An overview on Priority of Insurance Coverages for Motor Vehicle Accidents

Following a car accident, the first question you may ask yourself is “who will pay my medical bills?” While it’s true that ultimately the at-fault driver and their insurance will pay for your care, it’s not until you agree to settle your claim that they do. So what do you do in the meantime?

PIP Coverage and Health Insurance

Most drivers will carry both personal injury protection (PIP) and health insurance if they’re well insured. When this happens, it’s critical to know how each fits in the picture.

The first coverage that’s responsible for paying medical bills is your own PIP insurance, purchased through your own policy. This coverage will pay medical bills up to the policy limit, until that limit is reached. If you’ve got PIP coverage and signifiant injuries, the cost of your care will likely surpass the policy limit. So now what?

Once PIP exhausts, it’s time for health insurance to kick in. Your health insurance will send what is commonly referred to as an “incident questionnaire” to you for completion. As is the case with PIP applications for benefits, great care should be taken when completing this form. In fact, we recommend that you seek the guidance of a licensed personal injury attorney before completing and returning both forms.

It is vital that your health insurance receive both the “PIP exhaustion letter” which outlines that PIP his now exhausted, along with the “PIP ledger” which shows each payment made to medical professionals for bills accrued during your case. This will open the pipeline for health insurance to pay, and allows them to double-check their payments to be sure they aren’t paying a bill that has already been paid by PIP.

Potential Issues with Utilizing Your Own Health Insurance

The struggle that many people run into with utilizing their health insurance for accidents is that the heath insurance policy will only cover a set number of visits to each specialty per calendar year. Additionally, many policies call for significant co-pays at each visit, even after the deductible for the health plan has been met. Psychologically, most people feel that when an accident was caused by another’s negligence, that they shouldn’t have to use their private health insurance or pay co-pays along the way. We hear this frequently from our clients, and agree.

Hire a Personal Injury Attorney to Manage Medical Bills and Records

If you would rather not use your health insurance, there are often ways around doing so. When you are represented by our office, we work with the medical community to have you seen without having to pay anything upfront. The medical or chiropractic office is paid at the end of the case when we resolve it, and “holds” their medical bill until that time. This is a big deal, because it allows the injured person to focus simply on healing while their attorney manages the medical bills and records for them. This is a service we offer on every case.

If the above insurance coverages information is confusing to you (as it is to many people), please give us a call today to review your options. It’s free of charge, informational, and we are happy to assist you in either your handling of your own case, or to inform you on the many benefits we can provide if you allow us to handle it for you.

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