Will Your Health Insurance Cover Injuries from a Georgia Car Accident?
This Georgia legal guide explains how health insurance may pay your medical bills after a car accident and until your injury case settles.
Key Points:
- If you are pursuing a personal injury case after a car accident in Georgia, it is essential to understand how your medical insurance plan covers expenses related to the accident.
- Regardless of fault in an auto accident, most private healthcare policies or plans cover car accident-related medical expenses.
- Even if you do not have medical insurance, there are still options available to you.
- Be aware that your insurance company may seek reimbursement, a process where they ask for repayment of the medical expenses they covered once you receive a settlement. There are various strategies to retain the majority, if not all, of your settlement funds, and a personal injury lawyer can help you navigate this complex process.
In the aftermath of a car accident in Georgia, it’s natural to have questions about your finances. Since car accidents are uncommon, you might not fully understand who pays for what – especially if you are insured with health and auto insurance separately. You’ve probably given your health insurance information to medical personnel but may now wonder if that even matters since the injury was caused by a car accident. Here, we break it down for you.
Table of Contents
If I'm Not At-Fault for the Car Accident....
Will My Health Insurance Company Pay for My Medical Expenses Due to a Car Accident?
Yes, your health insurance company will most likely pay your medical bills according to the terms of your insurance policy. In Georgia, your medical insurance pays first and may be reimbursed later from your settlement or verdict, which is called insurance subrogation. Whether an insurance company may enforce subrogation depends on the type of policy you have.
Although it may sound unfair, this can be to your benefit to prevent the at-fault driver’s insurer from deciding upon your medical care. All good personal injury lawyers will review the type of health insurance policy you have and determine how much, if anything, a health insurance plan is entitled to receive. In most cases, the money that is reduced or avoided from a health insurance lien is money that the accident victim may keep.
Will My Auto Insurance Pay for the Medical Bills for an Accident That Wasn't My Fault?
If you were involved in an accident that was not your fault, your auto insurance will seek to avoid paying for your medical bills, and will rely on the at-fault drivers insurance company to cover all of the expenses. The at-fault drivers bodily injury liability (BIL) should cover it, if they do not dispute fault. Even then they will likely not pay the full amount. If that happens you should file a legal claim with the help of a car accident lawyer and work towards a settlement that gets all the expenses covered.
If the at-fault driver has no insurance and you have UIM coverage, your auto insurance company will most likely cover the medical bill.
If you have MedPay coverage, Medpay will often pay for the medical expenses regardless of who is at-fault.
Should I Provide My Health Insurance Information at the Hospital and to My Doctors?
Yes! If you visit a hospital and doctors after a car accident, you should provide your private medical insurance information. It is essential to note that hospitals typically ask for your health insurance information first, but they may also inquire about your auto insurance depending on the circumstances.
As attorneys representing accident victims, we are often asked, “Why should I use my own insurance for an accident that was not my fault?” This is a great question with two simple answers.
- You paid for your health coverage for this exact reason. The alternative is not getting the medical care you need, and this can be much worse for your health and your legal claim.
- Depending on the type of policy you hold, your insurance may eventually be repaid by the at-fault driver.
Not using your own medical insurance to pay for care after a Georgia accident can be an expensive mistake. You or your attorney must make sure that your bills are submitted to your medical insurance carrier. This will ensure the bills are paid immediately and that your bills will not be transferred to a collection agency while you are waiting for a settlement.
Does Using Health Insurance Limit My Potential Car Accident Settlement?
Using health insurance will not directly limit your potential settlement, but health insurance companies can seek out reimbursement from the settlement to cover any expenses they paid. Additionally, if your company paid your medical bills on your behalf, they will likely seek to have those expenses covered using any money from the settlement.
Will My Health Insurance Company Dispute the Car Accident Medical Bills and Subrogate?
Subrogation is a process in which your health insurance company tries to recover the costs it paid for your medical treatment from the at-fault driver's insurance company. While your health insurance company can help cover your immediate medical expenses, they have a right to be reimbursed if someone else is responsible for the accident.
Do I Have to Reimburse My Health Insurance Company Once the At-Fault Defendant Pays My Medical Bills?
