Insurance Claim Query

[OnlyHereForTheLolz]

This might seem a weird question but bear with me as I give back story to the query.

I was in a car accident last year, got rear ended. It left me in a fair amount of shock and anxiety and due to that I was having couselling. Counselling is expensive! Anyway I lodged a claim with the insurance through a solicitor so my counselling would be covered. They offered me £2,000 which I turned down because all in it will probably end up costing me £2,500 which is what I asked for. And for all I know it might even be more!

Now it sounds like they don't believe my claim and I might end up having to go to court as they aren't happy with the invoices provided etc. I kinda wish I just took the £2k but then I would be out of pocket for something that weren't my fault.

So my query is: Why would they be so resistant in offering the extra £500 to cover my counselling? Also if it did go to court, and I know this will only be speculation, why would they as I can obviously prove I am going to therapy/counselling?

I am just so confused. It's not like I tried to claim for physical injuries despite having slight backlash etc. I'm not trying to make money. Literally just want my expenses covered which is my mental health.

 

[Captainmouse]

They always try to get out of paying. My £1500 car was written off by a cabbie, he refused accept liability, it went to court, with hire fees, court time solicitors etc bill was over £20;000. He had so many points on his licence this was the final straw

 

[OnlyHereForTheLolz]

They always try to get out of paying. My £1500 car was written off by a cabbie, he refused accept liability, it went to court, with hire fees, court time solicitors etc bill was over £20;000. He had so many points on his licence this was the final straw

That is shocking. Instead of paying a small bill they clearly just hope people will give up

 

[Captainmouse]

That is shocking. Instead of paying a small bill they clearly just hope people will give up

He lost his licence, and thus his livelihood, which is why he refused to accept liabilit. The magistrate really tore him and his insurance company off a strip for wasting time and money

 

[LennyBriscoe]

That is shocking. Instead of paying a small bill they clearly just hope people will give up

I think that’s it in a nutshell. They make it so complicated in the hope folk don’t think it’s worth the hassle.

They’ll be thinking that you won’t want to go back to the Counsellor and ask for further paperwork, you’ll withdraw your claim and they won’t have to pay a penny. Stick with it - it’s not as if you’re asking for anything outrageous!

 

[justapossum]

This might seem a weird question but bear with me as I give back story to the query.

I was in a car accident last year, got rear ended. It left me in a fair amount of shock and anxiety and due to that I was having couselling. Counselling is expensive! Anyway I lodged a claim with the insurance through a solicitor so my counselling would be covered. They offered me £2,000 which I turned down because all in it will probably end up costing me £2,500 which is what I asked for. And for all I know it might even be more!

Now it sounds like they don't believe my claim and I might end up having to go to court as they aren't happy with the invoices provided etc. I kinda wish I just took the £2k but then I would be out of pocket for something that weren't my fault.

So my query is: Why would they be so resistant in offering the extra £500 to cover my counselling? Also if it did go to court, and I know this will only be speculation, why would they as I can obviously prove I am going to therapy/counselling?

I am just so confused. It's not like I tried to claim for physical injuries despite having slight backlash etc. I'm not trying to make money. Literally just want my expenses covered which is my mental health.

1. Did you have a medical examination arranged by your solicitors?
2. If so, what was the expert's opinion and prognosis regarding your shock and anxiety?
3. Did he recommend counselling?
4. If so, how many sessions?

You mentioned that you only had slight whiplash, so what was the impact of the accident? If it was only a slight bump that didn't cause you any significant physical injuries, the third party could be disputing how in that case it could have caused you significant (and accident related) psychological injuries.
Any treatment that you arrange yourself is at your own financial risk - you need to be able to prove that your treatment was necessary! As well as the amount of sessions.
This means that if you had a medical examination, and in the medical report the expert did not believe that you had significant psychological injuries that required treatment - you have no medico-legal evidence that you needed this treatment in the first place. You decided to arrange this for yourself and therefore third party are not legally obligated to pay for treatment that you decided to arrange for yourself.
(Imagine I had a car accident, let's say, I got reversed into in a car park at low speed - only slight damage, and I decided to privately pay for 50 sessions of physiotherapy and then asked the third party to cover these costs - these costs are unreasonable in this situation). - this is just an example by the way, I am in no way suggesting that you have not psychologically suffered, but you need to prove that 1) the injuries are appropriate to the impact of the accident and 2) that the treatment is appropriate to the accident.
I don't think they are disputing that you are in counselling/therapy - they're disputing your psychological injuries and treatment.

