Getting in an accident can be a scary experience, and one that is made even more stressful as you wonder how you will pay for medical bills and make up for lost income that is causing you financial strain. You have insurance to help cover these unexpected occurrences, but what happens if your medical bills are higher than your insurance coverage?
You may have various options for covering your medical bills after an accident that wasn’t your fault. An experienced attorney from Cousin Benny Personal Injury can help you evaluate them and advise you on the best course of action. Contact us today for a free, no-obligation consultation.
Pennsylvania Car Insurance Limits
One of the most common accidents that people may get in that causes them to exceed their insurance limits in Pennsylvania is a car accident. Pennsylvania only requires drivers to maintain liability insurance in the following amounts:
- $15,000 for injury or death to one person in an accident
- $30,000 for injury or death to more than one person in an accident
- $5,000 for property damage
This insurance covers the damages that the driver’s negligence causes to someone else. If the at-fault party only has this minimal insurance, the resulting medical bills may quickly exceed these limits.
Additionally, all drivers registered in the Commonwealth are required to carry personal injury protection (PIP), referred to as first-party benefits in Pennsylvania. This insurance pays for accident-related expenses immediately after the crash, regardless of fault, including:
- Medical expenses, including emergency room visits, hospital stays, surgical costs, physical therapy, and rehabilitation
- Certain lost wages if the car accident victim’s injuries prevent them from working
- Funeral expenses, in fatal motor vehicle accident cases
- Accidental death benefits, which are lump-sum payments to beneficiaries
Pennsylvania requires all insurers to offer up to $100,000 in medical benefits, but drivers are only required to maintain a minimum of $5,000. Some policies also offer optional coverage for catastrophic injuries, which may provide up to $1 million.
In the event of an accident, the order of recovery from first-party benefits is:
- Under the policy under which the insured is named
- Under the policy covering the insured
- The policy on the motor vehicle for the occupants of an insured motor vehicle
- The policy on any motor vehicle involved in the accident for someone who is not the occupant of a motor vehicle
An experienced personal injury attorney can review the policies that apply to your case and explain the coverage that might be available.
Medical Bills You Might Incur After an Accident
To understand why your medical bills might exceed your insurance coverage, let’s look at some of the common medical expenses that accident victims in Philadelphia County often incur:
- Emergency treatment and transportation: You could have bills from your initial emergency room visit, as well as ambulance charges. Many accident victims exhaust their medical benefits due to ER visits alone.
- Hospitalization: More serious injuries, such as those resulting from speeding accidents or truck accidents, may lead to long hospital stays.
- Surgical costs: If the accident caused a broken bone, internal organ damage, or other serious injury, surgery may be necessary to restore function or prevent more severe injuries.
- Home healthcare: If the accident caused an injury that requires ongoing care, home healthcare assistance may be necessary.
- Diagnostic tests: Doctors may use various diagnostic tests to properly diagnose patients, such as MRIs, X-rays, CT scans, blood tests, and urine tests. Accident victims may receive separate bills for these expenses.
- Follow-up treatment: The accident victim may require treatment from their primary care physician, specialist visits, or other medical providers, for which they will be billed.
- Physical therapy: Physical therapy involves the use of various exercises to improve range of motion, flexibility, and function. You could incur bills for seeing a physical therapist.
- Occupational therapy: You may also be sent to an occupational therapist to improve, regain, or build skills to complete activities of daily living.
- Rehabilitation: Accidents can result in weeks or months of rehabilitation.
- Chiropractic care: Some patients may visit a chiropractor to help manage pain and improve function.
- Medication: Accident victims may need anti-inflammatory medications, antibiotics, or other prescription medicines.
- Pain management services: Accident victims may receive shots, pain medications, or other pain management services.
- Counseling: In some cases, the accident victim may suffer psychological trauma and require mental health services to process it.
- Medical equipment: Accident victims may require wheelchairs, crutches, prosthetic devices, or assistive medical devices.
- Necessary future medical care: The accident victim may continue to require medical treatment.
Factors That Affect Medical Costs
Every accident is different, so every medical bill stemming from the accident can be different. Some factors that can affect the value of medical costs include the following:
Type of Injury
The type of injury can impact the associated medical costs and treatments. For example, treatment for a broken leg may be much different from that for a traumatic brain injury (TBI).
Severity of Injury
The more severe the injury, the more likely it is that extensive medical treatment will be involved. This can make medical costs spike.
Insurance
Insurance companies negotiate rates with various providers, so the amount that one patient pays for a medical service can be different from what another patient pays.
Network Status
If you receive treatment using out-of-network services, your medical expenses may be higher than if you use strictly in-network services.
Medical Provider
Each medical provider can establish its own rates. You may wish to compare costs or use your insurance company’s app to estimate costs before you receive additional medical services. Some healthcare providers may also use a sliding scale fee that charges patients different amounts based on their income.
