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Letter to PIP Adjuster

April 17, 2013

April 17, 2013

Ms. PIP Adjuster
State Farm Insurance Company
Via Facsimile: 888-898-6215

Re: Client

Dear Ms. PIP adjuster,

I am writing in response to our telephone conversation on this date. It is my understanding that you are requesting a utilization review of Mr. W’s medical bills due to the lack of severe property damage to the vehicles involved in the February 27, 2013 collision.

I would like to take this opportunity to point out a couple of things to you. The first I mentioned briefly in our earlier conversation; that is a rear end collision often does not cause significant automobile damage even when the impact is severe. In this particular collision, at least two of the five occupants were treated at a hospital emergency room on the same day. More importantly, my client had never had any back pain prior to this collision. He is now in disabling pain and is attempting to mitigate his damages with conservative therapy, as recommended by his neurosurgeon.

Secondly, I would like to bring your attention to the law governing PIP in Kentucky at KRS 304.39-020 which states at section (5)(a), “There shall be a presumption that any medical bill submitted is reasonable.” The policy reason behind this statute in Kentucky is to ensure that all Kentucky residents who are injured in an automobile collision have access to medical care, even if they do not have health insurance. Such is the case with Mr. W.

As Mr. W’s attorney it is my job to ensure that he is treated fairly under the law, and that is something I plan to do without hesitation. Please advise the status of your utilization review at your first opportunity so that I may take the proper course of action.

With Kindest Regards,

Natalie T. Stuart
Attorney at Law


Cc: File