May 30, 2015 • By Dennis Beaver
On June 15, 2014, Ying, and her daughter, Susie, were in their Lexus SUV, moving slowly on a freeway on-ramp controlled by a ramp-meter which allowed one vehicle to enter every few seconds, when they were rear-ended by a small Toyota that struck the driver’s side rear bumper.
This was a low-speed, low-impact collision, in which the right headlamp assembly of the Toyota punctured an almost perfectly-round 4-inch hole in the SUV below the trunk lid’s left side and caused a few scratches. Repair charges were only $2,500 for mostly cosmetic damage.
The next day Ying — who has a 10-year history of minor work-related back issues, one other accident, years of chiropractic care and Thai massage —went to Kaiser, the doctor finding: “Some tenderness on the right Trapezius and base of neck,” prescribed ibuprofen 600 mg and gave her “exercise sheets.”
Twenty-five-year-old Susie complained of neck and back discomfort, saw a physician and received a similar prescription.
14-hour flight to Taiwan
Two days after this accident, mom and daughter took a 14-hour plane ride to Taiwan where they spent four weeks visiting family, and, where Ying saw a chiropractor once.
Returning home, Ying — who moved from Hanford to Los Angeles and now reads us on The Sentinel’s website — contacted You and the Law, sent photos of the vehicles, the repair charges and asked a good question:
“I have no private or auto medical payments insurance that will pay for continued chiropractic [treatments] or massage. My chiropractor told me I have a right to a year of treatment and should expect the insurance company of the car that caused the accident to pay. Is that right?”
Who is going to believe you two were really injured?
“Ask your chiropractor to show you his license to practice law,” I replied, adding, “Look, this is a very minor accident. Who is going to believe you could really be injured, especially after your month-long vacation with no real care? Do not expect the other side to pay.
“Please, Ying, the insurance adjuster might agree to pay something to make the claim go away, but if you do what I am pretty sure you are going to do, regardless of what I say, you will be on the hook for thousands of dollars, and required to reimburse Kaiser for that visit and X-rays.
“If you are hurt, that’s one thing. But if — as I suspect — you like going to the chiropractor and you just love massage — but medical need cannot be proven, then don’t expect someone else to foot the bill.”
A chiropractor has a duty to not render unnecessary treatment
From August 2014 to February 2015, our reader had chiropractic treatments ($350 a visit, coming in at $4,000 and Thai Massage, at $720. She must reimburse Kaiser, $1,112 for the ER and X-rays. After an incredibly generous offer from the insurance adjuster, she will still need to come up with $3,000 to pay everyone off.
Forty-five days after the accident, Susie had three visits with mom’s chiropractor and received a bill for $1,025 which the adjuster “did not consider due to the delay in treatment,” but offered $500. That was $400 more than her case was worth in our opinion.
We ran these facts by “Dr. C,” a chiropractor in the Central Valley we have known for years as someone not afraid to point out examples of unjustified and over-treatment by other chiropractors.
He explained that “The necessity of chiropractic care, like all health care, is based on the extent of the injury, duration of care and documentation of functional improvement.
“Dennis, we always ask, ‘How much care was required, if any?’ It is the ‘if any’ part of this minor accident that is troubling. As health care professionals we are obligated to put the interests of patients ahead of our own personal financial gain, and I seriously doubt that’s what happened with your readers.
“At most, this is possibly a flare-up of mom’s industrial injury, and, with open medical, work comp insurance might have authorized six treatments at a rate of $60 a visit, not the $350 which was billed. The auto insurance company was absolutely correct in denying any payments for the daughter, in my opinion.
“When your article comes out, Ying and Susie just might want to hand it to the chiropractor — and I’ll bet the bill gets reduced by a large amount,” Dr. C. concluded.
Susie now has a questionable auto accident claim history on the Comprehensive Loss Underwriting Exchange — CLUE — which follows all auto and property claims for five years and is used to determine insurance rates.
This claim will cost her for years to come.
Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.