 

[OnlyHereForTheLolz]

1. Did you have a medical examination arranged by your solicitors?
2. If so, what was the expert's opinion and prognosis regarding your shock and anxiety?
3. Did he recommend counselling?
4. If so, how many sessions?

You mentioned that you only had slight whiplash, so what was the impact of the accident? If it was only a slight bump that didn't cause you any significant physical injuries, the third party could be disputing how in that case it could have caused you significant (and accident related) psychological injuries.
Any treatment that you arrange yourself is at your own financial risk - you need to be able to prove that your treatment was necessary! As well as the amount of sessions.
This means that if you had a medical examination, and in the medical report the expert did not believe that you had significant psychological injuries that required treatment - you have no medico-legal evidence that you needed this treatment in the first place. You decided to arrange this for yourself and therefore third party are not legally obligated to pay for treatment that you decided to arrange for yourself.
(Imagine I had a car accident, let's say, I got reversed into in a car park at low speed - only slight damage, and I decided to privately pay for 50 sessions of physiotherapy and then asked the third party to cover these costs - these costs are unreasonable in this situation). - this is just an example by the way, I am in no way suggesting that you have not psychologically suffered, but you need to prove that 1) the injuries are appropriate to the impact of the accident and 2) that the treatment is appropriate to the accident.
I don't think they are disputing that you are in counselling/therapy - they're disputing your psychological injuries and treatment.

This actually makes a lot of sense. From what you are saying I can see they might be scepticial. Thanks for explaining.

I have a history of anxiety and related MH issues so can demonstrate it necessary to have the counselling.
My car didn’t have much damage but she wrote her car off and nearly shoved me into on-coming traffic that were doing 50mph.
Also I did have an evaluation by a third party pshyciatrist to see if I was faking my MH and he agreed I needed the counselling.

They have all this info which is why I’m confused at their reluctance to cover my costs. In actual fact my counselling is “cheap”as most charge about £110 per session!

 

[justapossum]

This actually makes a lot of sense. From what you are saying I can see they might be scepticial. Thanks for explaining.

I have a history of anxiety and related MH issues so can demonstrate it necessary to have the counselling.
My car didn’t have much damage but she wrote her car off and nearly shoved me into on-coming traffic that were doing 50mph.
Also I did have an evaluation by a third party pshyciatrist to see if I was faking my MH and he agreed I needed the counselling.

They have all this info which is why I’m confused at their reluctance to cover my costs. In actual fact my counselling is “cheap”as most charge about £110 per session!

If you have a history of MH they’re most likely going to ask for access to your medical history (if they haven’t already) - this can be used to back up your claim for psychological injuries! However, they can also try and defend themselves by saying that the accident only ”added” to your pre existing condition.
It will be up to the court to decide on the reasonableness of your injuries and treatment. And the third party will have to “defend” themselves and provide evidence as to why they’re disputing elements of your claim. It’s worth speaking to your solicitor to find out where the issue actually lies and what they believe the prospect for success is. Your solicitor would not (should not!) agree to issue court proceedings if they believed you were likely to lose at the court hearing!

 

[Base2019]

This might seem a weird question but bear with me as I give back story to the query.

I was in a car accident last year, got rear ended. It left me in a fair amount of shock and anxiety and due to that I was having couselling. Counselling is expensive! Anyway I lodged a claim with the insurance through a solicitor so my counselling would be covered. They offered me £2,000 which I turned down because all in it will probably end up costing me £2,500 which is what I asked for. And for all I know it might even be more!

Now it sounds like they don't believe my claim and I might end up having to go to court as they aren't happy with the invoices provided etc. I kinda wish I just took the £2k but then I would be out of pocket for something that weren't my fault.

So my query is: Why would they be so resistant in offering the extra £500 to cover my counselling? Also if it did go to court, and I know this will only be speculation, why would they as I can obviously prove I am going to therapy/counselling?

