Dear USAA,
On the morning of May 12, 2011, I took my two eldest children to school, just like any other school day. I dropped my son (then aged 9) off first, because he was (is) still in primary school. Afterwards, I drove my daughter (aged 12) to middle school. After dropping two of my children off at their respective schools, I would have normally been on my way into the office but because I was on short-term disability at that time, instead I started to make my way back home. If you are curious as to why I was taking a paid leave of absence from work, it was because on May 12, 2011 I was officially 38 weeks pregnant. Now, I know it’s not all that uncommon for someone that far along to have already started maternity leave, but you see during that particular pregnancy (technically with all but the first of my pregnancies) I suffer from what is known as pubic symphysis diastasis.
If you’ve never experienced this condition before, let me try and describe it to you. Once I reach about 20 weeks in pregnancy, I suffer through Every. Single. Waking. Moment. with what feels like an ax wedged squarely in the middle of my pubic bone. As you can probably imagine, I was greatly looking forward to returning home so that I could crawl (literally!) back into bed to try and sleep my way through at least part of the day. Unfortunately, because of what happened next, I didn’t get the opportunity to realize any kind of respite from the physical agony I had been for months by that point. In addition to being prevented from any kind of anticipated sleep-induced time away from the severe pain I courted as a constant companion, that mid-May morning I was also forced to endure one of the worst thoughts that I, an expectant mother, could ever possibly have to consider — whether or not the baby growing inside of me was dead or alive. All because one of the motorists you insure was in such an obvious hurry that morning that she didn’t bother to stop (or even slow down) before she rear ended me while I was completely stopped at a yield sign in order to let oncoming traffic pass through the intersection.
If you’ve ever experienced the joy of preparing for your own flesh and blood to enter the world (as either a mother or a father), I’m confident that you’ll be able to empathize with me when I say that within a matter of nanoseconds I was terrified, shaking violently and uncontrollably due to the flood of adrenaline coursing through my veins. I had never been involved in an automobile accident (and I’d certainly never been in an accident while being 38 weeks pregnant). I knew immediately that I had been hurt, but I didn’t care. I wasn’t focused on myself. Instead, I was overwhelmingly sick, consumed with unrelenting worry and absolute distress at the thought of the baby girl in my womb being injured. I was in a state of shock and sheer panic and all I wanted to do was finish my journey home so I could ask my (then) fiance to drive me to the hospital. Nothing mattered to me more at that moment than to ensure my baby wasn’t hurt or worse.
Bordering on hysteria, I called my future husband who (thankfully) arrived on the scene within minutes. I was too afraid to even get out of my vehicle so he attempted to take charge of the situation by speaking with the woman who hit me. He provided her with our contact details and insurance information and in turn, requested the same from the driver you insure. I was so afraid that we were wasting time. Valuable time that would have been better spent getting checked out at the hospital. However, to add insult to injury, the motorist you insure refused to give any of her insurance information. Instead, she decided to call her husband (rather than you, USAA) so we ended up having to call 911 in order to have a police officer arrive on the scene to collect the details. Here I was, completely freaked out and then had to wait even longer because the driver that you insure flat out refused to provide her policy information.
After what felt like forever, the officer arrived on the scene and completed the accident report and only then were we free to leave so that I could FINALLY HEAD TO THE HOSPITAL. But the worst was left to come. I made it to the hospital and proceeded to be evaluated. The wonderful nurses and doctors treating me requested that an ER doctor come up to L&D so that the excruciating pain in my neck could be evaluated. After physically examining me, he advised that the only way they’d be able to truly understand the scope of my injuries was if I had x-rays done. Clearly, being 38 weeks pregnant and still waiting on the news as to whether my baby was OK, I refused the ER doctor’s offer. As I waited hour after hour in the Labour and Delivery ward of the hospital, all I could do was sit there and cry. My mind kept going back to the worst-case scenario I was facing. The thought of my baby girl, who only had a few short weeks to continue growing and developing, potentially dying inside of me was beyond brutal. We spent all day in the hospital but were finally given the news we wanted to hear. The baby was uninjured, and we were medically cleared for discharge. I couldn’t have been more relieved. Even though I was still in an incredible amount of pain (and was obviously NOT prescribed any type of pain medication because of the pregnancy), I was more than willing to suffer through however long it took for my body to heal. So, I waited, and exactly 2 weeks and 1 day later, or baby girl was born, healthy and beautiful. I hope this isn’t too much information, but I think it’s important to note that I delivered her without the assistance of an epidural. I feel like this is important to point out because in pushing a baby out of my vagina, not only was the lower half of my body doing a bunch of work (obviously), but putting my chin to my chest was no easy feat. All because of the car accident that your insured motorist caused.
