury claim. Do share about your progress and improvements, but in a general way. If there’s no progress reported to the insurance company, that can lead to the adjuster requiring you to attend an Independent Medical Exam (IME), which often results in the insurance company stopping payment for your medical treatment.

The PIP carrier keeps calling me and asking me questions about my treatments from my car accident, should I talk with them?

The PIP statute says you have an ‘affirmative duty’ to cooperate with the PIP carrier. This includes signing a medical authorization and answering their questions. While it’s important to be cooperative, you also need to be careful at the same time to protect your rights and your personal injury claim.

The insurance company is looking for reasons to stop paying for your medical treatment.

When the adjuster for the insurance company calls, keep your answers to their questions short and to the point. If the insurance adjuster asks, “How’s your medical treatment going?”

You can simply respond by saying something like, “You know it’s helping me and I am getting better.”

They may then ask you, “How much better are you?” When you answer that question, think about your response in a general sense. They’re not asking about how you’re feeling at an exact moment in time. They’re trying to get a sense of how you’re doing in general. So you don’t want to respond with, “Well I feel different every day.”

Recovering from an auto accident is not a straight line. There are going to be ups and downs — and good and bad days.

You can simply say, “I’m getting better and at this point in time I feel like I’m sixty-five to seventy percent better.” Or, whatever is the right number for you — that should be your answer.

Remember, if the percentage number you gave the adjuster when they called you six weeks ago is essentially the same, they are going to send you to one of their doctors for an Independent Medical Exam or what is known as an IME.

If the adjuster does require you to go for an IME, there’s a 95% likelihood that the insurance company will cut off the payments for your future medical treatment.

When you talk to the PIP adjuster, to protect the benefits for your medical treatment, it’s important to speak about your progress and recovery in general terms. Keep your answers short and succinct. Make sure the adjuster understands you are improving. If you are not getting better, you need to talk with the medical providers you’re treating with immediately.

Whether you’re our client or not, we want to be a bridge of support for you.

We’ve developed a robust library of articles and videos organized into four topics which include our responses to the personal injury claim-related questions we’re asked most often.

• Top 10 Personal Injury Claim Mistakes to Avoid
• What You Need to Know About Your Claim
• How Are My Medical Bills & Wage Loss Paid
• How to Prepare for Your Independent Medical Exam

The articles provide advice and guidelines to help you navigate each phase of the personal injury claims process. Whether we represent you or not, we are passionate about helping you protect your rights, you receiving the medical care you need to recover from your injuries, and having the information you need to avoid mistakes that can harm your personal injury claim.