I am just so confused. It's not like I tried to claim for physical injuries despite having slight backlash etc. I'm not trying to make money. Literally just want my expenses covered which is my mental health.

Can I ask why they weren’t happy with the invoices you provided? If they have declined based on this they would have to provide good reason. You mentioned that you haven’t claimed for any physical injury which would be a red flag for them. Physical injuries are easier to prove as they are often visible, photographs for proof etc. Usually they make people jump through more hoops when it comes to mental or psychological issues from accidents as it is not as easy to quantify and is hard to prove. Not suggesting you aren’t being genuine btw. I would be asking what info is lacking in what you have provided and go from there.

 

[justapossum]

Can I ask why they weren’t happy with the invoices you provided? If they have declined based on this they would have to provide good reason. You mentioned that you haven’t claimed for any physical injury which would be a red flag for them. Physical injuries are easier to prove as they are often visible, photographs for proof etc. Usually they make people jump through more hoops when it comes to mental or psychological issues from accidents as it is not as easy to quantify and is hard to prove. Not suggesting you aren’t being genuine btw. I would be asking what info is lacking in what you have provided and go from there.

I agree with this. Usually you actually can’t claim for psychological injuries alone (unless very serious and well documented).
There must be more to it - are they unhappy with the invoices as in - not enough information included in the documents (they might require information as to what each session included to ensure you were getting counselling for accident related problems only - rather than general counselling), amount of sessions, price of sessions, the therapist themselves? Was it a registered therapist/counsellor?
Usually a discharge note is required outlining the whole treatment process, did you get that?
Think it’s best you ask your solicitor what they actually have an issue with and then you can go from there!

 

[Hobbit87]

Hi all

Long time lurker on here but first time poster.

I also need some advise in regards to something car related and to what I believe is someone trying to scam me by creating a fake accident to scam money from me.

I was driving past some parked cars on a main road yesterday evening when I heard a thud in the side of my car, I looked and couldn’t see anything so carried on driving, It sounded like someone had thrown a rock at my car.A car then followed me and flagged me down saying I hit his car wing mirror.I know I didn’t as I was nowhere near the parked cars, I was driving in the middle of the road.

We looked and his wing mirror was fine if slightly wobbly. I felt something was off instantly but he was polite enough and was on my own sand felt intimidated so gave my phone number, he ended up saying not to worry about it so I didn’t ask for his contact details etc

He ended phoning me later being really aggressive saying the damage was worse that he thought and it had fallen off and kept changing his story saying it’s fine and he just want me to apologise. I recorded half the conversation as I felt something wasn’t right and as his story kept changing. He said he had dash cam footage and would send it to me but then changed his mind and got aggressive when I said it’s best to go through insurance as he didn’t want to provide proof. I had to block his number as he kept trying to call and text me. In the end he said if he got an apology he would leave it. He kept flipping from saying if was ok to saying he wants money for it.

I’ve been doing some research and have found this type of scamstuff has been happening in the area which the police are aware of. Apparently they hit you car with an air gun or water bomb to create a noise and make you think you did something.

I know I didn’t hit his car and there’s no damage at all, should I speak to my insurer anyway to let them know even though I don’t have his contact/insurance details.

Thanks in advance for any advice.

 

[justapossum]

Hi all

Long time lurker on here but first time poster.

I also need some advise in regards to something car related and to what I believe is someone trying to scam me by creating a fake accident to scam money from me.

I was driving past some parked cars on a main road yesterday evening when I heard a thud in the side of my car, I looked and couldn’t see anything so carried on driving, It sounded like someone had thrown a rock at my car.A car then followed me and flagged me down saying I hit his car wing mirror.I know I didn’t as I was nowhere near the parked cars, I was driving in the middle of the road.

We looked and his wing mirror was fine if slightly wobbly. I felt something was off instantly but he was polite enough and was on my own sand felt intimidated so gave my phone number, he ended up saying not to worry about it so I didn’t ask for his contact details etc

He ended phoning me later being really aggressive saying the damage was worse that he thought and it had fallen off and kept changing his story saying it’s fine and he just want me to apologise. I recorded half the conversation as I felt something wasn’t right and as his story kept changing. He said he had dash cam footage and would send it to me but then changed his mind and got aggressive when I said it’s best to go through insurance as he didn’t want to provide proof. I had to block his number as he kept trying to call and text me. In the end he said if he got an apology he would leave it. He kept flipping from saying if was ok to saying he wants money for it.