Form of Payment
If you receive treatment paying in cash, you may receive a discount.
Legal Options for Covering Medical Bills After an Accident
When someone else’s negligence is responsible for an accident that harms you, you should not be left having to pay out of pocket for medical expenses and other losses. Fortunately, you may have various legal options to cover your medical bills and other accident-related losses, including the following:
Use Your Health Insurance
Many accident victims turn to their health insurance for their first line of protection. This often comes as a welcome relief, as accident victims can seek medical treatment without having to pay for it out of pocket or wait for a settlement.
Health insurance might cover medical bills upfront. However, your health insurer may have the right to place a lien on any eventual settlement or award you receive for the accident. Your lawyer can help negotiate the amount of such liens.
Health insurance that could cover accident-related injuries and conditions could include:
- Insurance you purchase from work
- Insurance you purchase from the Marketplace
- Medicaid or Medicare
Use Other Insurance
You may have other insurance that covers your accident-related expenses and losses, including your medical bills. This could include:
- Auto insurance, including your first-party benefits
- Uninsured motorist coverage if an uninsured driver caused an accident
- Underinsured motorist coverage, if your expenses exceed the at-fault party’s liability insurance limits
An umbrella insurance policy - Hospitalization insurance
- Short-term disability insurance
- Long-term disability insurance
Your personal injury lawyer can review your insurance policies to identify available coverage.
File a Claim with the At-Fault Party’s Insurance Company
Many personal injury claims are resolved by negotiating a claim with the at-fault party’s insurance company. This could be their auto liability insurance policy, general liability insurance, commercial liability, or an umbrella policy. When you receive a settlement, you may be able to pay off your medical bills.
Negotiate a Payment Agreement
If you don’t have health insurance or another immediate option for paying your medical bills, you might be able to negotiate a payment plan. Many hospitals, clinics, and other medical providers provide flexible payment arrangements to help those in financial hardship. This can help you more easily manage your finances while you wait for a settlement, protect your credit by preventing creditors from referring your case to collections, and give you some time to secure a settlement or award.
Request a Medical Lien
With a medical lien, you agree to pay your healthcare provider out of any settlement or award you receive in your case. Medical providers may agree to this option if you don’t have resources to pay for the medical treatment you need now, and/or they might receive more money if they defer payment.
Consider Other Pathways for Compensation
In some cases, the at-fault party’s insurance coverage is insufficient to cover medical bills and other accident-related losses. Consider other options you may have for compensation.
Did another driver contribute to the accident and have insurance that could help cover your losses? Was the at-fault party working at the time of the accident, and could you file a claim with their insurance? Was a defective product involved? Did unsafe roadway conditions contribute to the accident, providing you with an option to file a claim against the governmental agency responsible for maintaining it?
An experienced personal injury lawyer can review your situation and identify all potential legal strategies and arguments to make under the circumstances.
Use Lawsuit Funding
Some financial services providers may pay upfront for certain costs, including medical bills, while you wait for your settlement or award. However, this can come with significant fees, so have your lawyer read over any contract you are considering signing beforehand.
File a Personal Injury Lawsuit
A personal injury lawsuit could help you recover compensation you need to pay your medical bills, as well as other expenses and losses, including your property repairs, lost wages, and pain and suffering (the last if you suffered a serious injury or have full tort insurance).
Your personal injury attorney can assess your situation and explain which option(s) are best for you.
Your Attorney’s Role in Negotiating Medical Bills
One of the services that personal injury attorneys might offer that clients might be unaware of is the ability to negotiate medical bills. They may be able to reach out to your medical providers, negotiate medical liens, and resolve these liens so that you get more of your settlement money. Seasoned personal injury attorneys know how to negotiate with insurance companies and medical providers and do so regularly. More complicated medical cases that require extensive treatment can take longer to negotiate than more standard medical bills.
What to Consider in Your Settlement
Once you settle your personal injury case, you usually cannot go back and request more money. This is a final moment in your case, so it is best that you consider all relevant aspects in your case, such as:
- The amount of your existing medical bills
- Your need for ongoing medical care
- Your future anticipated medical expenses
- Whether the settlement precludes you from filing other legal claims related to the matter
- Whether your injuries will affect your ability to earn a living
- The extent of your pain and suffering
Your personal injury attorney can negotiate for a favorable plea agreement and review any settlement agreements to ensure you understand your rights and limitations.
Contact an Experienced Personal Injury Attorney from Our Firm for Help Resolving Outstanding Medical Bills
If you would like to learn more about how to pay your medical bills stemming from an accident caused by someone else’s negligence, contact Cousin Benny Personal Injury. Our personal injury attorneys have extensive experience handling this issue. We can investigate your case, identify all pathways for compensation, and pursue maximum compensation from all of them. Call us today to get started with your free case review.