Using Health Insurance for Personal Injuries

Many personal injury claims stem from a car accident. When one person hits another while they are driving, chances are that the collision could have been avoided and an element of negligence was at play. If the victim is injured, they may need treatment to recover from the impact of the accident. The inevitable question is, how do they pay for it?

Because Florida is a no-fault state, vehicle owners are required to have insurance coverages that protect themselves in case they are hurt in an accident without regard to who is at fault. These coverages include $10,000 in personal injury protection and $10,000 in property damage. If you need medical treatment or reimbursement for income you lose because of the accident, personal injury protection (P.I.P.) may pay for it. Out of state drivers may not have these coverages. 

When to Use Health Insurance

You'd think that if you have a problem with your health because of a car accident that health insurance might pay for it. Well, that's possible too. Drivers who need treatment may be able to get treatment benefits under their health insurance policy. If you choose to use your health insurance benefits after reviewing the pros and cons with an accident attorney, make sure you choose a doctor that accepts your insurance. Let the doctor or hospital know your car insurance and health insurance information if this is the case. Although they bill PIP first, some policies only pay 80% of your coverages. For example, you may have a policy with $10,000 in PIP. Suppose you need $10,000 in treatment, but the insurance company will only pay $8,000 of that balance. The patient is on the hook for the extra $2,000. That may be too much for you to pay out of pocket, so having health insurance to absorb that extra cost might be essential.

Aside from paying for treatment, your insurance policy can help reimburse you for the wages you lose while you're recovering. Coordinating your insurance policies is important if you want to get wage benefits because when one policy's coverage runs out, that's it. Health insurance will only pay for health-related expenses, but PIP pays wage benefits also. If you want to claim benefits to help make up for the income you lose after an accident, notify your car insurance company. They can reserve a portion of your benefits before they are all taken for medical treatment.

When Not to Use Health Insurance

Now comes the natural followup question: what if a car accident victim doesn't have health insurance, Medicare, or Medicaid? If you don't have health insurance, you may have to hunt for a doctor's office that is willing to take a patient without this form of financial backing. Even if you do have insurance, it's possible that the doctor who doesn't accept your health insurance is the best one to treat your injuries. 

When your case is getting ready to settle, some of the proceeds may need to go towards paying back insurance companies. If any of your medical bills were paid by health insurance or medical payments coverage, you may have to reimburse them from your settlement. Payments from your personal injury protection coverage wouldn't need to be reimbursed. If you have any amount left over that you owe to a hospital or doctor's office, it's called a lien.

Paying Back through Settlement

Some attorneys advise their clients not to submit their bills to health insurance or medicare because they find it more difficult to pay back the insurance company than to work with a doctor's office in getting bills paid. The trade off is that health insurance and medicare pay bills at a discounted rate. Depending on your bills, your net recovery can be higher if the amount you need to repay is less than what a lien would be.

As you can see, you have a choice to make when it come to how you apply your insurance coverages following a car accident. A car accident may cause serious injuries, which may need extensive treatment. Injured drivers may not be able to pay for all of these costs out of pocket. Talking to a car accident lawyer as soon as possible can help you maximize your benefits and speed up recovery. 

  • Call 407.648.4940 or contact Coye Law Firm today for a free consultation about your case.

The expert injury attorneys at Coye Law Firm are experienced with Florida, New York, Michigan, and District of Columbia law and are here to help the injured.

If you'd like to learn more about injury law and your rights, read my book, Sharing the Secrets, Learning the Lies: A Guide to Florida Personal Injury

From this book you will learn… 

  1. The ONE THING you must do within 14 days of your accident (page 46)
  2. The two most important factors in determining case value (page 8)
  3. How to understand what your insurance will and will not cover (chapter 3)
  4. 6 critical steps you must take after an accident (chapter 7)
  5. Why you should not trust the insurance company’s repair shop (page 78)
  6. How to choose the right doctor (chapter 5)
  7. A claim you could make against your own insurance company if your car is damaged, but not totaled (page 87)
  8. The secrets to getting a fair settlement (chapter 10)
  9. An 8-step breakdown of the normal process for lawsuits (page 121)
  10. The one 4-letter word that might cost you (chapter 12)
  11. How to start gathering the most important evidence you need (page 75)
  12. …and more!

Click here to receive your FREE copy now.