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Delta-Lawyer
Delta-Lawyer, Attorney
Category: Personal Injury Law
Satisfied Customers: 3546
Experience:  Exeperienced Civil Litigator for both Plaintiffs and Defendants
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I am a 43 year old male. While at home with my infant daughter,

Customer Question

I am a 43 year old male. While at home with my infant daughter, I suffered a sezuire.
A neighbor came by and found me. An ambulance took me to a nearby hospital.
The insurance company is denying the claim, since I did not go to a hospital as outlined in my policy the treatment circle.
My question is..............How could I advise the ambulance staff to take me to the hospital within the circle, when I was convulsing on the way. The decision must have been made by the ambulance driver
Please advise.
Submitted: 1 year ago.
Category: Personal Injury Law
Expert:  Delta-Lawyer replied 1 year ago.
I hope this message finds you well, present circumstances excluded. I am a licensed attorney with over a decade of litigation experience. It is a pleasure to assist you today.
They insurance company should pay the claim because it was an emergent circumstance. As you stated, you could not make a decision as to where to go and the insurance company cannot hold you to a treatment circle directive under those circumstances.
They are posturing like most insurance companies will do.
You need to place them on legal notice that they better pay the claim within 10 business days, or you will file a complaint with your state's insurance commission as well as potentially file suit for insurance bad faith.
You can place them on legal notice with a certified letter and return receipt in which you explain who you are (DOB and insurance policy need to be in there), and explain the situation. Tell them 10 days from the post mark you take legal action if not resolved.
They will likely decide to pay the claim, as they are required to do under the circumstances.
Let me know if you have any other questions.
Please rate my answer positively as well.
Best wishes!
Expert:  Delta-Lawyer replied 1 year ago.
Did you have any other questions or comments? I just want to make sure you are as comfortable as possible as you move forward.
Expert:  Delta-Lawyer replied 1 year ago.
Just checking in one last time - not to bother, but just to make sure you are good to go moving forward. Best!