I’ve been doing some research and have found this type of scamstuff has been happening in the area which the police are aware of. Apparently they hit you car with an air gun or water bomb to create a noise and make you think you did something.

I know I didn’t hit his car and there’s no damage at all, should I speak to my insurer anyway to let them know even though I don’t have his contact/insurance details.

Thanks in advance for any advice.

He is probably trying to scare you into paying for the damage.
Have you got pictures of his car and your car?
You only need to contact your insurance company if you’ve had/caused an accident. If you’re certain you didn’t hit his car, then just wait and see if he makes a claim.
If he does, make sure to inform your insurer that you think he is making a fraudulent claim, and send them any pictures that you have - especially if like you say there is no damage at all on your car - send those pictures to your insurance company and tell them that you don’t even have a single scratch on your car so how could you have caused the “extensive” damage that he is trying to claim you caused.
Insurance companies take fraud allegations seriously.

 

[Hobbit87]

Thanks for your response.

I definitely think he was trying to intimidate me and when it didn’t work he lost his cool especially when I said to go through insurance, there no money for him profit for him that way.

I haven’t got any pics of his car but I have just taken some of mine just Incase so I can at least have proof of the condition of my car from the day after.
Unfortunately I didn’t take any pics of his as I didn’t even think about it the moment at the moment especially after he said not to worry. He did say he would sent me a pic and dash cam footage on WhatsApp but then said no as he didn’t want to hand me his evidence.

I am definitely sure I didn’t hit his car which is why I was shocked that something suddenly hit my car, just wasn’t sure if I should log with my insure, though it may of looked bad if I didn’t bad he tried to claim. I will probably leave for now and see what happens.

Hopefully I don’t hear from him again but I’m just concerned as this happened very close to my gym which I go to most day around the same time and park in the same place. I feel I may of been targeted and he may appear again.

He is probably trying to scare you into paying for the damage.
Have you got pictures of his car and your car?
You only need to contact your insurance company if you’ve had/caused an accident. If you’re certain you didn’t hit his car, then just wait and see if he makes a claim.
If he does, make sure to inform your insurer that you think he is making a fraudulent claim, and send them any pictures that you have - especially if like you say there is no damage at all on your car - send those pictures to your insurance company and tell them that you don’t even have a single scratch on your car so how could you have caused the “extensive” damage that he is trying to claim you caused.
Insurance companies take fraud allegations seriously.

 

[OhMyGaad]

Hi all

Long time lurker on here but first time poster.

I also need some advise in regards to something car related and to what I believe is someone trying to scam me by creating a fake accident to scam money from me.

I was driving past some parked cars on a main road yesterday evening when I heard a thud in the side of my car, I looked and couldn’t see anything so carried on driving, It sounded like someone had thrown a rock at my car.A car then followed me and flagged me down saying I hit his car wing mirror.I know I didn’t as I was nowhere near the parked cars, I was driving in the middle of the road.

We looked and his wing mirror was fine if slightly wobbly. I felt something was off instantly but he was polite enough and was on my own sand felt intimidated so gave my phone number, he ended up saying not to worry about it so I didn’t ask for his contact details etc

He ended phoning me later being really aggressive saying the damage was worse that he thought and it had fallen off and kept changing his story saying it’s fine and he just want me to apologise. I recorded half the conversation as I felt something wasn’t right and as his story kept changing. He said he had dash cam footage and would send it to me but then changed his mind and got aggressive when I said it’s best to go through insurance as he didn’t want to provide proof. I had to block his number as he kept trying to call and text me. In the end he said if he got an apology he would leave it. He kept flipping from saying if was ok to saying he wants money for it.

I’ve been doing some research and have found this type of scamstuff has been happening in the area which the police are aware of. Apparently they hit you car with an air gun or water bomb to create a noise and make you think you did something.