Following the momentous birth of our daughter, we were discharged about a day and a half later. Yes, the pain in my neck (literally) was still bothering me; however, the pain in my underwear place was my primary focus. Clearly I still had a lot of healing to do. Weeks went by and I felt as though my body was getting better. On my own I decided that perhaps a better pillow would solve the issues I was still experiencing with my neck. I tried several pillows, each more expensive than the last and finally in mid-August found one that helped at least a little. I have to say that I’m a little proud of my high tolerance to pain (hello? giving birth without an epidural?) and with so much going on within our household (e.g., me resigning from work in order to stay home with the baby, me and the two eldest children returning to school full time, taking care of a newborn who was Baby #4 for us) I simply could not justify spending the time or the money to see a doctor about the issues with my neck. Oh, and on top of ALL of that, in mid-August, we found out that we were expecting Baby #5. My fate was sealed at that point. I simply felt as though I had no choice but to live with my injury, because I knew that the first thing any doctor was going to want was an x-ray. (If you’re interested in why I am so adamantly opposed to x-rays in pregnancy, it was because of a miscarriage I suffered many years ago while I was 10 weeks pregnant after I had sprained an ankle and subsequently had x-rays done to confirm there was no fracture.) I’ll never know if there was any correlation between the two, but since then I’ve been strongly against having any kind of x-rays done while pregnant.
By mid-September though, I couldn’t take it any more. I finally made the decision to seek treatment for my injuries. This was no easy decision, partly because I felt guilty for taking any time away from my everyday responsibilities (you know, the full-time mom, full-time student, full-time wife gig). The other reason it took me so long to finally do something about my pain is because from May 12, 2011, (the date your insured driver hit me), I (and MY insurance company) paid for almost EVERYTHING out of pocket. Yes, that means that I paid my required co-pays and MY insurance footed the rest of the bill for:
- The trip to L&D, including:
- Each physician’s charge for seeing me.
- The ultrasound performed that my insurance didn’t cover AT ALL (because they deemed it “experimental” – a rant for another time).
- The rental car I needed while my vehicle was being repaired (because it’s not like I could just be without a car since I was full term and could have given birth at any time).
As you can see, seeking treatment wasn’t as simple as just finding a doctor. I knew upfront that I was going to have to pay for it all (“it” of course being any type of treatment I could find that would provide even a tiny measure of relief), and that my insurance would (again) cover the rest of the costs.
Since I had already provided proof of the above costs (on August 30, 2011), the USAA claims adjuster offered me a lump-sum payment of $3,500. He explained that this would cover the reimbursement owed to my insurance company, as well as reimbursement for the money I had paid out of pocket. This lump-sum payment also included some money to account for any “pain and distress” caused by the accident. During that phone call (in mid-September if memory serves correctly), I politely explained to him that I would consider USAA’s offer but that there were going to be additional bills because I had decided to go ahead and seek treatment for my injuries. He indicated that because there were going to be additional bills, that I should wait until treatment had concluded so that I could submit these additional expenses to be included in the lump-sum payment from your company.
I decided to make an appointment with my primary care physician because I figured that would be an appropriate way to begin this process. Unfortunately, my physician said he couldn’t treat me, because I was currently pregnant and therefore wasn’t comfortable with ordering x-rays or prescribing pain medication. In the midst of attempting to discover another route for treatment, I was forced to take a few trips to urgent care on a couple of nights when the pain was so terrible that I didn’t want to continue living. The urgent care doctors prescribed several pain medications and referred me to a neurologist, telling me that because the pain was so bad I really should consider just sucking it up and have an MRI done to see what the root of the problem was. Because I had indicated that the reason for my visit was due to being involved in a car accident, my urgent care office refused to bill my insurance company since the accident was the fault of your motorist. So, I got to pay for all of that out of my own pocket. In desperation, I called my OBGYN to get some advice on what to do next. She advised me to follow the recommendation of the urgent care physicians and see a neurologist, but that when I did, that I could only have an MRI done (no x-rays or CT scan), if and only if my abdomen was double shielded.
