This document is for educational purposes only and is not intended and does not provide legal advice concerning any individual situation.
North Dakota is a no-fault state concerning car crashes. This means that North Dakota requires all drivers to maintain an insurance policy that includes no-fault benefits. The most commonly used no-fault benefits are medical expenses and lost wages. Sometimes no-fault benefits are also referred to as PIP (personal injury protection) benefits.
When you are involved in a car crash in North Dakota your car insurance as part of your no-fault benefits initially pays for the medical expenses and lost wages that you suffer as a result of the crash. If you have been involved in a motor vehicle crash in North Dakota that requires you to seek medical treatment or causes you to miss work you must file an application for no-fault benefits with your insurance company.
MEDICAL EXPENSE BENEFITS.
For injuries suffered in a car crash requiring medical treatment your motor vehicle insurance company under the no-fault medical benefits is primarily responsible for the payment of your medical expenses. Your insurance company must pay the usual and customary charges incurred for reasonable and necessary medical expenses. These payments should cover the full amount of the medical bill without reduction for deductibles or copayments. If you receive a bill from your medical provider for any amount not covered by your no-fault medical benefits you should contact your car insurance company to find out why the full amount of the medical bill has not been paid.
If you do you have medical insurance your no-fault medical benefits may be coordinated with your health insurance coverage after the no-fault insurance has paid the first $10,000 of no-fault benefits. Depending on the circumstances it may or may not be to your benefit to have the no-fault insurance coordinated with your medical insurance. Any time you have incurred medical expenses or lost wages that exceed $10,000 you should consult an attorney to review the coordination of benefits issue.
ADVERSE MEDIACL EXAMINATIONS.
The North Dakota statute that requires car insurance companies to provide no-fault benefits allows the insurance company to require that a person receiving medical benefits submit to a medical examination by a physician selected by the insurance company. If you refused to attend a physical examination requested by your insurance company your benefits will be terminated.
The insurance companies call these independent medical examinations. Most often the insurance company hires a company that exists for the sole purpose of providing insurance companies with medical examination reports. These companies hire doctors who have agreed to travel throughout the state for the sole purpose of conducting insurance medical examinations. The doctor conducting the insurance medical examination has no obligation to you to provide medical advice or treatment and has no legal obligation to the person being examined if their opinion is wrong. These doctors charge somewhere between $3000-$5000 to review your medical records, conduct a short examination and write a report saying that you no longer need medical treatment as a result of the motor vehicle crash.
When the insurance company receives the report from the adverse medical examination stating that you no longer need medical treatment the insurance coming then terminates your no-fault benefits. If the insurance company terminates your medical expense benefits and you believe that you still require medical treatment as a result of your crash related injuries you must sue your insurance, a for breach of the insurance contract.
Any time that your insurance company demands that you attend a medical examination you should consult an attorney.