Depending on your specific health insurance plan, your health insurance company may be entitled to reimbursement in certain circumstances. While the at-fault driver, usually through an automobile insurance company, must ultimately reimburse your medical bills, in Georgia they do not have to pay immediately or as you incur the bills.
The good news, however, is that when your case settles or reaches a judgment, you are entitled to be reimbursed for both your own out-of-pocket expenses, such as copays or deductibles, and the costs paid by your medical insurance carrier.
Can My Health Insurer Recover Money from My Car Accident Settlement?
If your health insurer covered the expenses of your medical bills while you were waiting for your car insurance payout or car accident settlement, they can recover money to recoup the costs of your medical treatments.
If you provide the hospital with your private medical insurance, they will likely send the medical bills directly to your health insurance company; in turn, your insurance company will send you a copy of the statements detailing what the insurance paid and any costs you may be responsible for covering. Additionally, first-care providers such as ambulances or hospital emergency rooms may not require immediate payment, unless you refuse to provide insurance information.
If you have received a bill from the hospital or ambulance, this bill should be sent to your medical insurance company as soon as possible. If you have a personal injury lawyer, you may give the law office your bill and ask that the attorney submit the bill to insurance. Failing to submit the bill to insurance can result in you being personally responsible for the payment.
After a car accident injury, hospitals sometimes refuse to submit the bill to your health insurance company. While this is rare, hospitals may refuse to submit the bill to your health insurance company, believing they can charge a higher 'retail' rate due to your injury from a negligent driver, rather than the discounted rate negotiated with the insurer. However, under the contract the hospital has with most insurance companies they are legally required to bill your medical insurance company.
If this happens to you, here’s what you need to do:
Send the bill back to the hospital with a copy of your insurance card or policy.
Insist that the hospital bill your insurance company.
Contact a car accident personal injury attorney if the hospital still refuses to bill your insurance company.
If your health insurance company is refusing to pay bills related to a car accident where you weren’t at fault, you should first review your policy to make sure there aren’t any hidden exceptions that would prevent you from receiving coverage. Here are the next steps you should take:
Follow your insurer’s internal appeals process, which may vary by company, to your advantage. Your insurer may just be looking for additional information.
The Georgia Department of Insurance can provide you with assistance should the appeals process also fail. They may be able to help you with your dispute with the insurance company.
Attempt to file a claim with the at-fault driver’s car insurance company. Because Georgia is an at-fault state, car insurance carriers of at-fault drivers are required to provide coverage to the victim.
If all previous attempts fail, or if you need additional guidance through the various avenues you can pursue to get insurance coverage, consider connecting with an attorney.
Yes. If you have Medicaid or Medicare, you should notify the doctor or hospital, and you should be covered for your care and treatment. If you are not already on Medicaid, you may contact Georgia Medicaid to see if you can qualify for either Medicare or Medicaid. If you use Medicaid or Medicare to pay any part of your personal injury medical bills, contact an attorney immediately for help and advice.
After your car accident, if you used your health insurance for any doctor or hospital visits, your coverage likely paid for the related medical care you received. If you do not move forward with or win a lawsuit, then you will usually not be required to pay these costs back. However, if you do receive a settlement or judgment in your favor that is meant to compensate you for medical bills, your health insurance may be entitled to reimbursement.
It is worth knowing that in the State of Georgia, not all health insurance plans have an enforceable right to be reimbursed. You should have your plan reviewed by a personal injury lawyer to learn whether you must reimburse your insurance company.
If you've been injured in a car accident, an insurance adjuster from the at-fault driver's insurance company may meet with you to review the details of your case. While it may seem like the adjuster is there to help, remember, their goal is to minimize the amount they pay out in settlements.
Sometimes, adjusters will offer to cover medical bills quickly, but this may be well before you know the extent of your injuries. Be aware, when you sign a settlement agreement, you usually waive your rights to additional compensation.If you have already accepted a settlement and later incur additional medical bills, you are unlikely to receive more compensation from the at-fault party. This is one of the reasons it is so important to speak to an experienced personal injury attorney before accepting any settlement offer.
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