Testimonial for K.A
In July of 2008, I was stopped at a stop light in Verona, Wisconsin behind a black SUV when a silver SUV approached slowly from behind. Suddenly the silver SUV lurched forward and accelerated toward the back of my car. I watched as the silver SUV hurtled toward me and I prepared to become the filling in the SUV sandwich.
My Acura was rear-ended by the silver SUV, knocked over a high curb and then back down and then moved forward about six car lengths as the speeding SUV hit the black SUV that had been in front of me and then in an effort to pass that vehicle, hit it a second time.
I was taken to the Hospital by ambulance and released late that evening. I promptly reported the accident to my own automobile insurer of 47 years. I had a $100,000 med pay policy as part of my automobile insurance coverage, (that coverage expired one year after the date of the accident) Medicare and Blue Cross/ Blue Shield. If anyone had asked, I would have said, I am very fortunate to have the very best health care coverage available.
My automobile med pay was primary. After paying for an appointment with my internist and two weeks of appointments with my chiropractor, my med pay insurer denied all coverage, including my trip to the Emergency room and medical treatment provided there. My medical bills were then submitted to Medicare and Blue Cross/Blue Shield. Both indicated my med pay insurer was primary and that they had no liability for any of my bills. At all times I was paying for three insurance policies.
I tried repeatedly to resolve the denial of payment with my med pay insurer claims adjuster. After I had notified all providers of where to send my claims, the claims adjuster told me that the address where claims should go had been changed. After the address was changed with all of the providers, which took substantial time, then the claims adjuster refused to talk to me because I was a lawyer. She also refused to allow me to speak to her supervisor. So, I asked to speak to the legal department and she told me that was not allowed.
I retained the services of attorney, Alex Kammer, of Atterbury, Kammer & Haag S. C. My medical bills continued to grow and my med pay insurer continued to deny most of my coverage. Ultimately, the med pay insurer produced a report purportedly prepared by a D.O. they employed. The report indicated that my medical care should not be covered because I had several weeks of chiropractic treatment and my injuries did not improve. At this time they also denied all coverage for my transport to the hospital and my emergency room treatment. No written explanation was provided, just a denial.
At the end of the first year when the med pay was no longer available, my Medicare coverage became primary and my Blue Cross/Blue Shield supplemental. Because my med pay insurer had denied so many of my bills without explanation or buried my providers with incessant requests for duplicate materials or just failed to respond to my providers in any manner, it took a substantial amount of my attorney’s time before Medicare worked smoothly like it had before the accident. From the beginning of my representation, his office was on the phone daily with the insurers facilitating payment of my bills. Unfortunately, this was necessary until the day my case was resolved.
After twenty-two months of patiently attempting to get my med pay insurer to pay in accord with their contract with me, my attorney filed a BAD FAITH lawsuit against my med pay insurer. From the day of the accident my med pay insurer had full access to all medical records generated by my treating doctors indicating the nature and severity of my injuries, but they still denied coverage relying on the report of a man in their employ who had never examined me and who lacked appropriate credentials in some of the medical areas in which he was allowed to determine denial of my insurance coverage. In every instance his professional credentials were notably less than the treating doctors I trusted with my care. Alex Kammer called the insurer repeatedly, wrote and e-mailed, all to no avail. On a parallel track he was organizing and preparing my case for trial. At every opportunity he pressed the court for early dates for discovery, for contested hearings, for discovery deadlines, for depositions, for mediation and finally for trial.
When the various defense attorneys decided they wanted to try their cases separately, he successfully resisted, which led to a prompt settlement with the med pay insurer to resolve the Bad Faith lawsuit by paying all amounts owed under the contract of insurance. When attorneys for the defendant resisted a deposition of their client, he persisted. When those same attorneys sought to force me to drive to Milwaukee for a 9 AM deposition, two days in a row, in spite of knowing that I have never been able to drive in rush hour and have not travelled since the accident due to my accident-engendered PTSD, he briefed and then argued this point in court and prevailed.
His response to every delaying tactic of the defendant’s insurance company was to continue to diligently prepare for trial. Even after it became obvious that the “experts” selected by the defendant’s insurance company were not going to be able to provide the hoped for testimony for the defendant, Alex Kammer continued to prepare my case for trial.
As the date for trial was upon us, the insurance company changed attorneys and attempted serious negotiations for the first time. Alex kept me informed at all times. He provided copies of all correspondence and provided e-mail notes or calls to update me on his negotiation phone conversations. On receipt of each offer he provided exact information about the number of dollars that would be payable directly to me after payment of his attorneys fees, costs of the lawsuit, liens of the med pay insurer, liens of Medicare and liens of Blue Cross/Blue Shield. He explained all tax implications and all of the unusual aspects of Wisconsin law as relates to this kind of accident.
Throughout the pendency of the case I had a lot of questions. I went to every meeting with Alex with my list of new questions. Without exception, he answered all of my questions, patiently and completely. He never hurried me through a meeting, looked at his watch, took a phone call, looked at his cell phone or was other than totally present at our scheduled times. And, he was prepared for each meeting. Because of his court room experience he was able to provide an accurate assessment of my case. Because of his thorough preparation of my case he was able to reduce my stress level, keep my case moving and negotiate a satisfactory settlement and in the process avoid a one week trial which would cause me to re-live the accident, one more time.
After the case was settled with the defendant’s insurer, Alex shifted gears and started preparation for trial of the subrogation liens. Medicare and Blue Cross/ Blue Shield promptly settled their subrogation liens with him, but my med pay insurer sought return of all monies they paid to settle the Bad Faith lawsuit as well as all monies they paid for my health care from the date of the accident. Alex requested a date for immediate trial of these issues and several weeks after all other aspects of the case had been settled, my med pay insurer settled for 1/36th of the amount they had originally demanded in settlement. During this stressful time Alex kept me totally informed. He also explained the applicable Wisconsin law.
When the defendant’s insurance company sent the settlement check and release, the release contained language waiving all of my rights against the defendant and his insurer, but it also contained language preserving all of their rights against me. I was opposed to agreeing to any reservation of rights in the old guy who plowed into me or in his insurance company. Alex resolved those issues and I left that meeting with copies of everything, all of my questions answered and a check.
Before July 2008 I thought I was very fortunate to have the very best health insurance coverage. I am now older and wiser. The “best insurance” is only as good as the attorney continually and conscientiously pushing for just payment pursuant to the contract of insurance. For me, Alex Kammer was that attorney. He was in my corner for every fight from beginning to end.
Alex has my highest recommendation. He also has my sincere thanks for doing all he could to reduce my stress as my three insurers and the defendant’s insurer engaged in a shameful game of delay and behavior calculated to deliberately increase my stress.
K.A. – Madison, Wisconsin