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health claims denied

Old 10-Dec-2010, 02:26 AM
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health claims denied

My civic was rear ended a year and a half ago and my car was a write off. My insurance started denying my health claims this october. And, I am still experiencing major back pains since the accident.. need some advice on how to get my health benifits back...
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Old 10-Dec-2010, 09:59 AM
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Did you go back to work and are now experiencing back pain again? Or did they just all of a sudden deny your benefits??

Benefits are based on medical documentation. If you go for an assessment and your doctor deems you are fine then the benefits will stop.

Your insurance company won't hide anything from you, just call them up and ask them why they stopped the benefits, they will explain it to you.
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Old 13-Dec-2010, 05:39 PM
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Well I'm back to work after 2 months of the accident but I am still having back problems and it is getting worse right now maybe because of the friggin weather.. any ideas on how to ask for my benefits back?
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Old 14-Dec-2010, 09:32 AM
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thank you for ignoring all my questions, makes it easier for me to help you.

WHY did they stop treatment?

Have you ASKED your insurance company to reopen your claim? They will have you go for an assessment to determine if you still need treatment.
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Old 25-Dec-2010, 12:52 AM
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Sorry miss_ jess..

Did you go back to work and are now experiencing back pain again? Or did they just all of a sudden deny your benefits??

yes, I went back to work after three weeks, and on and off for a couple days after the third week ( almost a year ago..). They paid my loss income and still cont'd to pay my health benefits. Around 9 months after, they stopped my health benefits which i didnt know about it because I missed my physio for for a month and a half due to busy sched. But, when I came back to my physio, the insurance told me they stoped my health benefits because they think that I'm OK. I complained that my back pain and it was worse so they have to reopen the case. But now, they told I have to go to the assessement in feb which took them 2 months to book. cancelled my physio for almost two months now and still experiencing back pains...


Benefits are based on medical documentation. If you go for an assessment and your doctor deems you are fine then the benefits will stop.

Your insurance company won't hide anything from you, just call them up and ask them why they stopped the benefits, they will explain it to you.
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Old 26-Dec-2010, 06:08 PM
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because I missed my physio for for a month and a half due to busy sched

hmmm maybe this is why? I guess your ok then?
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Old 26-Dec-2010, 08:33 PM
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Originally Posted by civc12 View Post
Sorry miss_ jess..

Did you go back to work and are now experiencing back pain again? Or did they just all of a sudden deny your benefits??

yes, I went back to work after three weeks, and on and off for a couple days after the third week ( almost a year ago..). They paid my loss income and still cont'd to pay my health benefits. Around 9 months after, they stopped my health benefits which i didnt know about it because I missed my physio for for a month and a half due to busy sched. But, when I came back to my physio, the insurance told me they stoped my health benefits because they think that I'm OK. I complained that my back pain and it was worse so they have to reopen the case. But now, they told I have to go to the assessement in feb which took them 2 months to book. cancelled my physio for almost two months now and still experiencing back pains...


Benefits are based on medical documentation. If you go for an assessment and your doctor deems you are fine then the benefits will stop.

Your insurance company won't hide anything from you, just call them up and ask them why they stopped the benefits, they will explain it to you.

Well if you're injured, there is no such thing as a busy schedule to get the treatment you need. If you're too busy to get treatment then you're not injured.

If your insurance company already told you that you need to go for assessment, then what exactly is your question here. You know how to get your claim reopened and how to recieve your benefits again.

Best of luck getting them back, if/when you start to recieve them again, just a note of advice, don't miss any appointments.
Originally Posted by starboy869 View Post
because I missed my physio for for a month and a half due to busy sched

hmmm maybe this is why? I guess your ok then?
+1
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Old 27-Dec-2010, 03:34 PM
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i smell insurance fraud
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Old 28-Dec-2010, 12:01 AM
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Originally Posted by starboy869 View Post
i smell insurance fraud

I'll wait till you get into a serious accident an see how pain comes back..
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Old 28-Dec-2010, 10:23 AM
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Originally Posted by starboy869 View Post
i smell insurance fraud


Originally Posted by civc12 View Post
I'll wait till you get into a serious accident an see how pain comes back..
I'm sure he was just joking.... but looking at it in a non bias way, you missed a month of treatment, when you were injured, how much pain can you be in if you were willing to miss it............ right?

Anyways, go for the assessments, your insurance company will open up your claim again if the assessments show you still need treatment. If they come back saying you are fine, hire a lawyer.
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Old 25-Feb-2011, 01:29 PM
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any updates?
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Old 28-Feb-2011, 02:21 PM
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Originally Posted by civc12 View Post
I'll wait till you get into a serious accident an see how pain comes back..
this is true.

someone rare ended me 2 years ago, and i didnt feel anything at that time. but now after 2 years, during cold weather, my lower back hurts in the morning every now and then. and same goes for my neck as well, the very top back bone
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