Did you ever wonder what happens to your medical bills after a car accident? Let’s take a closer look at a few things you might want to consider about your medical care should you be a car accident.
Remember that this blog, as with all Copatient blogs, is for general informational purposes only and you’ll need to consult your car insurance carrier and your attorney for specific advice.
Who pays the medical bills after a car accident?
Generally speaking, your car insurance company will pay your medical bills after a car accident. After they have seen to your wellbeing (as their client), they’ll then seek out go after the person who caused the car accident (the defendant) to be reimbursed for the medical bills they paid on your behalf.
If you do not have car insurance, and the accident was not your fault (unless you live in a no-fault state), you may call the other person’s car insurance carrier to see how much coverage they have to pay your medical bills.
This is also the case if you do not have medical insurance; you’ll need to try to reach the other party’s car insurance company to have your medical costs covered.
In the event that car insurance carriers do not cover your medical costs, typically, your regular medical insurance plan should kick in as a last resort to pick up the costs of your medical care.
Any stipulations associated with your medical plan will also apply to your injuries after a car accident (i.e. copays, deductibles, etc.) and if you need to rely on your personal coverage, you’ll also have to pay these costs.
Do you live in a no-fault car insurance state?
Another consideration is whether or not you live in a no-fault state. This means it does not matter who caused the car accident. The insurance carrier will pay for your medical bills up to a certain value (which is predetermined by the state).
Once the state’s set value is met, it is up to your standard medical insurance to cover the rest of your medical bills. Can you read between the lines on this one? For one, hopefully you have good medical insurance coverage.
Second, if you have high deductibles, you may be required to meet them before your personal medical insurance kicks in. Ask your insurance carrier about this as well; perhaps your state has exceptions to this.
For example, in some states, if your car is hit by municipal vehicles such as a bus, garbage truck, or police vehicle, the municipality only pays your car insurance deductible. Your own insurance carrier must pay for the cost of repairs to your vehicle.
What are the limits of the other parties’ bodily injury policy?
In some states, you may pay for what’s called bodily injury, which you’ll see as a separate line item in your explanation of benefits of your insurance paperwork.
This is the amount that your insurance will cover for medical needs for yourself and any parties you injure during a car accident – including passengers. Once these limits are met, your insurance company is no longer liable to cover the costs of the medical services needed by any of the injured parties.
In the event that the defendant’s car insurance carrier has exhausted their limits, your car insurance carrier may then pick up the tab for your bodily injury under another line item called uninsured motorist coverage.
Personal medical insurance is the last source of coverage in many states and only kicks in after both car insurance policies have been exhausted. If you are not at fault for a car accident, however, you do not pay for the other party’s medical costs.
Was the driver an excluded driver on the car insurance policy?
In some cases, states require every legally driving member of a household to be on a car insurance policy. If they are not included in your coverage, they may be classified as an excluded driver (you will be asked to specify this when signing up for coverage).
In essence, this means that if the excluded person is driving your vehicle when there is a car accident, and they are at fault for the accident, none of the costs of the accident will be covered by your insurance company.
Be aware if your state includes this status as part of an insurance policy as nothing is more heart breaking than both suffering from an injury and being unable to have your car repaired after an accident.
Were you under the influence of drugs or alcohol during the accident?
If you were charged with a DUI or DWI, you’ll need to review your car insurance policy. There may be a clause excluding you from all coverage by your insurance company.
Since you are required to have liability coverage to protect other drivers, their damages should be covered by your car insurance policy. Personally, however, you could end up liable for 100% of your own vehicle damages.
As with other scenarios we’ve reviewed, your personal medical insurance policy should kick in as a last resort where car insurance coverage was not in effect.
Do you have any pre-existing medical issues?
One more issue to be aware of is if you are suffering from any pre-existing medical conditions. For example, if your knee was already injured, and then you feel the injury was exacerbated by a car accident, it is almost impossible for medical science to precisely differentiate the injuries.
Because of this, the waters can quickly become muddied in terms of what your car insurance carrier is willing to cover of your medical expenses. You should certainly consult your attorney if you have any questions following a specific incident where coverage was denied.
You should also keep in mind that:
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