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How a medical payment is disbursed following an auto accident is contingent on various factors. Some of these factors include how the insurance provider pays out medical coverage, who is responsible for paying the payments, and whether the case was settled in or out of court.
Regardless of the situation, you will typically be reimbursed for medical payments through some form of insurance.
The payment disbursement from the insurance will vary by the type. If you sue the at-fault party, you will receive medical payments from the ensuing settlement.
Receiving medical payment disbursement after a car collision can be a complex matter. Working with an experienced personal injury attorney is the best way to ensure you get maximum coverage for your medical expenses.
Who is responsible for paying for a car accident victim’s medical bills following a collision will depend on the state you live in. If you live in an at-fault state, the at-fault driver’s insurance policy will cover your medical expenses.
In no-fault states, your own insurance company provides coverage for medical treatment and expenses.
The driver who was responsible for the accident will typically be held liable for accident victims’ medical expenses via their auto insurance company policy.
However, how much you receive from the at-fault party’s insurance will depend on their specific insurance coverage and limit.
For example, if the at-fault driver has a $10,000 medical expenses cap, this means their insurance company will only pay out $10,000 in medical expenses to victims. In this case, the at-fault driver may have to pay out of pocket or you may choose to sue them.
In a no-fault state, every driver is required to carry personal injury protection coverage, or PIP. This coverage is part of your auto insurance policy and covers medical costs and medical care should you need it following a crash.
Examples of how your medical costs may be covered in a no-fault state include:
If you were driving your or a company’s vehicle while on the job when injured in an accident, your company may be required to pay your medical bills through its workers’ compensation insurance.
It’s important to note that in order to receive workers’ compensation, your injury must be considered work related. This means that you must prove you were performing on-the-job duties when the accident and resulting injuries occurred.
The specific rule surrounding workers’ compensation personal injury claims will vary from state to state.
Examples of on-the-job driving activities involving driving that may qualify for workers’ compensation include:
If you’ve been injured in an accident while working, work with your car accident attorney to determine if workers’ compensation can pay for your medical expenses.
If you live in a no-fault state and are injured in an auto accident, services provided by medical providers may be covered by health insurance. This is typically true if you possess private health coverage and have set up a coordination of injury benefits with your insurance company.
When coordinated with your auto insurance, your health insurance will be used first to cover services by medical providers. You may still be responsible for any co-pays, deductibles, or other out-of-pocket expenses typical of health insurance.
If your health insurance becomes maxed out, your auto insurance would then begin to pay for any medical expenses up to your policy limit.
In no-fault states, it’s common for auto insurance to not provide coverage for medical bills in personal injury cases. However, if insurance should pay but refuses, you can work with your personal injury lawyer to determine if taking the company to court is the right choice.
What’s more, if the at-fault party responsible for the accident is uninsured, you likely won’t receive payment for medical bills from them. You may choose to sue the at-fault party in this case for the amount of your medical expenses.
There are a few key steps that must be followed when seeking coverage for medical bills from a car accident lawsuit settlement.
These steps typically include:
How medical payments are disbursed will depend on the type of insurance you have and the state you live in. The following is a general overview of various payment types and how they may be disbursed.
In a fault state, the at-fault driver’s insurance will typically provide coverage for medical payments for accident victims. This often happens after you file a personal injury or accident claim with their insurance company and the claim is fully processed.
You will have to provide evidence of your injuries and proof of medical expenses. Your attorney can help you gather this evidence to include with your insurance claim.
In a no-fault state, your own insurance will likely distribute compensation for medical payments via your personal injury protection coverage or MedPay coverage. Similar to fault states, you will still need to file an insurance claim. However, you’ll be filing it with your personal auto insurance provider.
The timeframe of when you can expect payment will depend on how quickly your insurance company processes and approves your claim.
Medical payments through workers’ compensation are distributed after you or your employer file a claim through the employer’s workers’ compensation insurance and it is approved. Your payout will typically come within two to four weeks of filing this claim, but it can vary.
Whether you have private insurance or public insurance such as Medicare will determine when and if you receive medical payments from health insurance.
When you see a provider, they will typically ask for both your health and auto insurance policies. Depending on the type of auto insurance you have, your health insurance may provide coverage first, which is usually done directly to the provider’s office. This means you will only be responsible for out-of-pocket expenses like copays.
Medical payment disbursements from lawsuit settlements are highly dependent on how long the lawsuit lasts and how it’s settled, e.g. outside of or in court.
If you don’t pay your medical bills as a result of either waiting for insurance to cover them or an inability to pay, you run the risk of being sent to collections by the medical provider. This can result in a negative impact on your credit.
To prevent collections for car accident medical bills, follow these steps:
Consulting a lawyer is always a good idea when it comes to seeking reimbursement for medical bills for an auto accident injury.
This is especially true in the following instances:
For best results, contact a car accident attorney as soon as you are able following a car accident or as soon as you run into one of the problems mentioned above or others.
If you’ve been injured in a car accident and need help getting medical bills for those injuries paid, don’t wait to find a personal injury lawyer who can help you.
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Published: 19 March 2024
Bankrate. “What does no-fault state mean?” Retrieved from: https://www.bankrate.com/insurance/car/fault-vs-no-fault-accidents/
Medicare. “Workers’ compensation and payments.” Retrieved from: https://www.medicare.gov/supplements-other-insurance/how-medicare-works-with-other-insurance/workers-compensation-and-payments.
Progressive. “Does health insurance cover car accident injuries?” Retrieved from: https://www.progressive.com/answers/health-insurance-cover-car-accident-injuries/.
