CAR CRASH NETWORK

Who Pays For Medical Bills When You Treat A Car Crash Victim?

car crash victim wonders who pays medical bills

When you treat car crash victims who suffer accident-related injuries, such patients' car insurance coverage will compensate you (the medical provider) at a reasonable billing rate for all necessary treatment, even if such rate is greater than the rate you agreed to accept from the same patients' private or public health insurance.

When you treat car crash victims not in the scope of employment, you can maximize your compensation if you understand how to coordinate the following types of medical coverage: (1) car insurance's personal injury protection ("PIP") coverage; (2) car insurance's medical payments coverage ("MedPay"); (3) private health insurance coverage ("health"); and (4) car insurance's bodily injury coverage, uninsured motorist coverage, or underinsured motorist coverage.

When you treat patients who suffered injury from a car crash, you should immediately request from the patient all car insurance policy information that may cover such patient for accident-related medical treatment including, but not limited to, PIP and MedPay coverage.

First, almost every car crash victim will have access to a car insurance policy to pay at least the first $2,000 of reasonable and necessary accident-related medical expenses, also known as PIP coverage.

Second, once the patient/victim exhausts the first $2,000 in PIP medical benefits, you should seek to recover from the patient's private health insurance policy, if available. If no such health insurance is available, you may continue to bill PIP up to $8,000.

Third, if the private health insurance contract alleges that its coverage is secondary and it defers payment until the insured exhausts all primary car insurance coverage (i.e., PIP and MedPay), you should bill MedPay and exhaust MedPay benefits, if available, before you can resubmit the bills to the health insurance company.

If, however, the private health insurance company does not defer payments, you should skip to Fifth below.

Fourth, after you exhaust MedPay benefits, if available, you should re-bill health insurance.

Fifth, if the patient's health insurance does not defer payment, but also does not cover your reasonable and necessary accident-related medical bills (i.e., deductibles, co-pays, and or services were unavailable under the health insurance plan), you should seek to recover again from the car insurance policy providing the patient/victim PIP coverage.

Sixth, for payment of those reasonable and necessary accident-related medical treatments not covered by the PIP and health insurance, you can recover from the car insurance policy that provides MedPay coverage, if available.

Seventh, if a car insurance policy has available bodily injury coverage, you can attempt to recover those reasonable and necessary accident-related medical bills not covered by PIP, health, or MedPay from the at-fault party's bodily injury coverage at the time of settlement.

Eighth, if the car crash victim/patient has no or insufficient bodily injury coverage available to cover your outstanding bills, such patient may be able to recover for your outstanding medical bills from the car insurance policy providing uninsured/underinsured coverage.

Do not fear treating patients who suffer injury in a car crash. Working with these patients/victims and their attorneys can be very helpful to them and very beneficial to you.

Marc Diller, a Massachusetts attorney and partner of the Boston, MA, law firm DILLER & DILLER (www.dillerlaw.com), represents victims injured in accidents throughout Massachusetts. For questions or comments, Attorney Diller can be reached by phone at 617-523-7771 or by e-mail: marc@ dillerlaw.com.