Ask a Personal Injury Attorney a Question – Medical Expenses

Ask a Personal Injury Attorney

Medical Pay Questions... Who pays? Who is responsible?

After I was in a car accident, why did the Emergency Room want my automobile insurance information when I was not the one who was at fault?

The Emergency Room wants your automobile insurance information after you have suffered a personal injury through no fault of your own because most auto insurance policies include medical payments coverage. Usually the coverage limits for medical payments are between $1,000.00 and $5,000.00 but they can be much higher. The hospital wants to bill your auto insurance company instead of your health insurance company for a simple reason:  the hospital can get more money from your auto insurer.

Your health insurance company negotiates payments for services with various medical providers that are in your network. These are almost always significantly less than the hospital would charge to a person paying outside of an insurance policy. If the hospital submits a claim for payment to your health insurer, the hospital has to accept the amount it negotiated with the health insurer. The hospital wants to bill your auto insurer so that it does not have to honor the payment agreements with your health insurer and can charge you more. 

You have the right to refuse to disclose your auto insurer and insist that the Emergency Room and other medical providers bill your health insurer. That way you will get the benefit of lower medical bills and your health insurer will pay the bills while your case is pending. You also can reserve using medical payments money for items such as co-payments and unexpected expenses, such as diagnostic or other tests that your physician may recommend but your health insurer may not approve.

In our practice, we have seen not only medical providers but also collection agencies seek medical payments directly from accident victim’s auto insurers. These agencies know that your auto insurer is listed on the crash report for your accident, even if you are not at fault. They will pursue a victim’s medical payments coverage, sometimes without the person even knowing they are making a claim. To avoid this kind of hijacking of your medical payments coverage, it is important to talk to a lawyer soon after an accident. Your lawyer will notify your auto insurer that it is not authorized to send medical payments funds to anyone other than your counsel so that YOU are in control and can decide how best to use these funds. 

If you have been in an accident that was not your fault, Giardini, Poplar & Mason, LLC can help you get the compensation you deserve. 

©Daniel D. Mason at Giardini, Poplar & Mason, LLC

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