Q: We had an auto accident patient start care. When I called the patient’s auto insurance agent, he was down right rude and told me I couldn’t file with the patient’s auto insurance “med pay”, but to send the bill to the other driver’s insurance. Now what do I do?
A: Your clinic is in Wisconsin, but most states have similar laws to theirs. Under state statute Ins 6.11, Section (3) Unfair Claims Settlement Practices, Subsection (a) 9, the agent has no right to tell you this. Per statute, the following is an unfair practice and says: “Except as may be otherwise provided in the policy contract, the failure to offer settlement under applicable first party coverage on the basis that responsibility for payment should be assumed by other persons or insurers”. We have a great form that you can have the patient sign that directs the agent to follow the law. And by the way, per the same statute, if the agent refuses : “The commission of any acts listed … shall subject the person to revocation of license to transact insurance in this state.”
Click here for the form.