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Health Insurance San Diego Ca Question & Answers

2015 August 13
by Sarah Fields

Donna asks…

Hit from the back while sitting in traffic – who is responsible for injury fees? (CA)?

My mom was hit from the back while sitting in traffic. Her Ford Escape (2010) was rendered undriveable from the accident site – the rear door was completely smashed in and the exhaust pipe was detached from the most of the car, attached only at the front of the car. The other party’s car was also totaled. Both cars were towed. Immediately after the impact, my mom blacked out for a few minutes and the lady from the other car came around to check and make sure she was okay. The police were called and they took a statement from each of them once my mom recovered from the shock. Apparently, the other lady was distracted and when she realized that there was traffic ahead she went to hit her brakes, but stepped on her accelerator instead. Fast forward to the present: it has been two days since the accident and my mom’s headaches have been getting worse. In addition, her face is a bit swollen, her eyes bloodshot, and the left side of her back is hurting. Because we cannot afford to see a doctor, the extent of her injuries is unknown. Her insurance with AAA does not include an injury policy and she does not have health insurance. The case manager of the other party’s insurance company (State Farm) refuses to consider an injury claim unless my mom can prove that her injuries are due to the accident with a medical diagnosis. My mom’s insurance is already covering the repair costs of her car under the collision policy. The other party’s insurance company took two days to provide a rental car for my mom but they refuse to reimburse wage losses for the two days she was unable to go to work unless she can prove she was incapacitated for those two days by providing proof she was a hospital, which she was not and nevermind the fact that her only mode of getting to work was rendered incapacitated by their client’s negligence. More than the wage losses, I’m really scared for my mom’s health. She’s too worried about the medical expenses to see a doctor, but her health is getting worse everyday. What should we do? If a legal action is advised, could you recommend a lawyer in the San Diego, CA area? Thank you.
Thank you all for your responses.

Just for clarification: My mom has spoken with AAA and they told her that any medical expenses will be her responsibility since, as I stated, the agent she spoke with told her that her insurance does NOT include an injury policy. Her agent told her that she needs to speak directly with her case handler at the other person’s insurance company, State Farm. The case handler she spoke with there told her that unless the doctor can prove that her injuries were a result of the accident, they would not even begin to consider it in her claim. In addition, they told her that they are still trying to determine who is at fault; that while her side of the story may place the blame on their client, they doubt that that’s the case. Because of this, we feel trapped in by both insurance companies and will be hiring a lawyer for better legal representation.

I think what’s difficult for some to understand is that access to healthcare is quite intimidating

Sarah Fields answers:

This is a no brain-er. The other guys liability insurance will pay for Moms medical care. “What should we do?” “We” should go to see a Doctor immediately as we should have when we were rear ended. No insurance company is going to pay for medical expenses if there were no medical expenses. No Insurance company is going to pay for “pain and suffering” if there is no medical evidence to support that claim. Since your Mom used her collision insurance to pay for her car and if she has medical payments she can use that to pay her medical bills. Then her company will subrogate ( Subrogation in its most common usage refers to circumstances in which an insurance company tries to recoup expenses for a claim it paid out when another party should have been responsible for paying at least a portion of that claim) .with State Farm for repayment under the others liability coverage. In any case, why isn’t Mom or you asking these questions of AAA? If she asks, They will advise her on the best way to handle this.
You don’t need a lawyer, you need to see Moms insurer. If Mom has collision insurance, I find it difficult to believe that she does not also have medical payments. Most people buy that coverage and especially if they don’t have their own health insurance.

When you are injured, see a Doctor.
When you have insurance…. USE IT ! (if only to seek advice)…..

Maria asks…

I would just like some feedback about what you think about my resume…..?

I am job hunting for a Medical Assistant position, I am going tomorrow to meet with a family friend who is a Dr. to give me feedback, but it doesn’t hurt to ask the people of Yahoo! Answers.

ObjectiveTo obtain a challenging entry level position as a Medical Assistant that offers both personal and professional growth.

Skills & Qualifications
Microsoft Office (Word, Excel, PowerPoint)
Typing Speed: 50 WPM
Vital Signs
Injections
Venipuncture
Front Office Administrative Procedures
Anatomy & Physiology
Patient Reception and Registration
Appointment Scheduling
Filing and Data Entry
Telephone techniques
Customer service
Self-motivated, independently or as part of team
Reliable and dependable
Ability to multi-task, and be flexible when faced with diverse situations
Experience
March 2010-April 2011 Mills Chiropractic Office San Diego, CA
Externship
Organized various files and forms
Scheduled appointments
Greeted patients and clients
Data entry of patient information
Made phone calls

April 2010-Jan. 2011 Belfer Family San Diego, CA
Babysitter
Assist child with homework
Supervise children’s safety, nutrition, and activities
Created age appropriate craft projects
August 2008-March 2010 SDSU Children’s Center San Diego, CA
Office Assistant
Answered phones and triaged/transferred calls
Organized schedules and appointments
Greeted parents and families and answered various questions
Updated staff and children’s files
Filed billing and various paperwork
Ordered office and bathroom supplies
Data Entry
July 2006-August 2006 Von’s San Diego, CA
Courtesy Clerk
Cleaned check stands and maintained cleanliness of store
Monitored inventory and restocked items
Assisted customers with groceries and provided carryout service
Bagged groceries and gathered carts
Education
July 2010-April 2010 United Education Institute San Diego, CA
Cardiopulmonary Resuscitation Certified (CPR)
Automated External Defibrillator Certified (AED)
Occupational Safety & Health Administration Certified (OSHA)
Health Insurance Portability & Accountability Act Certified (HIPAA)
July 2008-December 2009 San Diego State University San Diego, CA
September 2004-June 2008 Kearny High School-SCT San Diego, CA
High School Diploma
ReferencesReferences are available upon request.

Sarah Fields answers:

Seems good to me but make minor changes like:

-use better action verbs. Here is a good reference that got me an internship in Web Design:

http://www.quintcareers.com/action_skills.html

I think that your certifications go separate from Education, Im not sure. I think once you have graduated college, you dont need to include high school diploma anymore. Thats what career services advised me. But other than that, it seems like you have the qualifications and experience to get the job!

Richard asks…

I’m looking for a BBB approved Dental Insurance plan–can anyone recommend one? I live in San Diego, CA…?

I am employed part time–EXTREMELY part time, so I’m not eligible for the greatest health benefits and I need a good dental plan. I am willing to pay a higher initial/annual fee to find a plan that will include lower co-payments and I would need them to cover or partially cover for sedation, as well. I know I need a lower bridge and I know I need a crown, too…

I live in San Diego and I’m aware of the fact that Google would give me some answers. There are SOOOO many out there that I just wanted some opinions from people that have gotten a dental plan they’re happy with so that I can make the decision a bit faster…

Sarah Fields answers:

I’ve never seen any private dental insurance policies that pay out more than they cost. And although they’ll cover an anesthetic, for sedation, you need to file the claim on HEALTH insurance, if you have it. Anesthesiologists sedate. Dentists numb.

Bottom line – your best bet is to find a dental school near you to get the work done cheap. You’re NOT going to find private dental insurance to do that kind of work, without you waiting a year, paying 50%, and hitting a cap of $500.

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