Paying for Reasonable and Necessary Medical Care After a Car Accident
November 7, 2019
According to a recent data analysis of hospitals, California, New Jersey, and Nevada carry the highest prices of any states for the cost of medical care and treatments. While the average cost of an emergency room visit in the United States is $5,036, California’s costs are 49 percent higher. This can be financially devastating for victims of a car accident. Fortunately, there are Orange County car accident attorneys who can help.
Seek Prompt Medical Attention
All too often victims will forego getting medical attention after an accident because they are worried about the cost of care. This can possibly be one of the biggest mistakes anyone involved in an accident can make. Your health is important and should be a priority. Do not hesitate to accept emergency transport services from the scene of the accident to the emergency room.
Additionally, auto insurance carriers frequently use the fact a victim had a delay in treatment as an excuse for denying a claim or attempting to reduce the settlement value of a case. The insurance company hopes you will be desperate enough for the money that you will not realize the amount is not sufficient to cover long term costs.
The Person Legally Responsible to Pay
California is an “at fault” insurance state. This means the person who negligently causes an accident or injury is required to pay all reasonable and necessary medical bills. Depending on who is found to be at fault, these bills may be paid:
- By the liable party’s insurer
- By a company determined to be responsible
- By the at-fault driver personally
The Wheels of Justice Can Turn Slowly
Unfortunately, when it comes to auto accidents in California, the wheels of justice can move slowly. This is a stall tactic of the insurance carriers designed to make a smaller than expected settlement less objectionable. When insurance settlements are neither fair or just, the injured party may file a lawsuit. The timeline for a personal injury lawsuit is based on the individual circumstances of each case, but in some cases, it can take up to two years or more to be settled.
The fact of the matter is, regardless of whether or not insurance coverage is in the future, the unpaid bills are the victim’s responsibility. When bills are not paid in a timely manner, it is possible they will be turned over to a collection agency.
Who Pays the Bills
Victims of automobile accidents may have viable options for getting medical expenses paid in a timely manner while they are waiting for the at-fault driver’s insurance carrier to assume responsibility and cover the costs of care.
Private Health Insurance
Victims of a car accident that have health insurance can use their medical benefits to cover the initial costs of care after an accident. Medical providers are contractually obligated to file insurance (providing they are participating in the patient’s particular health plan) when a patient presents a valid insurance card. Provided the premium has been paid, the insurance carrier is obligated to pay the claim in accordance with the terms of the policy.
When medical bills for an accident are initially covered by private health care insurance, the accident victim will still be responsible for any deductibles, or co-pays. It is important to keep accurate records concerning out-of-pocket expenses for future reimbursement.
California “Med Pay” Auto Insurance
Accident victims should check the provisions of their own automobile insurance policy. Many policies have Medical Payments (“med-pay”) coverage. This provision provides payments for medical expenses up to a certain policy limit amount.
- Med pay is not an automatic provision on an auto insurance policy
- If med pay is available, it will cover medical costs no matter who was at fault
Most auto insurance policies with Med Pay coverage will consider the following expenses reasonable and necessary:
- Emergency ambulance service
- Emergency room costs
- Radiology expenses
- Required surgery
- Hospital charges
- Physician bills
- The cost of prescribed medications
- Chiropractic care
- Physical therapy
Medi-Cal Health Insurance Coverage
The Medi-Cal program provides health care coverage and services for a wide range of California residents based on age, disability, income, citizenship, and medical needs. There are eligibility requirements, but qualified citizens can also get help with accident-related medical bills. These programs are funded by both federal and state governments and individual counties handle the eligibility approval process.
Although it is also possible that certain doctors will not accept Medi-Cal, it often pays to inquire about this program. Information about the program and eligibility requirements can be found on the California Department of Health Care Services website.
Accident victims who do not have health or med pay insurance coverage are still entitled to emergency medical treatment in California. Under both state and federal law, hospitals are required to provide emergency treatment to any patient injured in a motor vehicle collision. Once the victim is in stable condition, the treating facility will bill a patient with no insurance coverage directly. Many hospitals will offer discounts to uninsured patients, but they are not legally obligated to treat accident victims for free.
A “Medical Lien” Agreement
Some facilities and physicians will agree to an arrangement that allows the payment of medical bills to be satisfied once a settlement or judgment has been awarded. This written agreement usually requires an attorney to verify the validity of a legal claim for recovery.
Seek the Advice of Aitken * Aitken * Cohn
The best way to deal with medical bills after an automobile accident is to have a knowledgeable and experienced personal injury attorney fighting for your rights and financial recovery. An attorney will:
- Review the case and determine the best way to deal with medical bills
- Handle collection agency issues
- Have the expertise to maximize the value of a claim
- Negotiate with health insurance carriers and auto insurance companies
The experienced legal team at Aitken * Aitken * Cohn stands ready to guard you and your family during this difficult and complicated time in your life. Contact us online or call at (714) 434-1424 to schedule a free consultation regarding your auto accident case, and get the help you need to deal with those unexpected medical bills.