I have been ripped-off by Progressive Insurance and write this account in hopes that no one else need go through this. I also ask that Ripped-off help me in getting those monies due me.
As I was driving on March 12, 1998, I was rear-ended by a pick-up truck causing the inside of the rear-bumper of my 1994 Ford Taurus GL to be pushed up literally to the back of my head. As a result of this accident I was hospitalized with multiple trauma and later retired disabled from a United States Government position.
I was required by Progressive Insurance to attend two appointments that they paid for with Independent Medical Examiners (IME's). As a result of those visits on November 30, 1998, and May 25, 1999, Progressive Insurance denied all Loss of Earnings and Health Service Benefits.
As a result of the debilitating injuries I sustained in this motor vehicle accident, I was unable to return to work and the United States Government retired me disabled in a decision dated June 7, 1999. Later, a lawsuit was filed against the individual who struck me from behind causing my injuries.
Upon serving the defendants' with the complaint, Nationwide (their Insurance Company) without so much as a response to the complaint nor a deposition, offered the maximum insured policy amount to settle the case arising from their client's negligence "resulting in serious and permanent personal
injuries to the Plaintiff." (Release dated December 10, 1999). Moreover, the Social Security Administration Office of Hearings and Appeals in a decision dated December 28, 1999, made the findings that "The claimant cannot perform her past relevant work". However, the court did rule that claimant could not be found disabled under their definition due to claimant's age and what they felt as remaining residual capacity. Thereafter,
additional evidence that the Social Security Administration did not consider was forwarded to the Appeals Council forthwith by claimant's Attorney representing her in that matter and requesting that the claimant be rendered a fully favorable decision. Such Appeal is still pending. It is strongly noted that every decision was forwarded onto Progressive Insurance per their request with assurances that reconsideration for reversal of their prior denials of claims would be made; however, they continually raised the threshold to concede reinstatement of no-fault benefits to me.
Since, as a result of contributory factors from this motor vehicle accident the following health issues have arisen and/or are continuing and not limited to: numerous Epidural Steroidal Spinal and S.I. Injections; exacerbation of lymphedema requiring Manual Lymph Drainage/Complete Decompression Physiotherapy (MLD/CDP) done on a daily basis for the rest of my life (takes approx. 3 hours per day); as a result of medications, heartburn, GERD, hiatal hernias, surgeries and many further procedures as a
result of the aforementioned; left chest wall costochondritis; and medications with various side effects complicating matters. In addition, daily physical therapy at home as well as Aquatic Physical Therapy (2 programs) three days a week. All the above combined together with pain and fatigue contribute to daily suffering.
Consider the effects of the force against steel as outlined in the second paragraph, why should it amaze anyone what my body went through as a result of the same.
As a customer to insurance companies in excess of 25 years, I paid high premiums for peace of mind of coverage in the unforeseen case that benefits such as this are needed. It is common knowledge in Insurance Companies that Independent Medical Exams (IME's) are paid and used by them to deny claims and reduce costs for the Insurance Company. As a result of such practice, Progressive Insurance Company has withheld benefits of the policy from me. Furthermore, it is well known among the legal community that adjudicated cases are hard to access due to vacatur. Meaning, that a legal proceeding is set aside by judicial order; for instance, when the insurance company
agrees not to appeal a decision by trial in order for the settlement amount to remain undisclosed to the public. Thereby, foiling "bad publicity" for said Insurance Company.
Remember, in this case we have 1) a New York State Supreme Court matter that was settled without any further proceedings acknowledging serious and permanent personal injuries to the Plaintiff. 2) A decision by the United States Government as a result of this motor vehicle accident retiring me disabled from my job held at the time of the accident. And 3) a Social
Security Administrative Law Judge finding that I cannot perform any job held at the time of the motor vehicle accident nor any job held prior.
I appealed Progressive's denial to the Consumer Services Bureau of the State of New York Insurance Department and was told by them that they only need ensure that Progressive based their denial of no-fault benefits upon an report and that questions involving the IME's professional opinion are not under the scope of the State Insurance Department's review. A follow-up telephone call with the Senior Examiner of the Consumer Services Bureau told me that he wasn't saying that I didn't have a case but to take this matter any further I would need to take
Progressive to court or arbitration.
Progressive knows this and until they are forced to comply with benefits under their no-fault contracts, they keep denying. This is exactly what Progressive hopes customers will do - give up, thereby, allowing them to build their profit margin! After the accident and people including as consumers had told me good luck in trying to get policy benefits from Progressive and I kept telling them how good they were in the beginning of the accident and the response was, you wait and see. Well, they were right! Please "Ripped-off" allow my injustice to be a warning to all people considering Progressive as their auto insurance to BEWARE!!!!!! AND please "Ripped-off" help me get my money!
Please note that without the help of my husband, this long account of my story would not have been possible putting onto paper.