When you’re involved in a bad car accident, your first concern should be getting medical treatment for yourself and anyone else who was hurt.
But after the dust settles and the medical bills start rolling in, what’s the next step? Should you submit your bills to your own car insurance company? If you were in an accident that was caused by another driver, shouldn’t their insurance pay all your medical expenses?
While it’s true that the at-fault driver may eventually be responsible to cover a significant portion of your medical costs, it may take months or years to get that money—and in the meantime, bills still need to be paid.
When you’re the one receiving medical services, you (typically through your own insurance) are the one who has to pay up front. Your health care providers may not even know that someone else is at fault for the car accident. (They also can’t know for certain whether you’ll win your claim.)
If you’re successful in a personal injury claim against the at-fault driver, your compensation will include reimbursement for medical expenses. If your health insurance already paid those costs, they’ll be entitled to some of that recovery.
If this also sounds complicated, that’s because it is. We’ll break down the basics in this blog post, but for specific advice about how much money the health insurance company will try to claim, you should talk to an experienced car accident lawyer.
When it comes to Kentucky car accidents, there are several different policies designed to provide coverage for your medical bills. Here is a rough breakdown of how things should work:
First, in Kentucky, your “no fault” personal injury protection (PIP) coverage will cover immediate medical bills and lost wages following a car accident. You can start using it right away, and it covers you even if you caused the accident. However, the policy limit is usually $10,000 (unless you purchased more), which doesn’t go very far and is quickly exhausted if you require more than a minimal amount of medical treatment.
After your PIP coverage has capped out, the at-fault driver’s liability insurance should be responsible for everything up to their policy limits. Then, if that’s still not enough coverage, the next source would be the uninsured and underinsured motorist coverage (UM/UIM) in your own auto insurance policy.
However, this doesn’t mean you should submit your medical bills to the other driver’s auto insurance company (or your own). They won’t help you. In fact, they’re more than happy to use your financial hardship as leverage to get you to accept a lowball settlement offer.
Instead, you need an immediate way to pay your medical bills after a car accident, and for that you should use your own health insurance / Medicaid / Medicare. These will provide health insurance coverage for you, the same way they always have.
Imagine the scenario:
You suffered a car accident injury as a result of another driver’s negligence. Your life has changed, and you call up Karl Truman to talk about your personal injury case. You want the at-fault driver, and their auto insurance, to take responsibility for the pain you have to live with. It sounds like you have a good case, and you expect a fair settlement that reimburses you for medical costs. Your private health insurance company can smell a payout a mile away, and they are already knocking on your door telling you that you owe them money. What?
Here’s what’s going on. Under Kentucky law, there’s a priority order for which insurance policy bears primary responsibility. A very common scenario is the one described above: your PIP coverage first, then the at-fault driver’s liability coverage, then your UM/UIM coverage, and finally your health insurance.
But since your health insurance already paid for the bulk of your medical bills, they’re entitled to get reimbursed out of your personal injury claim settlement. (Your health insurance policy probably says this in the fine print that no one reads.)
There are different mechanisms for how they can get involved in your car accident claim. One of the most common is a subrogation claim. This is when the insurance company submits a claim to your settlement, including all the amounts that they think should be repaid to them from your settlement. When this happens, they get part of the damages awarded to you—before you even receive the money!
This can often have a huge impact on your settlement, particularly if your total medical costs are already higher than what you win from your personal injury settlement. That can happen especially if you’re found partially at fault for the wreck, or if the combined policy limits aren’t high enough. Medical expenses are well-known for being unaffordably high, and that can put quite a dent in the settlement you expected to receive.
A car accident injury lawyer can help you in many ways. One of the most obvious is by helping you get the most money possible out of your car accident settlement. A lawyer can help calculate the true value of your case, including the future medical expenses that you may have to pay for surgeries and/or physical therapy. Omitting these expenses could leave you in a financial bind down the road.
But that’s far from the only benefit of working with an attorney.
While your case is still ongoing, your lawyer can work with your healthcare provider to get them to accept a lien. Under this agreement, the provider agrees to put all collection efforts on hold. In exchange, you agree to pay off the lien from settlement funds before settling other debts and taking the remainder for yourself.
Once the case has been settled, a good lawyer will then go through the healthcare provider’s subrogation claim with a fine-tooth comb. Quite frequently, their reimbursement demands are unreasonable, unfair, or even inaccurate. Your attorney will scrutinize the claim carefully and be sure to remove any charges that not associated with the car accident, medically unnecessary, improperly billed, or otherwise unreasonable. They may even be able to negotiate a lower amount for the overall subrogation claim.
Every time your lawyer successfully reduces this amount with your health care providers, it means more money in your pocket when the case settles.
Medical treatment and medical bills after a car accident can be overwhelming, especially if you are not able to pay. Karl Truman Law Office is here to fight for you, and help you figure out how to stay afloat financially while you wait for the at-fault driver to take responsibility for their actions.
It it tough to hear that your own insurance company wants a cut of your settlement money, but Karl Truman will go the extra mile to negotiate with the insurance provider on your behalf. We want to see more money in your pocket, and we’ll do whatever we can to make it happen.
For a free consultation with our Louisville, Kentucky office, call (502) 222-2222 and for Jeffersonville, Indiana, call (812) 282-8500. You can always fill out our online contact form. We will compassionately fight to make sure you receive fair treatment after your life-changing accident.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.