Well to start off On the 30th of june last year, I wrecked my dirtbike(lost It on a jump I've sucessfully done more than a hundred times)ended up spending all day In the emergency room, as I pretty much landed on my chin causing 7 teeth to be damaged and ripped a whole In my chin and Inside my mouth(14 stitches total)I had swallowed so much blood I was throwing up the entire time at the hospital, Basically I needed to have 5 teeth reconstructed ,and 2 root canals/crowns aswell.

Well my Insurance company has had me running the gauntlet for over 4 months, first off stating because I didn't get any work done within thier 72 hour emergency dental coverage they don't have to cover It,no work could've been done within 72 hours cause the swelling was so severe and It was july 4th weekend.

After 4 months of talking to a dozen supervisors and employees on both my Dental and medical Insurance, I found out from Medical Deprtment Director on oct. 16th that because my dads Insurance plan Is Different than most government plans that this was definitely covered under Dental, Not medical to whom I had all documentation of work to be done sent to.It wasn't till the middle of november when I finally got the dental department to notice the difference In my policy.

I sent all the Documentation a few days after(hospital reports,hand written letters from the emergency room doctor,my Dentist,the dental assistants, and my Primary doctor, and any other Documents showing I wasn't making shit up to get something fixed due to tooth decay or something).The dental department told me that It would be sent to get pre-authorized(2-3 weeks) ,but would most likely fail as they only check the medical codes and not the reasoning behind them, so If the pre-authroization fails I would have to submit everything to the first of 4 levels of an appeal.

All through december I heard nothing.On the 31st of December I awoke to severe pain In one of the teeth(one needing a root canal) and my entire right side of my face swollen so bad I could barely see outta my right eye, I was having a lil pain the night before..Well I had an Infection set In, went to the dentist ,they drained the Infected fluid from my tooth and put me on antibiotics for 2 weeks.

All through January I've been told that the pre-Authorizations had not been completed yet, and as Of this morning the 29th of January, 6am(my 21st B-day aswell) I have another Infection setting In, my face Is a little swollen and I'm waiting till 7am so I can call my dentist.

I've called a few Attorneys, and most want anywhere between $1500-$3000 to get things rolling...I don't have this kinda money, even though Thier quite sure this type of case will settle outisde of court with me winning ,plus If I do that I'm definitely going to try and get damages for missed work,pain and suffering, and such things.so anyways If you guys have some advice plz. let me know thx

BTW to anyone that rides, sportbikes,cruisers,dirtbikes make sure you wear the gear,I'd probably be dead or need facial reconstruction had I not had a helmet on.

 

With obvious damage such as yours, some attorneys will settle for a share of the damages awarded. If you lose, they don't get paid. It'll usually "cost" you more, but it's not like you'll lose money on the case anyways.

Don't just call an attorney. Set up an appointment with an attorney and pay the $100 consultation fee (or whatever they charge). They get dozens of calls per day. Someone that wants to TALK is obviously somewhat serious, so you may get further with that AND you may get the consultation fee dropped as well if they take your case.

 

Who are you planning on suing? Yourself?

 

Why don't you get the work done and have them reimburse you for it. Your health is more important and you are getting infections on your head area.

 

I plan on suing the Insurance Company,I would pay for It myself ,but Its about $3k worth of work and I'm currently In pre-med with most of my money going to tution and my apartment.