How Medical Bills Are Paid After a Car Accident
If you’re injured in a car accident, you are initially responsible for your medical bills, no matter who is at fault. Your bills may be covered by your health insurance, auto insurance or out of y our pocket. But there are ways to be reimbursed.
Medical bills from car accident injuries can add up fast. Even an accident that isn’t that severe can be expensive, with ambulance bills, hospital care, outpatient care, prescriptions, therapy and more. There’s also loss of income if you can’t work, childcare if you’re hospitalized and long-term costs if you’re disabled.
Nearly 2.3 million people were injured in auto accidents in 2020; the average bodily injury insurance payout per accident was $20,235, but that’s just what liability insurance paid.
In reality, liability insurance (the coverage for your injuries if the other driver was at fault), are just part of the many ways medical bills are paid for after a car accident.
Your health insurance may cover a lot of your medical costs, but that’s after the deductible. Some auto insurance coverage, like PIP, MedPay and uninsured/underinsured motorist coverage, may pay some of it as well.
If the accident was serious, fault is unclear or the insurance company is denying your claim, you may need a personal injury attorney to sort through the mess, whether it’s just dealing with the insurance company or filing a lawsuit against an insurance company or the other driver.
Who Pays for Medical Bills After a Car Accident?
You are the one who pays your medical bills if you are injured in a car accident. If you have health insurance, your medical expenses should be covered once your deductible is paid, and the insurance company will pay the bills, no matter who is at fault for the accident.
If the other driver is at fault and their liability insurance covers the medical bills, that check will go to your insurance company to reimburse what it paid after the total medical costs are tallied and agreed to. If you had to pay out of pocket, you will get the portion of the check that goes beyond what your insurance paid.
If you live in a no-fault state, you are responsible for your medical bills after an auto accident, no matter who was at fault.
While standard auto insurance doesn’t pay your own medical bills after a car accident, there are options to fill that gap. Personal injury protection (PIP), medical payment coverage (MedPay) and uninsured/underinsured motorist coverage all can pay medical bills after an accident.
Drivers with PIP or MedPay are generally required to use that before their health insurance kicks in to pay medical bills.
PIP insurance, also known as no-fault insurance, pays medical bills from a car accident as well as non-medical expenses, like lost income. It pays no matter who is at fault. PIP pays up to the policy limit. After that, you must pay. Drivers in no-fault states are required to have PIP. In all other states, it’s optional extra coverage.
MedPay is similar to PIP, but only covers medical bills and funeral costs. It usually has a cap of $10,000 or less and helps close the gap between health insurance deductibles and medical costs. MedPay is optional in all states except Maine, where it is required. In New Hampshire, which doesn’t require auto insurance, those who do get insurance are required to get MedPay.
Most health insurance will pay for at least some of the medical bills caused by a car accident. While health insurance exists to pay your costs if you are sick or injured, insurers can deny claims if they believe you don’t have coverage for the injuries or other expenses. Even if the other driver’s liability insurance ultimately must pay, your health insurance is expected to cover your bills and be reimbursed. In no-fault states, health insurance covers what’s left over after PIP coverage. In any state, what you may have to pay out of pocket depends on your deductibles and coverage.
Medicare and Medicaid
Medicare and Medicaid function the same way private health care insurance does in an auto accident, paying for medical costs. The extent of coverage varies based on what type of Medicare coverage you have (Advantage or Supplement). Medicare has deductibles. Medicaid does not.
Uninsured/Underinsured Motorist Coverage
Uninsured/underinsured motorist coverage is an auto insurance option that pays medical bills, lost wages and property damage if you are in an accident with an at-fault driver who is not insured or whose insurance isn’t adequate to cover your medical bills.
Workers compensation will likely cover your medical expenses if you are hurt in an accident while performing your job. Workers compensation doesn’t have deductibles, and it won’t matter who is at fault.
Personal Injury Lawsuit
If your health insurance company is denying your claim, or parts of it, an attorney can help. An attorney can also file a personal injury lawsuit if the other driver is at fault and their insurance company is refusing to pay.
Drivers in no-fault states, can file a lawsuit if their injuries exceed what insurance covered. A personal injury lawsuit can lead to a judgment or car accident settlement that will reimburse your insurance company for what it’s paid, reimburse you, pay for future medical costs and more.
Most personal injury attorneys don’t charge until a settlement is reached or there’s a judgment. Personal injury lawyers know how to navigate insurance issues and the legal system.
