If you’ve been injured, one of the first things you are going to be thinking about is your medical bills. If you decide to pursue a personal injury claim, the culmination of that process—if you are successful—is that the person, organization or insurance company responsible for your losses will compensate you for your medical bills. But the claim process can take a long time. In the meantime, who is going to pay your immediate medical bills?
There are a number of potential options available to deal with your medical bills while you are waiting on your personal injury claim to resolve. Every case is different, and it is important to take an exhaustive look at all possible options.
PIP Coverage
The first, and most straightforward option applies if you have been in a car accident. State law requires your own auto insurance to provide minimum benefits of up to $15,000 in bills for up to a year. This is called personal injury protection—or “PIP”—and is a no-fault benefit of your policy. Your insurance company will seek reimbursement of the benefits it pays from the insurance company for the other driver, if it is determined that the other driver was at fault.
If you were a pedestrian or cyclist injured by a car or other motor vehicle, then you are entitled to PIP benefits under your own auto policy. If you don’t have an auto policy, then you are entitled to PIP benefits from the insurer for the driver of the car or other vehicle involved in the accident. Coverage is provided on a no-fault basis. In other words, you are entitled to coverage even if you were at fault.
Workers Comp
If PIP coverage isn’t available and you’ve been hurt on the job, you may be entitled to workers compensation benefits.
Health Insurance
If none of those coverages are available, then your own health insurance, if any, will pay your medical bills, subject to the terms and conditions of your policy.
Coverage Provided by the At-Fault Party
The next potential source for paying your medical bills is no-fault insurance coverage purchased by the at-fault party. There are a couple of different coverages that might be available there. The first, as noted above, is PIP, which is available to pedestrians and cyclists injured by a motor vehicle.
The second potential source of benefits is medical payments coverage, know as “med pay.” If you have been injured on property owned by another person, such as a commercial business or a private home, med pay benefits may be available. Trip-and-fall accidents are a type scenarios where the injured person can receive med pay benefits under an insurance policy issued to the property owner. Unfortunately, the policy limits often are relatively low, on the order of $5,000.
Government Assistance
If none of the above options are available, then you need to investigate federal and state medical benefit programs. Eligibility for, and availability of, government benefits is a complex topic beyond the scope of this FAQ.
Open Accounts with Providers
Finally, if you don’t have access to any source of medical benefits to pay your bills while your personal injury claim is pending, some medical providers will agree to “hold” your account. That means the provider not send your bill to collections, provided you agree to pay the provider once your claim is resolved. The willingness of medical providers to hold your account varies greatly from provider to provider. If a provider agrees, they typically will request a “letter of protection” from your attorney. A letter of protection generally says that in the event of a settlement of jury verdict, you agree to pay the provider first, before you receive any compensation.
Reimbursement of Benefits–a Big Surprise to Many
One thing many people do not realize is that even when insurance or other benefits are available to pay their immediate medical bills—whether PIP, workers comp, health insurance or government programs—these entities almost always have a right to get paid back from any settlement or jury verdict in your case.
The right to reimbursement comes as a big surprise to many people. Why should you care about reimbursement? Because your health insurance company–to whom you’ve been paying huge premiums year after year–will seek to get reimbursed for all the payments it has made on your behalf. That means your health insurer will attempt to take some–and in the worst case scenario, all–of your settlement or jury verdict.
One of the important tasks that a personal injury lawyer undertakes is: (1) locating and establishing sources of payment for your medical bills; (2) keeping track of all your bills and any outstanding balances; (3) ensuring that the correct source is paying the bills; and (4) negotiating reimbursement with your health insurer and any other entity that has provided medical benefits on your behalf.
If you have any questions about how to handle payment of your immediate medical bills, feel free to contact us. There is no charge for an initial consultation to discuss your personal injury claim and payment of your immediate medical bills.