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  1. #1
    Join Date
    May 2007
    Posts
    2

    Default Knee Injury - Getting The Run-Around

    I no longer work for the company that I was injured at. I have already lost one job because of the negligence of the insurance agent that is in charge of my case. She will not return calls, does not answer her phone. I was scheduled to have surgery once and she cancled it because I didn't return a form she never sent to me. She got my medical history... no history of any knee problems... EVER. I am without medical care, and have been for a few months now. The hospital where I got my initial care has closed down and is in bankruptcy. No one can gain access to these records. She said that she was sending me for a 2nd opinion. I told her that I moved and gave her my new address TWICE. My old address was my parents house. I finally get a letter in the maill telling me to go to this new doctor. I could not get to this appt because I only had a 2 day warning to try to get off at my new job. Rescheduled for the following week. It was canceled by the Dr office because the DR was stuck in D.C. . rescheduled for friday... went to the appointment 100 miles away.. sat in the waiting room... went back to the eval room... then they took me for more x rays since the hospitals xrays are inaccessable.
    Took me back to the eval room and I waited for 45 minutes... then this lady comes back and tells me I cannot see the Dr because the Insurance lady lied to try to get me in faster.
    The doctors office thought i was there for a second opinion... as did I. But the information that the insurance lady wanted to collect was an "independent Consultaion something Appointment" and the rates are different for that and require pre payment from the Ins co, and require more time. So 4 hours of my time, 200 miles traveled, no meds, no dr, nothing!
    How do I get to a dr... I ice my knee very night since october. I can't climb stairs, I can't kneel down to hug my neice. I am 28 and cannot imagine what my knee will be like in 10 years. I need some kind of medical care untill she irons out the surgery thing... what can I do?

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Knee Injury.. getting the run around

    you can get one at your own expense and seek reimbursement.

  3. #3
    Join Date
    May 2007
    Posts
    2

    Default Re: Knee Injury.. getting the run around

    I am worried that I will not get reimbursed. This insurance company seems so shady.
    They sent me a letter stating that they would only pay for the Dr I was supposed to see.
    This whole thing is so depressing...

  4. #4
    Join Date
    May 2007
    Posts
    2

    Default Re: Knee Injury.. getting the run around

    I am assuming you do not currently have a lawyer???? I would suggest contacting the Ombudsmans office at the Indiana Comp. Board. They represent workers w/o legal representation to a point. They will intervein and try to get the insurance company to comply with current state codes. Be prepared to write out a detailed letter of complaint as to your current situation and be specific about your complaints, with dates and contact persons if possible.

    Been where you are...this was the first step I took prior to hiring an attorney I just fired. He was lacking as much due diligence as the insurance company I filed the same charge against. Go on line and read the condensed version of the state codes or request a written copy, you have the right to one.

    My original injury was 2000, reinjured at work in 2003, my fifth surgery was a full knee replacement a year ago. Be prepared for the wheels to turn slowly!!!

    Good luck.

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