Understanding Whether Car Insurance Pays Your Medical Bills After an Accident

Nobody wants to get in a car accident, but sometimes it happens, even if you are an excellent driver. A vehicle accident might not be your fault, or perhaps you experience a mechanical issue that leads to a crash. Whatever the circumstances, though, if you hurt yourself in the accident, you’ll probably wonder whether your car insurance will cover all of your medical bills.

The answer is seldom easy and can often get quite complicated. Let’s break down some car crash and insurance scenarios if you’re looking for your policy to cover your medical bills.

Pennsylvania’s No-Fault Laws

For this article, we’ll say the car wreck happened in Pennsylvania. This is a good state to talk about because they’re one of the ones that have what insurance companies call “no-fault” car crash laws.

Each Pennsylvania driver must carry a minimum of $5,000 in what the insurance industry calls first-party insurance benefits. They also call this PIP coverage. This is to reimburse medical expenses if you do wreck your car and hurt yourself.

The no-fault aspect comes in because if you wreck your car and hurt yourself, Pennsylvania is one of the states where it doesn’t matter if you caused the accident or someone else did. You’ll be happy to hear this, especially if you made a driving mistake like an illegal turn or your smartphone distracted you.

This minimum of $5,000 is the first source if you have medical bills. You should know that many drivers in this state have policies that cover a lot more than that. Coverage policies for $10,000 are not uncommon.

What if the Medical Bills Are for More Than the Coverage Amount?

It starts to get tricky when you have medical bills that are either more than $5,000 or more than the total no-fault policy amount. Maybe you have $10,000 on your policy, but your medical bills total more than double that.

It’s hard to think that your medical bills could be that much, but six-figure medical bills are not all that uncommon in some instances. Medical procedures cost a lot, and if you need surgery or a bunch of tests after the car wreck, you could face a staggering number of bills from doctors and hospitals.

Your Personal Health Insurance

That’s when you’d better hope you have personal health insurance. It will be the next source you can tap to pay those bills after you have exhausted your no-fault insurance coverage.

You might have personal health insurance through your work. If you don’t have a job or you are self-employed, you also may have a policy that you purchased through the marketplace. This is insurance through the healthcare.gov website, or what some people call Obamacare.

As for whether that policy can cover the rest of the bills, that depends on how much you still owe once you’ve used up your no-fault insurance amount and also how extensive your personal insurance policy is. For instance, you might have a pretty good policy that has a low deductible. Plans that are not as good have higher deductibles, and they also typically have higher copays for services.

What About Other Car Insurance Policies?

Maybe you run into a situation where a car accident in Pennsylvania hurt you very badly. Perhaps you sustained a traumatic brain injury, or you broke several bones.

If that happens, you cannot reasonably expect your no-fault policy alone to cover all your medical expenses. These injuries and the medication, tests, surgery, physical therapy, hospital stays, and so forth that happen afterward can mean massive medical bills you must pay.

You might have another car insurance policy that will help you with the rest after you have tried to use both your no-fault car insurance policy and your personal insurance. Some people get more expensive policies that can cover nearly any car crash injury.

The problem is that sometimes, the insurance company will try to deny your claim for one reason or another. These reasons could make sense to you, or they might seem nonsensical.

Why Would an Insurance Company Deny Your Claim?

If you’re unsure why a car insurance company might try to deny your claim, you should understand that these are always for-profit entities. They make more money if they can deny claims and pay out as few of them as possible.

Insurance companies are not your buddies, even if they act like they are. They will sometimes only keep up that façade until you hurt yourself and need a large amount of money from them to cover your existing medical bills.

At this point, you might need to look into hiring a lawyer who knows about battling car insurance companies to get them to pay you what you’re due. There are some firms and lawyers who deal exclusively with this type of problem, and they have plenty of prior experience on which they can draw.

You Can Also File a Claim Against the Other Driver

You might also pursue the other driver for damages, but only if you can establish that they caused the wreck. You might think they did, but you’ll need to present the facts to your attorney so they can tell you whether pursuing the matter is worth it.

If it’s obvious that the other driver caused the accident, and there is abundant evidence which suggests that, you might file a claim against them. They could try to settle with you if they know they’re going to lose in court.

If that happens, you might accept that settlement if you feel like the amount will cover what’s left of your medical bills. However, remember that you may have future medical bills related to your condition to pay.

It’s almost always beneficial to hire a lawyer if you’re trying to navigate this often-murky process. You do not want to have to pay for any of the medical bills out of pocket, so use your attorney’s expertise to help you.