Medical Injuries In A Car Accident: Who Pays?

No one needs to tell you that car accidents are dangerous, and that even after your ride has been in and out of the shop, the experience can continue in the form of aches and pains and feelings of whiplash. In fact, some injuries can persist to the point that you need to seek medical attention. If that happens, who pays?

Much will depend on the insurance coverages that you have. Of course, most health policies will cover accidents and the residual injuries that are borne from them. But you may also have coverage as part of your auto insurance.

There’s also the matter of who’s responsible for the accident — you or the other driver.

According to attorney David Goguen, “Injured parties are often unsure of what insurance to use, and it may even be unclear whether their standard health insurance will cover car accident injuries.”

Some of the most common factors for determining who foots the bill are as follows: the policies themselves (and their deductibles), the at-fault party, and the existence of an active car insurance policy.


Bills And Deductibles

In most cases, car accident injury bills will follow a basic pattern of payment responsibility, Goguen notes. “The first piece of the pie will involve any deductibles in place on the insurance policy in question, whether it’s a car insurance policy or standard health insurance. The injured will have to pay bills up to the deductible amount.”

Ambulances, doctors, and hospitals, will often not require upfront deductible payments from injured parties, but instead perform the needed services and then work with involved insurance companies to determine where the money will come from.

“Accident victims, however, can expect to be billed for the deductible amount once responsibility is determined,” Goguen notes.


First Up: Your Auto Insurance

As far as injuries resulting from a car accident are concerned, the auto insurance company typically handles first payments. “Most states require motorists to have personal injury protection,” Goguen says. “The amount of coverage can vary greatly, but medical bills will or should be charged up to the policy limits before actual health insurance should come into play at all for a car accident injury.”

Of course, these rules can vary by region, and you will need to check with your state’s laws to be certain.


Next: Medical Insurance Payments

Medical insurance policies usually kick in after the auto insurance has exhausted limits on payment for personal injuries. When it comes to coverage from a health insurance policy, Goguen notes that injured parties are responsible for “their deductible amount under their health insurance policy, any co-payments that are required … [and] any charges that are not typically covered by the policy.”


Recovering Expenses

Last but not least, an injured party may have to pay upfront — or have their own policies pay upfront rather — and then focus on recovering expenses. Goguen explains: “If the injured party in question is not the at-fault driver, the car insurance companies involved may work behind the scenes to get the at-fault party’s policies to absorb some of the costs. Victims of car crashes can also sometimes recover some of their out-of-pocket expenses by making that part of any car accident settlement agreement with the at-fault driver and/or their insurance carrier.”


In Summary

When there are multiple policies and multiple companies involved, it can get confusing for the typical insurance customer regarding who doles out for medical injuries. However, that’s the value in a quality insurance company. As Goguen explained about recovering expenses, most quality companies will take care of you once you’ve provided the initial information. This “working behind the scenes” that he explains will free you up to focus on priority one: getting better.

Share this Article
Farmers - The Hartford - State Farm - Kemper Direct - Nationwide - Allstate - New York Life