The neurologist that I was finally able to see in mid-November (apparently all of the San Antonio area neurologists that accepted my insurance have considerable waiting lists for new patients) refused to do an MRI (or anything else for that matter) because even if an MRI confirmed a ruptured or slipped disc in my cervical spine, there wasn’t going to be anything he could do about it because I was pregnant. He did prescribe some muscle relaxers though that were safe to take while pregnant. Unfortunately, it was a fruitless endeavor in getting that prescription filled (again, something I had to pay for out of pocket!) because they didn’t help at all.
After waiting for WEEKS (in constant pain) to even see the neurologist (all the while living with profound anxiety because I had been conditioned to believe that x-rays and an MRI was going to be an absolute requirement in order to obtain treatment), I felt ultimately defeated. I didn’t know what else to do. I had almost resigned myself to the fact that I was just going to have to live with the issues in my neck.
One of the best decisions I made throughout this entire ordeal was finally looking into “alternative” types of treatment. It took some time and work, but by mid-October I finally found a wonderful chiropractor who agreed to treat me. I was thrilled when she recommended an aggressive treatment plan that included ultrasound therapy, massage therapy, physical therapy, and adjustments to my cervical spine. Relief didn’t happen overnight. In fact, it took 3-4 visits each WEEK for a full month before I started to feel normal again. In the beginning, I had my doubts about how effective a chiropractor was even going to be. Especially because each and every visit cost me a $35 copay (again, with MY insurance footing the remainder of the bill). Slowly but surely though, I was finally getting better.
Out of the blue, a day or two before Christmas, I received a phone call from the claims adjuster. I wasn’t able to call him back until 2 days ago (in part because of the holidays and also because a week and a half ago we moved our entire household over 100 miles away from the San Antonio area). I’m not entirely sure he was looking at the correct claim because he seemed way too enthusiastic when he exclaimed that USAA was prepared to offer me a lump-sum settlement payment of $1,200. He then prattled on about how this amount was to reimburse what my insurance company had spent, and would also cover all of my out of pocket expenses, and included some additional money to cover “pain and distress.”
I attempted to stop him in order to clarify why the settlement amount was over $2,000 less than the original amount offered. I received no explanation. I attempted to explain that in addition to the expenses and bills he had received
from me previously that I had more that I would be submitting. I was told that any time there was lapse in time between the date of injury and treatment that this “raises a red flag” and that I would have to get a letter from my doctor that explains why so much time passed between the two events. When I attempted to remind him that the reason I didn’t get immediate treatment was due to the fact that I couldn’t BECAUSE A DRIVER YOU INSURE HIT ME ON THE DAY I OFFICIALLY STARTED THE 38TH WEEK OF PREGNANCY he only stated that my claim would have to be “carefully evaluated” because USAA generally won’t cover expenses for treatment that extend as long as mine have. Then, he explained that not only would I need to provide all EOBs from my insurance company that pertain to medical attention received due to the accident but that I would also need a letter from my doctor explaining why there had been such a gap in treatment. When I asked him which doctor this letter would need to be from, he finally indicated that it should be from my chiropractor. He then said that he would follow up with me in “about a month” to see where I was in gathering all of this documentation. I decided to leave it at that and let him know that I would print and scan every single EOB and I also let him know that I would call the chiropractor in an attempt to get such a letter. 48 hours later, I have the EOBs requested. However, in speaking with my chiropractor’s office, the receptionist stated that the chiropractor was on vacation until next week but that it wasn’t likely that she was going to be able to produce such a letter because ultimately, the chiropractor would not be able to fully explain this whole ordeal since I only started seeing her in mid-October. It would be too much of a “liability” she explained.
And truthfully, I understand the logic. For my chiro to try and explain this whole ordeal would be impossible. Hell, it’s taken me a few days now to finish this “letter” myself. So here we are. I’ll have everything scanned in as soon as we finish unpacking so that I can get my scanner hooked up. When I submit all of the EOBs, I’ll also be sure to include a copy of this letter. And then, I’ll give USAA a reasonable time to evaluate all of the information. But be forewarned that if each and every expense my insurance company has paid, and each and every expense that I have paid, along with a reasonable amount for “pain and distress” isn’t included in the next settlement amount you have to offer, you’ll be hearing from a personal representative on behalf. I will not sit idly by and continue to be insulted.
Sincerely,
– Julie
