Securing Full Benefits

A client injured in a car accident struggled to receive full no-fault benefits from their insurance company, which had denied several critical medical treatments and wage-loss benefits.

Arguments by Defense

Denial of Benefits: The insurance company argued that the client’s injuries were either not severe enough to warrant the requested treatments or were pre-existing conditions unrelated to the accident. Challenging Wage-Loss Claims: The insurer claimed that the client could return to work sooner than stated and that the lost wages claim was exaggerated.

Questioning Medical Necessity: The defense disputed the necessity of certain medical treatments, arguing that they were excessive or unrelated to the accident.

Challenge

Establishing the Need for Treatment: Proving that the denied treatments were necessary and directly related to the accident required extensive medical documentation.

Validating Wage-Loss Claims: Demonstrating that the client’s injuries prevented them from working as claimed required clear evidence and possibly testimony from the client’s employer.

Overcoming Insurer’s Denials: We faced the challenge of reversing the insurer’s decision to deny critical benefits, which involved detailed expert legal and medical arguments.

Solutions

Comprehensive Medical Documentation: We worked closely with the client’s healthcare providers to gather extensive medical records and expert opinions that substantiated the need for the wrongfully denied treatments. Detailed Wage-Loss Evidence: By collecting pay stubs, employment records, and statements from the employer, we demonstrated the validity of the wage-loss claims.

Legal Advocacy: We filed a formal claim against the insurance company, leveraging the strong evidence to pressure them into reversing their decision.

Results

Full Benefits Restored: The insurance company ultimately approved all previously denied benefits and agreed to a lump sum payment to cover the client’s past and future expenses.

Financial Relief for the Client: The client was able to receive the necessary medical care without further delays and was compensated for the wages lost due to the accident.

Case details

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Lawyer name :

Client name :

Defense lawyer :

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No-Fault Claims

Mohammed Assad Khalil

$650

Completed