This Georgia legal guide explains how health insurance may pay your medical bills after a car accident and until your injury case settles.
- Understanding how your medical insurance plan covers expenses following a car or truck accident is crucial for a favorable outcome in your injury case.
- Most private healthcare policies or plans cover car accident-related medical expenses, irrespective of who is at fault.
- Even if you don’t have medical insurance, there are still options available to you.
- Be aware that your insurance company may seek reimbursement. Discover strategies to retain the majority, if not all, of your settlement funds.
In the aftermath of a car accident in Georgia, it’s natural to feel overwhelmed and concerned about the financial implications of your medical expenses. Two of the most common ways to cover these costs are through your health insurance or auto insurance policies, but understanding which to use can be a confusing task. Both options come with their own set of pros and cons, which will significantly impact your finances and compensation for the accident.
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. Although it may sound unfair, this can be to your benefit. Do you really want the insurance company for the at-fault driver deciding what medical care you deserve? We don’t think so either.
If you later receive a settlement or judgment against the other driver, then your health insurance provider may ask you to reimburse them for the costs they covered. This is called insurance subrogation. Whether an insurance company may enforce subrogation depends on the type of policy you have.
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’re involved in an accident that wasn’t your fault, your auto insurance may still cover your medical bills, depending on your policy. Typically, bodily Injury liability (BIL) or medical payments (MedPay) coverage pays for your medical expenses, regardless of who was at fault for the accident.
If the at-fault driver has no insurance, and you have UIM coverage. Your auto insurance company will most likely cover the medical bill expense.
It’s important to note that at hospitals they will not ask for your auto insurance. They will ask for your health insurance.
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.
As attorneys who represent accident victims, we are often asked “why should I use my own insurance for an accident that was not my fault – it seems unfair?” This is a great question with two simple answers.
First – You paid for your health coverage for this exact reason. The alternative is not getting the medical care you need, and can be much worse for your health and your legal claim. Secondly – 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 collection agency while you are waiting for a 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. If you believe you may have to pay back your health insurance provider or receive a request for reimbursement, then contact an attorney to review your plan policy.
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 general rule in Georgia is that the at-fault driver and his or her insurance company do not pay your bills on an ongoing or as-incurred basis. Instead, you must pay for, or find a way to cover, your medical costs to be reimbursed later by the other driver’s insurance company.
At this point, assuming that the crash that injured you was not your fault, you may be worried or upset. After all, why should you have to pay to get medical care for an accident that some careless or negligent driver caused? Unfortunately, what you need to know is that in Georgia, it is your responsibility to obtain medical care.
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 co-pays or deductibles, and the costs paid by your medical insurance carrier.
If you give the hospital your private medical insurance, they will most likely send the medical bills directly to your health insurance company. Your insurance company will then send you a copy of the statements, what the insurance paid, and any cost 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. Medical providers will work with you to provide the care you need and then bill your insurance company.
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. Doing nothing can result in you owing the bill personally. Your health insurance plan will then deal with the emergency room, doctor or ambulance company.
After a car accident injury, hospitals sometime refuse to submit the bill to your health insurance company. While this is rare, hospitals generally do this out of greed, because they believe that because you were injured by a negligent driver, they can bill you at a higher “retail” rate, instead of the discounted or contract rate they have already negotiated with the health 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, we suggest that when you receive a copy of the hospital bill, send the bill back to the hospital with a copy of your insurance card or policy and insist that the hospital bill your insurance company. If the hospital still refuses to bill your insurance company, contact a car accident personal injury attorney.
When Will Georgia Medical Payments Coverage (Med Pay) Under A Car Insurance Policy Cover My Medical Bills?
If your car insurance policy includes medical payments coverage, it will usually pay your medical expenses up to a certain amount, regardless of whether you were at fault.
Medical Payments Insurance coverage is an optional benefit that you can purchase, usually it is fairly inexpensive, often costing only $10.00 to $20.00 per month. Med Pay covers you and your passengers up to a certain amount if you or they are hurt in an accident.
Many Georgia residents do not know whether they have med-pay coverage. The fact that your agent told you that you have “full coverage,” does not always mean you are fully covered or have MedPay. We recommend you check your insurance card, call your insurance agent and have your coverages reviewed by your personal injury law firm.
If you have medical payments coverage on your car insurance policy, your health insurance provider will generally be responsible for medical expenses above the limit of your med-pay coverage.
In Georgia, Med Pay coverage is generally sold in certain limits, often $2,000, $5,000 or $10,000. Although, we have seen medical payments coverage as high as $50,000 or $100,000. MedPay also usually does not have a deductible (a payment amount that must be met before health insurance pays).
If you have med-pay coverage, we recommend giving that coverage information to the hospital or the doctor, along with you health insurance plan information. Medical Payments coverage can be used for a wide-variety of expenses, including ambulance bills, emergency room costs, chiropractic and physical therapy, at-home therapy, and more.
Finally, some people are afraid to use their MedPay coverage out of fear that it may raise their auto insurance rates. This is a fallacy. Georgia prohibits car insurance companies from raising your premium or canceling your coverage if you were not at fault in the collision. O.C.G.A. 33-24-45.
Can Medicaid or Medicare Pay My Medical Expenses After a Car Accident?
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.
One thing to know is that if you do receive a settlement or judgment in your favor, you may be required to repay Medicaid or Medicare for the medical portion of your recovery. Rarely, however, do Medicaid or Medicare pay the full retail value of the medical care and their liens may also be negotiable. If you Medicaid or Medicare pay any part of your personal injury medical bills, contact an attorney immediately for help and advice.
If I Win a Settlement or Judgement That Includes Medical Reimbursement, Do I Get to Keep the Money?
After your car accident, if you provided your health insurance at any doctor or hospital visits, then 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.
Does The State of Georgia Have PIP?
The State of Georgia does not require PIP (personal injury protection) on automobile insurance policies.
PIP protection is a type of “no-fault” insurance coverage that was in place at one time in Georgia. No-fault insurance provides medical coverage regardless of which driver was at fault for an accident. PIP coverage may be available from certain insurance companies and may be worth asking your insurance agent about.
What If I Have No Medical Insurance?
In Georgia, if you do not have health insurance it is still your responsibility to find a way to pay for needed medical care following an accident. If you have no medical insurance, do not qualify for Medicare and do not have Med-Pay Coverage, you may still have options.
Some doctors or clinics may agree to treat you on a medical lien, meaning that you may sign an agreement to repay the care provider when your case settles or reaches a verdict. Other medical clinics may agree to treat you on a payment plan or using medical-legal funding.
You may also wish to contact a good well-established personal injury law firm. An experienced personal injury attorney may help explore your options to receive medical care while you recover and your injury claim is open. The fact that you do not have medical insurance may not keep you from receiving the medical treatment you need.
What Happens If I Receive More Medical Bills After I Accept a Settlement?
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, it is their job to get you to agree to settle for as little money as possible.
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 related to your injury, it is unlikely you will be able to get more money 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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