A car accident can be emotionally and physically traumatic and can make life after the crash extremely complicated. The injured party will likely require both immediate and lasting medical treatment for their injuries. Medical and health insurance can be complex, and this is amplified in the event of an auto accident.
If there are a number of different insurance policies in place, including both health and auto, making the determination of who will pay for the injuries sustained can quickly become convoluted. Understanding the different factors that impact which policy will pay for your injuries is crucial to making sure you don’t end up on the hook for expenses related to your recovery.
Here’s what you need to know about using your medical insurance after an auto accident:
Meeting Your Deductibles
The first factor affecting medical bills after an accident will be the presence of deductibles on any policy. Before either of your insurance policies start to pay, you will have to ensure all deductible amounts are met. Most medical providers will first render the necessary treatment, and then subsequently worth with insurance providers to determine who pays what. You will likely then get a bill for the amount of the deductible.
Auto Insurance as The First Line of Defense
Generally, the initial payments after an accident will be charged against an existing auto insurance policy. Nevada requires drivers to carry a liability protection policy on any vehicle they operate. These policies pay up to a certain amount of medical bills for any injuries associated with an accident. Depending on who is at-fault for the crash either your personal policy or that of the other driver will be used to cover the initial medical bills.
It’s important to remember that many of these policies have relatively small limits. On average, a person generally carries between $15,000 and $50,000 worth of liability coverage. This amount is not much when you consider the average costs of medical care after an auto accident.
It’s also important to note that if you are required to use your own policy for this coverage, you will be responsible for a minimum of 20 percent of the bills until the maximum is reached. These personal plans only cover 80 percent until max. Once you reach the maximum amount, you will be responsible for all the rest of the expenses.
Personal Health Insurance
Once all other forms of payment are exhausted your personal health insurance will generally begin to cover the medical costs associated with your injuries. Just like with your auto insurance policy, you are required to meet deductible amounts before the insurance company starts to cover treatment. You may also be required to cover co-pays and any other obligations required by the insurer.
It’s important to remember that what is covered and what is not will depend largely on what is included within the policy itself.
In some cases, your attorney can arrange for doctors to provide care for your injuries by providing them with a guarantee of payment once the case has been settled. These arrangements will be made by your attorney and will be separate from any payments or obligations to your health insurer.
What Is Subrogation?
Your health insurer will seek reimbursement for anything that they paid out on your behalf due to the accident. Reimbursement will come from whatever settlement amount you receive, potentially cutting into the compensation you need for full recovery.
Nearly every medical insurance policy will have a clause that states they are entitled to receive reimbursement for care provided for an accident from the at-fault party’s liability insurance. These policies contain language that allows them to seek reimbursement for any amount that they were required to pay on behalf of the accident. If your health insurance is Medicaid, your state will seek reimbursement. Medicare will also seek reimbursement but from a federal level.
Why You Need a Qualified Car Accident Attorney
Although it’s both common and legal for the health insurance company to seek reimbursement payment from your settlement amount, a lawyer can help you find a way to address such claims in a way that is beneficial to you. Your personal injury attorney will explain that there are certain protections available to injury victims from the Subrogation Clause.
Upon reviewing the amount of the debts owed to the private health insurer, and comparing it to other obligations owed by the injury victim and the amount of the settlement, your attorney has the authority to negotiate with the health insurance company to reduce the costs of your medical care.
The insurer can reduce the amount that they will receive for your care by any given amount. The amount taken off the bill will depend on many things, including your future health prognosis from your injury.
As a worst case scenario, your attorney can go before the court and show how the amount the insurance company is demanding from you for your care is harming you and your future. If this occurs, the court has the option to set the amount that you will pay the insurer from your settlement, and the insurer must comply.
Why Does This Have to Be So Complicated?
The entire insurance system is set up to be frustrating and intimidating to the inexperienced person. It was created to prevent people from making claims. By making the process difficult or impossible to manage, people simply give up on the claim before receiving any compensation they are entitled to for their injury or losses.
Getting Legal Help
Your best option to beat this system is to protect your rights as a victim of a personal injury and seek quality legal representation from a knowledgeable attorney. A lawyer can help you effectively communicate with the different insurance companies, to ensure you don’t end up giving away more of your settlement than is fair. Your lawyer can also draft and send important correspondence to insurance and health care providers regarding payment and reimbursement after an auto accident.
By allowing your case to be represented by an experienced accident attorney, you will avoid all the traps and pitfalls of the insurance company and see the best possible results for your case. Schedule your free consultation today to discuss the specifics of your injury claim and insurance obligations.