MVA No Fault State: Bad Faith and PIP Question

[bent]

I was in an MVA in North Dakota, 8-24-13
Insurance coverage in Oregon where I live legally. Other driver 100% at fault. Atty hired for BI claim against at fault driver.

Our no fault insurance carrier has continually delayed paying wage loss and then denied by lying about my work status. Once proof was shown they were lying to my Atty, the no fault ins. agent went back to delaying asking for more doctor notes before paying. They rendered two weeks wage loss in one check back in December...stating they were doing it as a favor.

All this has taken six months, I finally got them two more Doctor's notes and test results etc all exactly how they asked for them and because the diagnosis is CRPS type 2 resulting from Nerve Injury (brachial plexus stretch and ulnar nerve contusion) caused directly from airbag deploying into my arm which was across my body in front of my chest. Now they still have not paid any wage loss out of our PIP and have demanded I see an IME, which I will.

When they initially lied to my attorney about my not working because they said my work said I had failed to meet company goals etc and my lack of employment was not due to the accident, I produced two emails from my boss stating that I was released due to their need to cover my position and that they wished me the best in healing and that I should come back and apply as soon as my injuries allowed me to. Then they requested yet another doctors note, They already had one from previous visits. I scheduled with a specialist and asked him to do an EMG to find out why I wasn't healing and what all the pain was being caused from and to determine the prognosis of the injury. It was then that I sent them another letter from this Neurologist giving me and extended release from work time. At the follow up appointment for consult on test results of the EMG I was given the horrible news of the diagnosis of CRPS II.
No Fault Insurance won't back pay up until their request for IME for wage loss and now say it depends on IME if i'm even eligible? I have proof and emails of everything I have done to meet their constant ever changing demands and of their lie.

My Questions are::
1) Do I have a case for breach of contract ie: bad faith, and if so my atty for the BI is not actively willing to discuss it or pursue it so
2) I wonder if I can get a second attorney for that issue?
3) If so can it be in the state the policy is written in or does it need to be in the state the MVA was where the claim is currently handled?

Thank you ahead of time for any insight and advice shared. It is much appreciated as I am exhausted from feeling like I've had to be my own advocate through all of this and very well might end up filing a Bad Faith Claim "Pro-Per" since my Atty has been dismissive and taken a just wait and see attitude this entire process and only finally called me for the first time this week. Up until now I have dealt only with her Paralegal even after requesting an email or phone call from Atty. I'm at the point of losing faith.

~Bent

 

[djs]

Sorry, but the acronyms make this a bit tough to read.
I understand this is taking longer than you feel it should, but, your attorney has probably already told you this can take some time to work through. It does, especially when there appears to be conflicting information.

Your employer probably gave a different answer to the insurance company than you did. This happens all the time and they have to go with what they are told through official channels, not what you have from an email from your boss. They will also look at things that may have been documented prior to the accident for your work as well.

I understand you are anxious to get this resolved, but you have to give it time and work with the system. Insurance companies don't mind writing checks, but they want to make sure they are legit. If there was a faster way, your attorney would be all over it, he wants to get paid as well.

Have a sit down with your attorney and get him to lay out a timeline for you. There will be a lot of the 'if this, then that' type of things in it, but he should be able to lay this out for you.

The other complication, if I understand CRPS correctly, is the accident would be a contributing factor to an existing condition. This significantly changes what the insurance company is liable for, since they would not be responsible for the underlying condition, just the additional aggravation. This may be why they are going through so many tests. It would get very complicated at that point (I'm not very familiar with CRPS, so I could be wrong on this).

Dan

 

[bent]

Dan, the MVA is motor vehicle accident, PIP is person injury protection, and BI is bodily injury. Yes, you misunderstood the CRPS..it is actually caused by the injury that happened in the accident. basically my body responded incorrectly to the injury and my sympathetic nervous system short circuited and is stuck in a crazy cycle of creating pain and arching and spreading the pain into new neuropaths that are not even injured. It is a disease with no cure that is progressive, only gets worse and is considered to be the most painful disease known to man.

I guess my questions still remain.... at what point has my insurance company acted in bad faith toward me and can I have a separate lawyer represent that and does it have to be in the state of the accident where the state is or can I pursue that in my home state possibly where the policy is written at?

I understand completely the Bodily Injury taking time. I realize they have to find out exactly what the effect on me will be long term. Doc says he will Maximum Medical Improvement my case next appointment as this disease as I stated is progressive, only gets worse in almost every circumstance. That portion of the claim is against the at fault drivers policy, not mine. The Bodily Injury portion is and open close case...easy. I was not at fault, person at 100% fault admitted so, police report agrees, I have underinsured coverage. I don't doubt that other drivers insurance will pay whatever his policy limit is as this will be a medically highly costly life long expense for me. I will be left with the amount after the lawyers fee's which will be gone in medical expenses almost immediately. I've no qualms with that.

My attorney however, having spoken with her, is not interested in even talking about bad faith with my insurance company until the rest of this other part is settled. If I do pursue that route of Bad Faith in the future I would not be inclined to use the same attorney. I'm just not sure where the line is that makes that decision. I have read as much law on it as I can and I feel I have a case considering the tactics employed...but I also know it is a fine line.

Thank you for your answer Dan. I appreciate you!

 

[djs]

Just a hunch, but I doubt there is any 'bad faith' to go after until a settlement is offered (or denied). That is probably why your attorney isn't interested in it yet. Don't confuse due diligence with bad faith. Don't confuse a few lost pieces of paper with bad faith. Bad faith is more like them denying something they clearly should have paid, which it doesn't sound like they have done yet.



Dan