8 Ways Insurance Companies Try to Deny Your PIP Claim and How to Fight Back!

8 Ways Insurance Companies Try to Deny Your PIP Claim and How to Fight Back!

By Dr. Aaron Corley, D.C.
📞 Call: 941-539-3412
📍 Suncoast Health Center – Nokomis, FL

What is Personal Injury Protection (PIP) and Why Do Insurance Companies Deny Claims?

If you’ve been injured in a car accident, Personal Injury Protection (PIP) insurance is supposed to help cover your medical expenses and lost wages—regardless of who was at fault. However, many insurance companies try to minimize, delay, or completely deny PIP claims to protect their bottom line.

As a chiropractor specializing in injury recovery, I’ve seen firsthand how insurance tactics can leave accident victims struggling to get the care they need. Below are eight common ways insurance companies deny PIP claims—and how you can protect yourself.

1. Claiming Your Treatment Was “Not Medically Necessary”

One of the most common ways insurers deny PIP claims is by saying that the medical treatments you received were unnecessary, excessive, or unrelated to your accident. They may:

✔️ Request an Independent Medical Exam (IME) with a doctor they choose (who is often biased in their favor).
✔️ Dispute your chiropractic, physical therapy, or massage therapy treatments, even if they help your recovery.
✔️ Claim that your pain is “subjective” and doesn’t require ongoing treatment.

🔹 How to Fight Back: Ensure your doctor provides detailed medical records and documentation explaining why your treatment is essential.

2. Denying Claims for “Incomplete or Missing Documentation”

Insurance companies look for any reason to delay or reject claims, and paperwork errors are one of their favorite excuses. They may claim:

❌ Your medical records weren’t submitted on time.
❌ Your doctor’s notes were insufficient or unclear.
❌ You failed to provide lost wage documentation from your employer.

🔹 How to Fight Back: Work with a trusted medical provider who understands insurance requirements and submits complete, timely documentation.

3. Using Recorded Statements Against You

After your accident, an insurance adjuster may ask for a recorded statement. They’ll sound friendly, but their goal is to find inconsistencies that could be used to deny your claim. Even simple statements like:

🚨 “I feel fine.” → Could be used to argue that you weren’t actually injured.
🚨 “I’m not sure what happened.” → Could be twisted into admitting fault.

🔹 How to Fight Back: Never provide a recorded statement without consulting a personal injury attorney or your medical provider.

4. Arguing That Your Injuries Were “Pre-Existing”

If you’ve had previous injuries or chronic pain, insurers may claim your new pain isn’t related to the accident.

🚗 Example: You had mild back pain before the crash, but now it’s severe. The insurer may argue that the accident didn’t actually cause the pain.

🔹 How to Fight Back: Your doctor should provide a clear comparison of your condition before and after the accident, showing how the crash worsened your injuries.

5. Denying Claims Based on Policy Exclusions

PIP policies may have fine-print exclusions that insurers use to deny claims, such as:

❌ Treatment outside a specific time frame (like Florida’s 14-day rule).
❌ Excluding certain providers, like chiropractors or massage therapists.
❌ Denying claims for injuries in rideshare accidents (Uber/Lyft).

🔹 How to Fight Back: Carefully review your PIP policy coverage and work with a provider experienced in navigating insurance loopholes.

6. The 14-Day Rule in Florida

In Florida, you must seek medical attention within 14 days of your accident to qualify for PIP benefits. If you miss this deadline, the insurer can legally deny your claim—even if you were seriously injured.

🔹 How to Fight Back: Always get checked by a doctor or chiropractor immediately after an accident, even if you don’t feel pain right away.

7. The Emergency Medical Condition (EMC) Rule

Florida PIP laws limit coverage to $2,500 unless a doctor certifies that you have an “Emergency Medical Condition” (EMC). Without an EMC diagnosis, you won’t get the full $10,000 in benefits.

🔹 How to Fight Back: Ensure your doctor provides proper documentation proving that your injuries require ongoing care.

8. Offering Quick, Lowball Settlements

Some insurers try to rush you into accepting a low payout, hoping you’ll settle before realizing the full extent of your injuries.

🔹 How to Fight Back: Never accept a settlement offer without consulting a doctor or attorney to assess your long-term medical needs.

How to Protect Your PIP Claim

✔ Get medical attention immediately – preferably within 24 hours of your accident.
✔ Choose an experienced provider – one who understands PIP claims and proper documentation.
✔ Follow all recommended treatments – skipping appointments can weaken your claim.
✔ Keep all records and receipts – document every visit, bill, and medical report.
✔ Avoid talking to the insurance company without professional guidance.

If your PIP claim has been denied, don’t give up! You have options. As a chiropractor, I work closely with injury attorneys and can help you navigate your case.

📞 Call Dr. Aaron Corley at 941-539-3412 to schedule an evaluation and ensure you get the care (and coverage) you deserve! 🚗💥

Comments

Post a Comment

Popular posts from this blog

Chiropractors education

  What a Chiropractic Education Consists Of Chiropractic education is a rigorous and comprehensive journey that prepares individuals to become skilled and knowledgeable chiropractors. Chiropractors are healthcare professionals who focus on diagnosing and treating neuromuscular disorders, primarily through manual adjustments and spinal manipulations. Their education involves extensive coursework, hands-on clinical training, and licensing examinations to ensure competency in providing holistic, non-invasive care to patients. This article outlines the educational path required to become a Doctor of Chiropractic (D.C.), including prerequisite education, chiropractic school curriculum, clinical training, and licensure requirements. Prerequisite Education Before entering chiropractic school, aspiring chiropractors must complete undergraduate coursework. Most chiropractic programs require at least 90 semester hours of college education , though many students earn a bachelor’s degree b...
Read more

Marijuana and FMCSA Rules

  Marijuana and FMCSA Rules By Aaron Corley, D.C., 941-539-3412 The Federal Motor Carrier Safety Administration (FMCSA) enforces stringent drug testing regulations under 49 CFR Parts 382 and 40 to ensure safety in the transportation industry. Despite increasing state-level legalization of marijuana, FMCSA maintains a zero-tolerance policy for its use among commercial motor vehicle (CMV) drivers, reflecting the Department of Transportation’s (DOT) stance that marijuana remains a Schedule I controlled substance under federal law. This creates significant implications for drivers, employers, and the industry. FMCSA mandates drug testing for CMV drivers in pre-employment, post-accident, random, reasonable suspicion, return-to-duty, and follow-up scenarios. A positive marijuana test—defined as THC levels at or above 50 ng/mL (initial test) or 15 ng/mL (confirmatory test)—results in an automatic failure. Consequences include immediate removal from safety-sensitive duties, a “prohibited” ...
Read more

Lose 30 lbs as a Truck Driver

Lose 30 lbs as a Truck Driver By Aaron Corley, DC Truck drivers are the lifeblood of our economy. But life on the road often means long hours sitting, greasy truck stop meals, and little time for exercise. I’ve met hundreds of drivers who feel stuck—physically and mentally—when it comes to their health. If that’s you, I’ve got good news: you can lose 30 pounds , and you don’t need a fancy gym or some magic diet. All you need is a simple plan, a little commitment, and a few tools to work with your lifestyle, not against it. As a chiropractor who works with DOT drivers daily, here’s what I recommend: 1. Cut the Sugar & Liquid Calories The number one enemy? Sugary drinks. That includes sodas, energy drinks, sweet tea, and even those "healthy" fruit juices. Goal: Cut out 1 soda or energy drink per day. Replace it with water or unsweetened iced tea. Result: This one change can drop 10–15 pounds over several months—without doing anything else. 2. Pack High-Protei...
Read more