Does the Insurance Company Have to Pay Your Medical Bills After a Car Accident?

“The bottom line is to submit the medical bills from your car accident case to your group health insurance carriers for immediate payment.”

You’re Involved in a Car Accident. Fortunately, You Have Insurance.

You’re involved in a car accident in Sevierville, TN, caused by another driver’s negligence. You have two herniated discs and a broken arm. You need surgery. You are discharged from the hospital after three days and are still in shock. The accident happened so fast. You don’t know how you are going to manage your medical bills since you can’t work due to your injuries. In a couple of weeks, you begin physical therapy to increase the strength and range of motion in your back and arm. Therapy lasts four months.

The medical bills start coming in, and you can’t believe how much they are: $83,000. Fortunately, you have health insurance benefits through your employer. But, your health insurance tells you that since the car accident was caused by the other driver’s negligence, his insurance ought to pay your medical bills as they come in. You agree—heck yeah, his insurance should pay! So your health insurance doesn’t pay the medical bills from your car accident submitted by your doctors and the hospital. Your health insurance tells your doctors to submit your bills to the at-fault driver’s insurance company for payment. While your insurance company is busy playing “pass the buck,” you begin to receive collection letters seeking payment of your medical bills. What should you do?

The Bills are Your Responsibility

First, you must recognize that regardless of the reason for your medical bills, doctors provided service to you, and to no one else. The bills are 100% your responsibility. And doctors, like everyone else, do not want to wait two years for your legal case to resolve before they are paid. The negligent driver’s auto insurance company will not pay your bills for a number of reasons:

  • They won’t make payments in advance of a personal injury settlement or a jury verdict in your favor.
  • They are under a duty to compensate you only when the defendant is found liable for the car accident. This means trial (unless settlement is reached).
  • Moreover, the defendant’s auto insurance company will not pay your doctors/hospital directly. Rather, the jury will decide the value of your case and the insurance company will pay that amount (same thing for settlement). How that money is divided is not the business of the defendant’s insurance company. Lastly, don’t expect the defendant’s insurance company to make your life easier by paying your bills. Your financial struggles work to their benefit. Many a person has settled a personal injury case far below actual value because they need money sooner rather than later.
Submit Your Bills to Your Health Carrier

Your group health insurance plan (e.g., BlueCross, Aetna, Humana, etc.) provides you with a benefit you’ve likely never considered in paying your medical bills. It’s called a negotiated fee plan, under which your doctor or hospital agrees to provide services at a rate below billing charge. That is, your insurance company will say to your doctors and hospital “we will provide you with our insureds as patients, but at pre-approved rates.” Once the doctor agrees to accept this negotiated, lower insurance company

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