Understanding Auto Accident Medical Insurance Coverage

If you've been in a car accident, you might be wondering how you're going to pay for any resulting medical treatment. The short answer is that, yes, you should use your health insurance to cover these costs, regardless of who was at fault. This is the best way to ensure you get the medical care you need without delay. Your health is the top priority, and your insurance is there to help cover your treatment costs.

It's important to note that insurance companies do not pay car accident medical bills directly to the hospital or doctors. Instead, they pay the claimant once a settlement has been reached, which could take months or even years. In the meantime, you are generally responsible for making sure your medical bills are paid. This is where your health insurance comes in.

When to use auto insurance vs. health insurance

Whether you use your auto or health insurance after a car accident depends on your current coverage levels and location. If your car insurance policy covers any medical expenses, this will usually take priority over your health insurance. However, it's important to have both types of insurance coverage.

Auto Insurance Coverage

Auto insurance coverage that can help with medical bills includes:

• Medical payments coverage (MedPay): This is available in most states and is required for drivers in Maine and those in New Hampshire who purchase insurance. MedPay covers injuries to you and your passengers in an accident, regardless of who is at fault. It also covers injuries you suffer while riding in someone else’s car, or if you’re hit by a car as a pedestrian or cyclist. In some states, MedPay can cover your health insurance deductible and help with co-pays, as well as dental and chiropractic services. However, MedPay coverage usually has low limits, often $10,000 or less.
• Personal injury protection ( PIP): PIP is required in about a dozen states and is offered in about ten others. Like MedPay, it covers you and your passengers in an accident, regardless of who is at fault, and it covers you when you’re in another person’s car, bicycling or on foot. Although it tends to be more expensive than MedPay, it typically has higher coverage limits and often includes things your health insurance might not, like lost wages, childcare services, and funeral costs.
• Uninsured/underinsured motorist bodily injury coverage ( UM/UIM): If you’re injured by another driver who doesn’t have car insurance or has only the minimum required liability coverage, UM/UIM will pay for medical expenses for you and your passengers. In some states, you can also get UM/UIM property damage coverage, which pays for repairs to your car if it’s hit by a driver with no insurance or insufficient coverage.

Health Insurance Coverage

If you don't have auto insurance coverage for your medical expenses, your health insurance will usually cover your car accident injuries. However, there are usually some restrictions:

• Your health insurance may be considered “secondary” if you're injured in a car accident and there's other "primary" insurance available to cover your injuries (i.e., your own car insurance coverage or the other driver's). In this case, you would use your car insurance coverage first, and if this isn't enough, your health insurance would pay for the remainder of your care.
• Your health insurance may have in-network or out-of-network distinctions when it comes to care providers, or similar restrictions on what's covered.
• Certain kinds of treatment you receive in connection with your car accident injuries might not be covered under your health insurance, including alternative forms of treatment.

No-Fault States

Certain "no-fault" states have regulations governing the relationship between health and car insurance after an accident. In these states, each driver must cover their own medical payments after an accident via medical payments (Med Pay) or personal injury protection (PIP) coverage.

How to submit medical bills to auto insurance

If you've been injured in a car accident, it's important to get treated by a medical professional as soon as possible. If you have health insurance, you should use it to cover your medical treatment. This will ensure you get the treatment you need when you need it, and it will be more affordable. It's also the best way to ensure that you don't end up in debt while you wait for a payout from your auto insurance company.

Step 1: Get Treated Using Your Health Insurance

If you've been injured in a car accident, don't delay getting medical treatment. Use your health insurance to cover the cost of treatment. This will ensure that you get the care you need when you need it, and it will be more affordable. It's also the best way to ensure that you don't end up in debt while you wait for a payout from your auto insurance company.

Step 2: Submit Your Medical Bills to the Auto Insurance Company

Get in touch with the relevant auto insurance companies and inform them about the accident as soon as possible. Keep a record of any medical treatment you receive related to the car accident. If another driver was at fault, their insurance company may cover your medical bills. In some cases, your own auto insurance may cover medical bills if you have "medical expense payments" or "med-pay" coverage. To start this process, call your insurance provider and tell them about the accident. They will give you a claim number that you can use when submitting your medical bills.

Step 3: Work with the Adjuster

Provide the insurance adjuster handling your auto accident claim with all the necessary bills and records. They will review the paperwork and ask for additional information if needed. The adjuster will then decide to fully or partially reimburse the appropriate party or deny the claim.

Step 4: Receive a Payout

Once your medical treatment is complete and you have submitted your medical bills to the auto insurance company, you may receive a payout. Depending on the circumstances, it could take months or even years to receive this payout. In some cases, you may need to reimburse your health insurance provider after receiving the payout. However, as medical insurers receive discounted rates, you will still pay less for your medical care than if you hadn't used your health insurance.

What to do if the insurance company does not contact you

If you've been in a car accident, it's important to contact your insurance company, regardless of who was at fault. However, if the other driver was at fault, they are expected to contact their insurance company, and you may be unsure of what to do if they don't. Here's what you can do if the at-fault driver doesn't contact their insurance company:

Get Their Insurance Information

Firstly, try to get the other driver's insurance information. If you don't have it, you can try to get a copy of the police report, which may contain the name of the other driver's insurance company. Alternatively, if you have a copy of the other driver's details, you can contact them to ask for their insurance information.

Contact Your Own Insurance Company

Provide your insurance company with the other driver's details and insurance information, if you have them. Your insurance company may then be able to contact the other driver's insurance company directly.

