Does Health Insurance Cover Car Accident Injuries?

Will Health Insurance Cover Pay for Car Accidents Injuries?

Car accidents can result in injuries that range from minor scratches to severe injuries. If you’ve suffered a serious injury requiring medical treatment, you may be faced with high medical bills. Pennsylvania is one of the few no-fault states in the country. This means that those involved in a car accident will first be required to seek compensation from their own insurance coverage for the damages they have suffered as a result of the car accident. However, there are also other avenues to seek financial recovery and pay your medical expenses. Below, we take a look at the role health insurance plays in covering car accident injuries in Pennsylvania.

Options for Covering Medical Expenses After a Car Accident in Pennsylvania

There are various options for covering medical expenses through insurance in Pennsylvania. These include:

• Personal Injury Protection (PIP) Coverage: Pennsylvania is a no-fault state when it comes to car insurance. This means that drivers are required to carry Personal Injury Protection (PIP) coverage as part of their auto insurance policy. PIP coverage is intended to cover the medical expenses and lost wages of the insured and their passengers, regardless of who was at fault in the accident. PIP coverage can help pay for medical bills and other accident-related expenses.
• Health Insurance: If you're involved in a car accident in Pennsylvania, your health insurance may also cover medical expenses. Depending on your health insurance policy, it can help pay for doctor visits, hospitalization, surgery, and other medical treatments related to the accident.
• Coordination of Benefits: When you have both PIP coverage and health insurance, there may be coordination of benefits. In many cases, PIP coverage is primary, which means it pays first for your medical expenses, and health insurance is secondary. Health insurance may cover costs that exceed the PIP limits or services not covered by PIP.
• Med Pay Coverage: Some people may also have Med Pay (Medical Payments) coverage as part of their auto insurance policy. Med Pay can be used to cover medical expenses, co-pays, and deductibles not covered by PIP or health insurance.
• Uninsured/Underinsured Motorist Coverage: If you're injured in a car accident and the at-fault driver is uninsured or underinsured, your own uninsured/underinsured motorist coverage may also come into play to help cover medical expenses.

It's essential to review your auto insurance policy, PIP limits, health insurance policy, and any other coverage you have to understand how your medical expenses will be covered after a car accident. Additionally, you should promptly report the accident to your insurance company and seek medical attention for any injuries sustained.

Remember that each insurance policy is unique, and the specific details can vary. Consult with your insurance provider or an attorney specializing in personal injury cases if you have questions about how your health insurance and auto insurance will work together to cover medical expenses after a car accident in Pennsylvania.

Common Challenges Car Accident Victims Encounter when Trying to Access Health Insurance Coverage after a Car Accident

Car accident victims may encounter several challenges when trying to access their health insurance coverage. These challenges can vary depending on the circumstances of the accident, the insurance provider, and the policy specifics. Here are some common challenges car accident victims may face when trying to access their health insurance:

• Coordination of Benefits (COB): In cases where the victim has both PIP (Personal Injury Protection) coverage through auto insurance and separate health insurance, there may be complications in determining which insurance should cover what. The coordination of benefits between the two insurers can be complex and may lead to delays in payments.
• Delayed Claims Processing: Insurance companies, including health insurers, often engage in a claims review process that can be time-consuming. Delays in processing claims can be frustrating for accident victims who need prompt medical treatment and financial assistance.
• Pre-authorization Requirements: Health insurance policies may require pre-authorization for certain medical procedures or treatments. Car accident victims might face difficulties getting these pre-authorizations in a timely manner, which can delay necessary medical care.
• Denial of Claims: Health insurance providers may deny claims for various reasons, such as deeming certain treatments unnecessary or not covered under the policy. This can leave accident victims responsible for medical bills they believed would be covered.
• Out-of-Network Providers: Car accident victims might be treated by medical providers who are out-of-network for their health insurance plan. In such cases, the victim may face higher out-of-pocket costs or denials of coverage.
• Subrogation Claims: If a third party is at fault for the accident, the victim's health insurance provider may assert a subrogation claim, seeking reimbursement from any settlement or judgment the victim receives from the at-fault party. This can complicate the financial recovery process.
• Insufficient Coverage: Some health insurance plans may have low coverage limits or high deductibles, leaving car accident victims with significant out-of-pocket expenses.
• Lapsed or Uninsured Coverage: If the victim's health insurance policy has lapsed or they were uninsured at the time of the accident, they may face difficulties in securing coverage retroactively. This can result in personal responsibility for medical costs.
• Complex or Unresponsive Claims Process: Understanding the terms and conditions of health insurance policies can be challenging for individuals who are not well-versed in insurance matters. Additionally, dealing with unresponsive or uncooperative insurance companies can add to the frustration.
• Legal and Disputes: If the accident results in a legal dispute or a lawsuit, car accident victims may face complexities related to their health insurance, such as subrogation issues and potential liens on settlements.

Talk to An Experienced Car Accident Attorney

When you’ve been injured in a car accident and are seeking medical treatment, the last thing you want to deal with is the complex issues that often arise when attempting to access health insurance coverage. We at van der Veen, Hartshorn, Levin & Lindheim appreciate the suffering that car accident victims undergo. We are committed to providing legal representation to help them access the funds they need so they can get the medical treatment they seek. Contact us to schedule a free consultation and learn more about how we can help.