The Role of Health Insurance in a Personal Injury Claim

Most people who suffer an injury in a car accident pay for auto insurance, which has a certain amount of medical coverage. However, while $100,000 or $200,000 in medical coverage on your policy or the defendant’s policy sounds like a fair bit of money, any accident victim will tell you that those sums of money evaporate in a real hurry if you have to spend any time in the hospital or receive extended medical treatment! Automobile insurance companies normally will not pay any medical bills until the time of settlement or jury award. If you depend on the liability carrier’s medical coverage to cover the costs, you’ll most likely end up with a staggering amount of debt.

The best way to ensure that your medical provider receives timely payment is to submit your bills to your health insurance carrier. This is a logical step as the amount of coverage for medical expenses in your health insurance policy is very likely to exceed that of your auto insurance policy. In turn, your personal injury attorney will request what is known as a ‘subrogation lien’ from the health carrier for payment at the time of the settlement. Then, you can use the available medical coverage in your auto insurance to pay any deductibles and charges for office visits so that you will not have to pay any out-of-pocket expenses.

A combination of private carriers, Medicare, and your state’s welfare agencies will cover the remainder of your medical bills. Some of these organizations are notoriously slow at paying so you can expect your medical care providers and treatment facilities to loudly protest and insist the liable party’s insurance carrier cover the costs. But if the medical care provider has a contract with the health insurance company, they are legally OBLIGATED to accept that payment.

Any subrogation liens are most often negotiated to a lower figure when the case is settled, which leaves more money in the pocket of the claimant. If this process seems a bit complicated and convoluted at a time when you or a loved one is injured, vulnerable and confused in the aftermath of being injured in an auto accident, this is yet another reason to have an experienced personal injury attorney by your side. They will be able to protect your rights and explain your options so that you can make decisions best for you–not the insurance companies.