Florida car crash? Wondering who will pay your medical bills? Here’s a quick primer to get you up to date, quickly.
Who Pays my Medical Bills After a Car Crash in Florida?
Florida is a “No-Fault” state. As such, your own insurance carrier is responsible for paying your initial medical bills. If you have auto insurance coverage in the state of you have a type of insurance called Personal Injury Protection, or PIP for short. PIP pays 80% of your medical bills until it is exhausted. You then become responsible for the remaining 20%. The limits of PIP are $10,000.00 if your medical provider deems that you have an Emergency Medical Condition and $2,500.00 if you do not.
What is an Emergency Medical Condition?
It is a medical condition wherein the absence of immediate medical attention would reasonably result in one of the following: serious jeopardy to patient health; serious impairment of bodily function; serious dysfunction of any bodily organ or part. Once your healthcare provider has examined you, they must include specific language in their medical records reporting your Emergency Medical Condition to your insurance company so that you may obtain your full $10,000.00 PIP benefits.
How long do I have to seek medical treatment?
You have fourteen (14) days after an auto an accident to seek medical treatment and access your full PIP benefits. You can still seek treatment after the 14-day period, but your treatment may not be covered by your PIP insurance.
Can I use my health insurance?
While your PIP insurance is the primary payor of your medical bills after an auto accident, your health insurance can be billed as secondary insurance. Simply present your medical provider with both your auto insurance and your health insurance at the time of service and ask them to bill both. Once your PIP benefits have exhausted, you can use your health insurance for your medical services.
What if my doctor won’t bill my auto insurance as primary?
Your doctor’s office may not have procedures in place to bill auto insurance. Although Florida law states that they must bill auto insurance for an auto accident, they may be your health insurance instead. In these cases, health insurance may or may not pay the bill. It may be up to you to submit the bill to your auto insurance carrier for reimbursement. You may also choose to see a medical provider who will bill your auto insurance.
What do I do if my doctor won’t bill my health insurance as secondary?
Although your doctor is contractually obligated to bill your heath insurance as secondary, you cannot force them to do so. If they refuse, you can seek medical attention elsewhere if you wish your health insurance to be billed.
My doctor says I must pay my health insurance company back for my treatment and there is no point in billing them, is that true?
It is true that if you get a settlement from the at-fault driver you do have to pay back your health insurance company the money it paid for bills caused by the accident. The health insurance company has a ‘lien’ for the amount they paid against the settlement. However, billing your health insurance has numerous advantages. The primary advantage is you will not have outstanding medical bills in the present, preventing the likelihood of collections and mounds of medical debt. Another important advantage is the monetary adjustments your medical provider must make to your medical bills. Health insurance companies never pay the full price of your medical services, they only pay the contractual amount they have with your medical provider. You will only have to reimburse your health insurance carrier for the contractual amount they paid, which is often far less than the price your doctor would charge you. In many cases your health insurance carrier will reduce the amount you have to reimbursement them to help compensate you for your legal fees and costs at the end of you case. That’s actually part of your attorney’s job after they settle the case. They should attempt to reduce the bills with your medical providers to maximize the amount of money that you receive in your pocket from the settlement.
My doctor says they can’t bill Medicare for my auto accident. The doctor says they are the “payor of last resort”, what do I do?
While your doctor must bill your auto insurance as primary, they can bill Medicare as secondary for your accident and Medicare will pay the medical bill. If your doctor is refusing to bill your Medicare, you may choose to treat with a doctor who will. Don’t let a medical provider’s office prevent you from getting the full benefit of your Medicare coverage. Just like with non-Medicare policies, you will have to pay back Medicare for the lien they will have for the bills that they paid related to the crash. Once again, it is part of your attorney’s job after they settle the case to negotiate with Medicare to get as much money in your pocket as possible.
Who pays for my medical bills after my PIP insurance is exhausted?
If you make a claim against the at-fault driver and receive a settlement, your remaining medical bills will be paid from your settlement funds. Settlements come from two sources, the insurance carrier of the at-fault driver or, in some cases, your own insurance carrier.
Bodily Injury coverage is a type of coverage on an auto policy that pays for injuries to another party if you cause an accident. If you make a claim against an at-fault driver, it is their Bodily Injury coverage that pays you a lump sum settlement for your injuries. You can also receive a settlement from your own Underinsured/Uninsured Motorist coverage. Underinsured/Uninsured Motorist coverage is a type of coverage that you can carry on your policy in case an at-fault driver does not have Bodily Injury coverage or does not have enough Bodily Injury coverage to cover your bills, lost wages, and pain and suffering.
Will my settlement pay all my medical bills?
There is no definitive answer to this question, it is recommended that you obtain an attorney as soon as possible after an auto accident. There may not be enough Bodily Injury or Underinsured/Uninsured Motorist coverage to pay any and all potential medical bills you may incur. An attorney can review the coverages and help you plan your road to recovery.
The other guy caused this crash, why isn’t his insurance company paying my medical bills?
The at-fault driver’s insurance carrier will not pay your medical bills as you incur them. They will only pay out one lump sum when you have concluded your treatment. You will then have to pay your medical bills out of that lump sum that you receive from the insurance carrier. Managing medical care and the medical bills that come from it after an auto accident can be a daunting task. It is recommended that you consult with an attorney.
If you have been in an auto accident in Florida, it is recommended that you seek the help of an attorney as soon as possible so that you can safely navigate the auto claims process. Chelsie M. Lamie is a former insurance adjuster, former insurance defense attorney, and has been fighting for accident victims exclusively since 2008. You can reach Chelsie day or night at 813-787-3993 on her cell phone. Our main office is in Clearwater but we handle personal injury cases all throughout the State of Florida.