Do I Have to Pay Back My Health Insurance After an Accident?

medical bill

Being involved in an accident or injured through no fault of your own can be a traumatic experience. You need to take care of your injuries and figure out a way to pay your living expenses. You may also be worried about keeping your job if you cannot work because of your accident injuries. 

One of the frustrating and challenging issues after an accident is how to pay for your medical care. An accident can result in substantial medical bills. Who is responsible for paying your medical bills after an accident? 

Liability for Medical Costs After an Accident

You are responsible for paying your medical costs after an accident or injury. For example, if you are taken to the hospital after a motor vehicle accident or slip and fall accident, the hospital bills you for the charges. Likewise, if you go to the doctor after an injury caused by a defective product or construction accident, the doctor bills you for the cost of treatment.

Medical expenses after an accident could include, but are not limited to:

  • Ambulance services, emergency room costs, and hospital charges
  • Bills from doctors, specialists, laboratories, and other medical providers
  • Therapy bills, including physical therapy, vocational therapy, and occupational therapy
  • Medications, medical supplies, and medical equipment
  • In-home health care and personal care
  • Long-term care facilities
  • Surgical costs and costs of other procedures

If another party caused your injury, that party might be liable for your medical expenses. However, you must file a personal injury claim to recover compensation for your medical bills and other damages

In some cases, a victim must file a personal injury lawsuit if they cannot reach a settlement with the insurance company for the negligent party who caused their injury. It could take years for a personal injury lawsuit to go to trial. Even then, the victim might not receive money right after the trial if the other party appeals.

The other party and its insurance company do not pay your medical bills and expenses while the claim is pending. Your medical bills are included in the settlement. You do not receive any money for your claim until the case is settled. 

Ways To Pay Medical Bills After an Accident

money

There are several ways you can pay your medical bills after an accident. If you have Med Pay or Personal Injury Protection (PIP) coverage on your automobile insurance policy, you can file claims against your insurance coverage to pay for medical bills after an automobile accident. 

If your injury was not caused by a car accident or you do not have medical payments coverage, you can file a claim with your health insurance provider. Your health insurance provider should pay the medical bills based on your coverage. You are responsible for any co-pays or deductibles under your claim.

Victims who have Medicaid or Medicare coverage may also be able to pay medical bills after an accident by filing claims with their Medicaid or Medicare providers.

When a person does not have a health insurance plan or other insurance to pay medical bills after an accident, they may agree to a medical lien. A medical lien is an enforceable agreement you sign with a medical provider agreeing to reimburse your health insurance from the proceeds of your injury claim. 

The medical lien must be paid before you receive any settlement proceeds. If you do not recover money for your injury claim, you are responsible for paying the medical bills.

Why Is My Health Insurance Company Demanding I Pay Them Back?

Suppose another person is liable for your medical bills and you recover money for an accident claim. In that case, your health insurance company may demand reimbursement for any medical bills it paid related to the accident injuries. The health insurance company is exercising its subrogation claim

Most health insurance contracts contain subrogation clauses. The policy states that if you receive money from a third party as compensation for medical bills, the health insurance company has the right to be reimbursed for payments it made. Subrogation claims must be paid before you receive any money from the settlement proceeds.

It may not seem fair that the health insurance company can take part of your settlement proceeds. However, the settlement includes compensation for your medical bills and expenses. The money is intended to pay your medical bills.

However, you did not pay the medical bills because your health insurance company paid the bills. If the health insurance company had not paid the bills, the medical bills would have been paid from the settlement proceeds. In either case, you would not have received the money intended to pay medical costs incurred because of the accident.

You Can Negotiate a Settlement for a Health Insurance Claim 

lawyers

Your personal injury attorney may propose a lower amount to settle the health insurance company’s claim against your settlement proceeds. The health insurance provider may accept the offer if the settlement proceeds do not compensate you fully for all damages caused by the accident.

Other damages that you may receive compensation for after an accident include loss of income, pain & suffering, permanent impairments, and disfigurement. In some cases, a settlement may not cover all damages.

For example, if you are injured in a motorcycle crash, you might incur substantial damages if you sustain a catastrophic injury. You could require surgery, physical therapy, and special medical equipment. You might also miss a lot of time from work because of your injuries. 

However, the at-fault driver carries minimum insurance coverage. Even after the car insurance company pays the full policy limit and you file a claim against your underinsured motorist coverage, the proceeds do not come close to compensating you for all damages. 

Your personal injury attorney may propose that the health insurance company accepts a percentage of the amount owed so that you receive some money for your other damages. 

Having an attorney negotiate a settlement with the health insurance provider may be better than if you tried to negotiate with the company. Your lawyer has experience drafting compelling arguments why the health insurance company should settle for a lower amount. 

In addition to negotiating with the health insurance company, your lawyer can also negotiate settlements with medical providers for medical liens. Your lawyer may also work with Medicaid and Medicare to lower the amount you might have to pay back for medical bills after an accident. 

Call Our Texas Personal Injury Lawyer for a Free Consultation 

Being injured in an accident is a traumatic experience. Our Texas personal injury lawyers help accident victims fight for fair compensation for damages. Contact our Houston law office to schedule your free consultation to discuss how we can help you protect your legal rights and best interests. Call us at (713) 224-4878.

Remember, your time is limited to sue the other party for damages under the Texas Statute of Limitations. Do not wait too long to seek legal advice about an accident claim.