How Do Insurance Companies Pay Accident Medical Bills?
Health insurance and auto insurance companies pay medical bills differently, but you do not receive a check for your medical bills from either.
Health insurance pays the bills for injuries and expenses covered by your policy as the bills come in. Your medical provider may submit bills directly to the insurance company, or you may submit them, depending on the provider and the insurance company. You are responsible for deductibles and medical bills that are not covered by your policy.
The insurer may pay the medical bill, may only pay part of it, or may deny your claim, depending on what the bill is for, and your coverage.
PIP and MedPay claims are also submitted to the insurance company, either by you or by the medical provider.
If your injuries are covered by worker’s compensation, the medical provider usually submits the bills directly to your employer’s insurer and you never see them.
If the other driver in your car accident was at fault, has liability insurance and their company has agreed to pay, the insurer won’t directly pay your medical bills. It usually takes time to reach a settlement, and the insurer will reimburse you or your health insurance company for medical expenses, or you if you had to pay anything out of pocket, after the bills are paid.
It can take months, or even years, for the insurance companies to sort out fault, costs and billing after a car accident. A personal injury attorney can help you with the process. Once a judgment or settlement is reached, your insurance company and you are both reimbursed.
How to Submit Medical Bills to Auto Insurance
If you are injured in an accident, let your auto insurance company know as soon as possible. While all auto insurance companies take information by phone, many also take accident claim information online and some even have a mobile app for submitting claims. You have to load the app to use it, but once it does, it has your policy information, numbers to call, information on filing claims, and more.
Find out what your coverage is and, if you have PIP or MedPay, or have to use uninsured/underinsured motorist coverage, how best to submit claims.
However you file the claim, your insurance company will want to know specifics about the accident: who was driving, what happened, the covered vehicle involved, time, location and the other driver’s name and insurance company. They also want a police report.
Once you file a claim, your insurance company will give you a claim number related to your accident.
If another driver was involved, notify their insurance company as well. If you didn’t exchange information at the scene of the accident, the police report should have the other driver’s insurance information.
Keep records of all the expenses related to your injury. The auto insurance company will assign an adjuster to your case, who will ask for medical records, medical bills and proof of other expenses, like lost wages.
How you file claim information, like medical bills, depends on your company. It’s important to file information as soon as you have it, no matter how you do it, and be thorough and accurate to make the process go quickly and smoothly.
How Long Does an Insurance Company Have to Pay a Medical Claim?
How long an insurance company has to pay a medical claim varies, depending on what state you live in. Some states have a deadline – usually 30 days – others just say it has to be paid in a timely manner, or similar wording.
Get treated for your injuries as soon as possible and provide the company with any information and documentation they ask for, and you’ll get paid faster. Some states have a deadline for someone in an accident to file a claim, most of them 30 days, but if you are injured don’t wait to file.
Once you file a claim, the insurance company investigates. Most states have a deadline on how long this can take, usually 30 days or less. The timeline can be complicated by the severity of the injuries, complexity of the investigation, questions about fault, and other factors.
If the company accepts your claim, and the injury is something simple, like a broken arm, the claim is usually paid within a month.
Insurance companies like to pay quickly in order to avoid paying for future medical issues that may crop up. If your injuries are severe and could have a long-term effect on your health and livelihood, don’t rush to sign off on a claim.
A personal injury lawyer can review an insurance settlement for you and make sure you are getting enough compensation to cover all your medical expenses.
- Kasperowicz, L. (2022, January 27) Can Health Insurance Deny a Claim Caused by an Auto Accident? (Claims + Laws). Retrieved from https://www.autoinsurance.org/can-health-insurance-deny-a-claim-that-was-caused-by-an-auto-accident/
- N.A. (2022, March 2) Overview of Motor Vehicle Crashes in 2020. Retrieved from https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/813266
- N.A. (ND) Facts and Statistics: Auto Insurance. Retrieved from https://www.iii.org/fact-statistic/facts-statistics-auto-insurance
- N.A. (ND) What is covered in a basic auto insurance policy? Retrieved from https://www.iii.org/article/what-covered-basic-auto-insurance-policy
- N.A. (ND) When is an Auto Accident Injury Covered by Workers Compensation Insurance? Retrieved from https://www.employers.com/blog/2014/auto-accidents-and-workers-compensation