State Farm Insurance, State Farm Fire And Casualty
Auto Insurance, Auto Accident, Denied Medical Claim, Unethical Business Practices, Romain-Claims Manager, Julie Ocker-Claims Adjuster, Dr. Joyce Ivy-Price-Reviewing Chiropracto

I am a current State Farm policy holder, and was in an auto accident in the month of 05/08. I was driving a Saab 93 and was rear ended by a Toyota pick-up truck. The driver failed to apply his brakes until the last minute, in rain, and I was hit at a stop light at about 30-35 mph. Almost $6k in damage was done to the backend of my vehicle (this was covered by Farmers insurance), and per Farmers most of the damage was done due to the type of vehicle, the angle, and the velocity in which I was hit. I also suffered back and neck injuries due to the accident, which State Farm was required to cover and then to seek reimbursement through Farmers Insurance.
I initially went to the doctor following the accident, had an x-ray performed, and was told by my family medical care doctor that I had inflammation and to take an anti-inflammatory. I suffered for several days, and then the back pain subsided for awhile. But the problem is my back pain would flare up here and there, then go away. I kept in touch with the PIP division of State Farm and advised them that I was continuing to experience periodic back pain, and asked if it continued to worsen if they would still cover my medical expenses. They advised me that if the problem was related to the accident that they would pay for my medical expenses.in addition, I honestly did not want to go to the doctor until the problem became more than I could control with an anti-inflammatory, and I surely did not want to go back to my primary care physican because he is not a specialist in the field of back problems.
About seven months following the accident the pain became more than I could ultimately bear. Again, I called State Farm and they advised me that if the problem was related to the accident then they would pay for my claim. I promptly went to a chiropractor who diagnosed my back, related it to the accident, and went through treatment for almost 3 months. He cleared up my back, and the bill, as of today, amounts to over $3,000.00.
A few weeks after my treatment stopped, I received a letter from State Farm, precisely Julie Ocker, in their claims division, stating that my claim had been denied. They sent my claim to an outside vendor, who referred it to a chiropractor by the name of Joyce Ivy-Price, and Dr. Price failed to take into account many of the details that were pertinent to making a logical decision on my claim. Dr. Price stated that my back problem could not have been related to the accident, that it didn't take that long for back problems to manifest themselves (inaccurate). She failed to review the pictures of the accident, the angle in which I was hit, the velocity, and that I have a curvature in my spine that is aggravated more than the typical person by events such as these. She also stated that my chiropractor didn't make good notes, another reason why why claim was being denied.
I contacted my agent, Don Kersten, as well as Julie Ocker herself and the claims manager whose name is Romain. Julie Ocker all but interrogated me, asked me why I had not gone to see a doctor sooner than seven months, I explained, but she continued to interrogate me which I felt was completely uncalled for considering I gave her my answer. I requested an appeal, which was granted, and several weeks later I received another turn down from State Farm.in between this time, I had verified that State Farm had never requested a copy of the accident, or the report, with Marjorie Meeker at Farmers Insurance.in the new letter, Julie Ocker flagarantly misrepresented that State Farm did indeed request pictures from Farmers, and that they were supplied, as well as the accident report, to Dr. Joyce Ivy-Price. Dr. Ivy-Price's letter contradicts this information, stating that State Farm did not supply her with pictures or a police report, velocity was not taken into consideration, angle, etc, but she was only given x-rays at the time of the accident and the file from my chiropractor. Dr. Ivy-Price stated, in the appeal, that back problems from an accident do not continue to worsen at a year (keep in mind that I went to see my attending chiropractor at about 6-7 months), and she cited two books that state that back problems from accidents do not manifest themselves in more than a one year period. I don't believe that my chiropractor would have treated me if this was the case, especially considering I did not have health insurance at the time. I have also consulted with several health care professionals that contradict the data given on back problems cited by Dr. Ivy-Price, and that back problems following an accident can manifest themselves up to 9 months following, 12 months is pusshing it. But as I stated before, I went to see my chiropractor at 6-7 months.
It also should have been obvious that this was accident related considering I had not visited a doctor, a chiropractor, or a therapist for back pain for well over three years. Three years prior, I made a couple of visits for an adjustment, but that was it. Prior to that, I had not been for well over ten years and have been able to manage my back quite well. None of this was taken into consideration.
I have made numerous complaints to State Farm, including requesting another chiropractor review my case file (or send it to another vendor), as well as requesting my chiropractor to rework my claim and forward it to State Farm. I would be interested to see if Dr. Ivy-Price applies her systematic formula for my back problem to her clientle and filing their insurance claims... I truly believe they would be diametrically opposed in nature. As with any insurance company, State Farm wants to keep claims as low as possible and I would imagine forwards case files to vendors that help keep their ratio in line. So, in other words, if Dr. Ivy-Price approves too many files I would imagine that the vendor will not send her as much business. This procedure rings of ethical ramifications, and in turn I have filed a complaint with the state healing board against Dr. Joyce Ivy-Price. I have also filed numerous complaints with governmental bodies against State Farm.
Once this is resolved, I plan on dropping State Farm and going with another provider. I'd suggest you do the same. They are not neighborly to say the least, all they take care of is their own interests. Not a good neighbor.

Company: State Farm Insurance, State Farm Fire And Casualty
Country: USA
State: Illinois
City: Bloomington

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