I know I didn’t hit his car and there’s no damage at all, should I speak to my insurer anyway to let them know even though I don’t have his contact/insurance details.

Thanks in advance for any advice.

I would actually report to the police especially because he's been harassing you and changing his story. It's very likely he could be doing it to multiple people to scam money. I was in an accident, similar situation. No injuries reported, everyone fine. Weeks later police ring me about personal injury claim. Police actually told me to ring them ever again - he believed me and knee the scumbags in the other car were lying but they couldn't do anything about it.

 

[NoseyNiamh]

This actually makes a lot of sense. From what you are saying I can see they might be scepticial. Thanks for explaining.

I have a history of anxiety and related MH issues so can demonstrate it necessary to have the counselling.
My car didn’t have much damage but she wrote her car off and nearly shoved me into on-coming traffic that were doing 50mph.
Also I did have an evaluation by a third party pshyciatrist to see if I was faking my MH and he agreed I needed the counselling.

They have all this info which is why I’m confused at their reluctance to cover my costs. In actual fact my counselling is “cheap”as most charge about £110 per session!

If you have a history of anxiety or mental health they will claim it was an existing illness and not something caused by the accident. You should have taken the 2k when offered!

 

[justapossum]

If you have a history of anxiety or mental health they will claim it was an existing illness and not something caused by the accident. You should have taken the 2k when offered!

They’ll suggest the accident only worsened a pre existing condition - meaning a very small value claim, and probably why they offered the £2k to settle. But the solicitor should have advised whether to accept or reject the offer based on evidence and prospect for success.

 

[OnlyHereForTheLolz]

They’ll suggest the accident only worsened a pre existing condition - meaning a very small value claim, and probably why they offered the £2k to settle. But the solicitor should have advised whether to accept or reject the offer based on evidence and prospect for success.

I can show my anxiety was under control when the accident happened, so think that is why the solicitors advised me to reject the offer. They actually wanted me to claim twice as much but I told the solicitor I only needed the £2.5 as I'm not wanting to make a profit.

I've been annoyed about all of this but now think let things fall where they may. If I end up with nothing then that is meant to be. I'm a big believer in karma so if this is "taken" from me then I strongly believe something else good will happen to me.

I just couldn't understand why they wouldn't settle as even the third party psyciatrist endorsed my claim but as somebody above explained they might just be unwilling or thinking I'm trying to "make" money but if that was the case I could've just pretended my whiplash was really bad

 

[Rose28454]

My daughter has someone pull out of a row of parked cars and hit her car just up tie road from my house. She had her baby in the car and was shaken up and had neck pain for weeks. She went through her insurance for the car damage and personal injury. It went back and forth through the solicitors for months and they made her a small offer as compensation. Her solicitor advised her to go to court abd on the day she went her solicitor said the other persons solicitor had advised them that morning to settle but they would wouldn’t. They were all elderly couple dressed like they were going to a fancy dress party. My hubby was there and said our daughter read our her statement and corrected their solicitor a few times when he got the details wrong. Half way through the other people left and finally our daughter got a decent offer and the judge added on £250 as they had left early and could have settled that morning and saved the courts time
They thought as she was a young woman she would be frightened of court but that’s not how I brought her up
Hang on in there and get what you deserve

 

[justapossum]

I can show my anxiety was under control when the accident happened, so think that is why the solicitors advised me to reject the offer. They actually wanted me to claim twice as much but I told the solicitor I only needed the £2.5 as I'm not wanting to make a profit.

I've been annoyed about all of this but now think let things fall where they may. If I end up with nothing then that is meant to be. I'm a big believer in karma so if this is "taken" from me then I strongly believe something else good will happen to me.

I just couldn't understand why they wouldn't settle as even the third party psyciatrist endorsed my claim but as somebody above explained they might just be unwilling or thinking I'm trying to "make" money but if that was the case I could've just pretended my whiplash was really bad

If your solicitor advised you to reject the offer then it’s best to take their advice.
The case most likely won’t proceed to court as if they’ve admitted liability and now they’re just arguing over costs, that means that if they do go to court - they will be responsible for all the court costs! It’s not worth it for them. They’ll probably keep negotiating.