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skfinkel's avatar

What action should be taken if insurance co. rejects claim for broken leg?

Asked by skfinkel (12877 points ) October 6th, 2010

The apartment I live in had the rugs washed, and they were buckled and slippery. Going down the stairs, my foot slipped (I didn’t fall, though) and weirdly twisted, ending up with my upper leg breaking the lower leg. It took me three weeks to get to a doctor, who figured out the fracture. Because I didn’t complain right away, and because there was no witness, the building’s insurance co. rejected the claim (I asked just for my co-pay). Do I have any recourse? Can I take this to small claims court? Do I just forget it? I know I do not want to hire a lawyer. Suggestions?

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7 Answers

marinelife's avatar

Hiring an attorney is your next recourse. They will evaluate your claim potential for free and if they think it is worth while, they will take your case on a contingency basis, meaning they get paid when you get paid.

WestRiverrat's avatar

Many insurance companies will deny the first claim regardless of whether it has merit. Call them again and ask to speak to a supervisor.

Tell them if you have to hire an attorney to persue the matter you will sue for pain and suffering and legal fees as well as just the copay.

wundayatta's avatar

@marinelife and @WestRiverrat both gave you good advice. I would follow it. First what @WestRiverrat said and then what @marinelife said.

iamthemob's avatar

What @wundayatta said. ;-) Insurance companies reject, claimants appeal, and then after that potential litigation comes into play.

skfinkel's avatar

Thanks all. I will follow your advice and call back and tell them I want to speak to a supervisor. Then if I have to hire an attorney, I will charge them for more. (As long as it’s contingency). By the way, this claim was just rejected, but I broke my leg in May and it took two months, but it was better by mid-July. Now I am fine.

BoBo1946's avatar

Yes, a good plantiff attorney would be your next step. Also, add pain and suffering, loss of income, etc. into the equation!

thekoukoureport's avatar

Vote Democrat so they can’t do that again thanks to our new healthcare plan.

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