Get a "Declarations Page"

If you are unable to get the other driver's insurance information, ask your insurance company for a "declarations page", which will show the extent of your coverage. This will help you understand your options and whether your coverage will be enough to fix your damages and pay any medical bills.

Contact a Lawyer

If your coverage is insufficient, or you are unable to contact the other driver or their insurance company, you should consider hiring a lawyer to help you with your case. A lawyer can help you navigate the claims process and ensure your rights are protected. They can also deal with the other driver's insurance company on your behalf.

File a Claim with Your Own Insurance Company

Even if you are not at fault, you can file a claim with your own insurance company for payment of damages and injuries if you have the right coverages. If you have collision insurance, you can file a claim with your carrier, who will pay for the cost of repairs or the total loss of your vehicle. If the other driver is uninsured and you have uninsured motorist coverage, you can file a claim for your vehicle's damage.

Take Legal Action

If the other driver's insurance company refuses to pay, you may need to take legal action. Consult with a lawyer to discuss your options and gather the necessary evidence to support your claim.

Remember, it's important to act promptly and gather as much information as possible after a car accident to protect yourself financially. Exchange insurance information with the other driver, take photos of the accident scene, and, if necessary, file a police report.

How to respond to a subrogation letter

If you've been in a car accident and have sustained injuries, your health insurance will likely cover your medical costs. However, if you have car insurance with medical coverage, this might be a better option as it could save you money and hassle.

If you receive a subrogation letter, it will be some time after the accident. A subrogation letter is a notice from your insurance company requesting details about the accident and your injuries. They want to know if there was a third party involved, if your accident was work-related, and the name of the insurance company/adjuster for the at-fault party. They will also ask whether you have an attorney and request their contact information.

• Contact a lawyer: It is highly recommended to consult a lawyer, especially if you are considering suing the at-fault driver or if you plan to file a personal injury claim. A lawyer can help you understand your rights and protect your interests.
• Read the letter carefully: Understand what the insurance company is asking for and what their intentions are. You are legally obligated to cooperate with them, but be mindful of providing too much information.
• Respond to the letter: Even though you are not required to respond, doing so will keep you prepared for any potential legal proceedings. If you have car insurance, it is advisable to respond and provide your carrier with the details of the accident. This will facilitate a smoother process.
• Negotiate a settlement: If a subrogation claim has been filed against you, consider negotiating a settlement out of court. This can save both parties the costs associated with litigation, and you may be able to pay less than what the insurance company is asking for.
• Waiver of subrogation: A waiver of subrogation is an agreement between parties to waive any subrogation with regards to a particular claim. This occurs when you and the other driver involved decide to settle directly. However, many insurance companies do not allow their clients to sign such waivers and require prior notification.
• Check your insurance policy: Review your insurance policy to understand if and how subrogation is allowed. In some states, subrogation is restricted or prohibited by law.
• Request a reduction in financial obligation: You may be able to request that your attorney's fees be deducted from the reimbursement claim, especially if your health plan does not state that attorney's fees are not covered.

Remember, the most important thing is to ensure you get the medical care you need. If you've been injured in an accident, seek treatment first and then address the financial and legal aspects.

What to do at the scene of an accident

Being in a car accident can be stressful and scary, but knowing what to do ahead of time can help you stay calm and collected at the scene. Here is a list of things to do if you ever find yourself in such a situation:

• Park your car at a safe distance: If you come across a car accident and wish to help, make sure to park your car at a safe distance from the crash site. A minimum distance of 100 feet is recommended to allow emergency vehicles to reach the scene and to keep yourself out of harm's way.
• Call 911: Alert the police or highway patrol, especially if anyone is hurt. Provide specific details about the accident, such as the location, the number of people involved, the severity of the injuries, and any other relevant information. If another witness arrives simultaneously, ask them to call 911 while you assist those involved in the accident.
• Help victims who need it: If it is safe to do so, approach the scene and assist the individuals involved. Do not move any of the victims unless they are in immediate danger. Unless you are professionally trained, do not attempt to treat any injuries. Instead, focus on keeping them calm and reassured until help arrives.
• Make the scene safe: If you are involved in a minor accident and are not injured, carefully drive your car to the side of the road and turn on your hazard lights. Set up flares or reflective emergency triangles to alert other drivers to slow down and change lanes, following the Move Over law. If the accident is more severe or someone is hurt, leave the vehicles where they are to avoid causing further injury.
• Assess injuries: Your first priority is to ensure everyone's safety. Check if anyone is hurt and get medical assistance if needed. Call 911 if there are any injuries, and tend to those who require immediate attention.
• Collect information: Gather important information, such as the names, addresses, phone numbers, and driver's license numbers of everyone involved in the accident. Obtain vehicle information, including the year, make, model, color, license plate number, and vehicle identification number. Exchange insurance information, including policy numbers and company contact details. If there are witnesses, get their contact information and ask them to describe what they saw.
• Document the scene: Use your smartphone to take pictures and videos of the accident scene, capturing details such as the position of the cars, skid marks, property damage, and any relevant road signs or signals. Record the date, time, weather conditions, and street names, as well as the direction each vehicle was heading before and after the accident.
• File an accident report: Even if the police cannot come to the scene, file an incident report with the nearest police department or on their website. Having an official report can protect you in case of legal proceedings or insurance claims.
• Notify your insurance company: Contact your insurance provider as soon as possible to initiate the claims process. The longer you wait, the harder it may be to recall important details.

Frequently asked questions