If I Am Hurt in an Auto Accident, Does My Health Insurance Pay My Medical Bills?

Yes. It is important to always get the treating physicians and doctors to first bill your health insurance company for all bills and expenses related to the collision. Often, the hospital or medical provider will take your health insurance card but not report the claim. They will instead file a medical lien and seek payment against any settlement or verdict you obtain. You do not want this to occur.

Why Do I Want My Health Insurance to Pay My Medical Bills from an Auto Accident?

There are several reasons for wanting your health insurance to pay your bills from an injury suffered in an auto accident or truck collision:
1) The settlement and/or verdict for your injury claim usually will not occur overnight. At a minimum, you don’t want to settle your injury claim until you have fully recovered, to the extent possible, from your injuries. Once you settle, you cannot go back and ask for more money, even if the doctor surprises you with the need for a surgery you were not expecting. For this reason, you need to wait until the end of your treatment to settle your injury claim.

2) It is cheaper for you to let your health insurance pay it. The hospital or medical provider may attempt to charge you much more for the bill than if your health insurance company paid the bill. Your health insurance carrier already has a “contracted rate” set in place with medical provider. This “contracted rate” is always less than the amount actually listed on the bill by the medical provider. If you pay your provider out of the settlement, rather than allowing your health insurance to pay it, the medical provider will attempt to collect 100% of what it billed you – which it almost never collects from anyone else, including self-pay patients.

Do I Have to Pay Back My Health Insurance Carrier Out of My Verdict or Settlement for My Injury Claim?

Sometimes. The answer will depend on what type of health insurance plan you have. If you have a health insurance plan governed by state law, then you generally are not required to reimburse the health insurance from your injury settlement. If you have a health insurance plan governed by federal law (ERISA), then you may be required to reimburse the plan, but again depending on whether the ERISA plan is “insurance backed” or “asset backed.” (A detailed discussion of these issues is beyond the scope of this article.) Part of our job is determine the type of insurance coverage that you have and to advise you on issues like whether you need to pay back your health insurance plan.

Do I Have to Pay Back Medicare or Medicaid for Bills They Paid Related to My Auto Accident?

The answer is a resounding “yes,” but we can help negotiate and reduce the amount you are required to pay back out of your injury settlement.