“What am I entitled to?”
Anyone who has valid auto insurance who has been in an MVA is automatically approved for $2200-$3500 worth of care within the Minor Injury Guideline (MIG). If the doctor determines your injuries are beyond what the MIG can provide, we will apply for more; which the insurance company has the right to approve or decline. Regardless, you are automatically approved for the amount of care the MIG can provide, so don’t deny yourself the care you need for fear the insurance company will not pay for it.
“When will I know whether or not I’m approved?”
The insurance company has ten days to reply to your request for benefits. During that time we can supply treatment to you at no cost. Upon receipt of their decision, we will determine with you how to proceed with your claim.
“What do you need from me?”
There are several documents that your insurance company requires in order to process your claim:
1) OCF-1: Application for Accident Benefits
2) OCF-2: Employer’s Confirmation Form
3) OCF-3: Disability Certificate
4) OCF-5: Permission to Disclose Health Information
5) An examination by the doctor to reveal the extent of your injuries will help us determine whether to submit an OCF-23 (to use the MIG) or an OCF-18 (to go beyond the MIG). This document is completed by the doctor, but will require your signature consenting to the recommended care.
“How will my accident claim affect my extended health benefits?”
We ask if you have extended health benefits through your employer, that you bring your claims prior to the accident up to date, as the insurance companies dictate we must use your existing benefits before they will pay the remainder of the claim. Any paperwork we need from you will have to be submitted to us upon beginning the claim. Once your extended health benefits have been exhausted, we will require a statement to that effect from benefits provider to send to your auto insurance company in order for your auto insurance to pay the remainder.