If you've been injured in a car accident or motorcycle accident and received medical treatment, then you're probably thinking: "The accident wasn't my fault but I have these medical bills to pay. Who pays my medical bills after an accident?" The short answer is that the person who caused the accident is responsible to pay your medical bills. But how they get paid is a different scenario and, unfortunately, the existence of insurance policies and companies make the answer more nuanced.   

The nuanced answer is that it depends on what insurance policies are available to cover the bills. In most situations, there are three insurance policies that may cover your medical bills: (1) the at-fault party's liability coverage through their car insurance company; or (2) your auto insurance policy if you purchased Med-Pay or Uninsured/Underinsured Motorist Coverage (aka, 'UM/UIM Coverage'); or (3) your health insurance policy.

Every situation is unique and needs to be investigated to determine what policies may cover the loss. In most situations, it is a combination of 1, 2, and 3.  

1. At-Fault Party's Auto-Liability Coverage

California law requires that all vehicle owners purchase and maintain auto-liability coverage with minimum limits of $15,000 per person and $30,000 per occurrence. That's a small amount of coverage considering the cost of medical treatment in today's world. Liability limits above the minimum are available for purchase. For example, liability coverage can be purchased at $25,000/$50,000, $100,000/$300,000, $500,000/$1 Million, or more. If you have been involved in a car accident, then you need to determine the liability limits of the at-fault party's insurance coverage. Unfortunately, the at-fault party's insurance company will refuse to disclose the amount of coverage unless a lawsuit has been filed. A car accident attorney can help determine the amount of coverage without filing a lawsuit. 

Also, liability coverage is only available to cover your bills if the at-fault party is legally responsible for causing the collision. In a rear-end accident, it is easy to see that the at-fault party is 100% legally responsible for causing the accident. But liability is often disputed by the at-fault party's insurance company based on the type of collision. For example, liability is denied when the accident involves a red-light/green-light dispute with no witnesses; or a lane change dispute with no witnesses; or where there are allegations that you were driving too fast or not paying attention, etc.   

So how do you get the at-fault party's liability coverage to pay your bills? You need to open a claim with the insurance company, submit all records demonstrating the legal liability of the at-fault party, submit all records that demonstrate your injuries, submit all bills, insurance records, and out-of-pocket expenses (for example, lost wages), and submit a demand for pain and suffering. The at-fault driver's insurance company will review the documentation, perform their own investigation, determine who is at-fault, what your injuries are, what the "reasonable" amount of the medical bills should be, what your pain and suffering is worth, and the value of your claim. The insurance company will then offer you an amount to settle. If you are unhappy with insurance company's determination, then you can try and negotiate a better settlement or file a lawsuit.     

Hiring a car accident attorney to fight the insurance company is in your best interest. Your attorney should be able to determine the amount of potential liability coverage and if you have Med-Pay or UM/UIM coverages that apply. Your attorney will also investigate liability based on the California Vehicle Code and case law and will know the true value of your claim based on your injury and damages.  

David Blain, Esq., has been a car accident lawyer for more than a decade and has represented several hundred people injured in car accidents. In the last few years he has obtained settlements and jury verdicts totaling more than $30 Million. In countless situations he has obtained policy limits settlements for his clients - meaning he has obtained 100% of the liability and/or UM/UIM coverage available to pay medical bills and other damages. If you have been injured in a car accident then call David today at (949) 945-6233 for a free consultation. David represents clients on a contingency fee basis, meaning you pay no fee unless he obtains a verdict, award, or settlement on your behalf. 

2. Your Auto Insurance Policy: Med-Pay and UM/UIM Coverage 

Your own auto insurance policy is another source of payment for your medical bills. When you purchased auto insurance, you had the option of purchasing Med-Pay Coverage and Uninsured/Underinsured Motorist Coverage. These coverages apply in different situations. 

Med-Pay Coverages will pay for medical bills incurred as the result of a car accident. Med-Pay Coverages are not all the same and will be applied according to the language of your auto policy. It is important that you obtain a copy of your auto policy and read it. Some Med-Pay Coverages are considered "excess", meaning the coverage kicks in only after your health insurance is first applied. Some Med-Pay Coverages are considered primary, meaning the coverage will be applied regardless of your health insurance. Also, most Med-Pay Coverages are reimbursable, meaning your auto-insurance company will demand reimbursement for bills it paid on your behalf out of any settlement you obtain from the at-fault party's liability coverage.

If you purchased Uninsured Motorist Coverage, then your auto insurance will pay for your medical bills and other damages but only if the at-fault party is truly uninsured. In this situation, your own auto insurance company becomes your adversary. Your auto insurance company steps into the shoes of the at-fault driver and will make the same arguments AGAINST you that the at-fault driver would. Your own auto-insurance company will deny liability, will argue that you were not injured, that you did not need medical treatment, that your medical charges were excessive, that you could have returned to work earlier, and that your pain and suffering was minimal. 

Underinsured Motorist Coverage comes with Uninsured Motorist Coverage. Underinsured Motorist Coverage applies when your medical bills and other damages exceed the amount of the at-fault driver's auto-liability coverage. For example, assume that the at-fault driver has auto-liability coverage of $15,000 per person, your medical bills and other damages exceed $25,000, and you have UIM Coverage of $50,000. In that situation, you could recover the full $15,000 in liability coverage and then make a claim with your own car insurance company for the balance of your medical expenses and damages. Please note that in California the UIM coverage does not stack on top of the liability coverage. The UIM Coverage limit represents the maximum amount that you can collect from all insurance sources including your own coverage. If you collect the limit or more, then you cannot collect your UIM Coverage.  

David Blain, Esq., has been a car accident lawyer for more than a decade and has represented several hundred people injured in car accidents. In the last few years he has obtained settlements and jury verdicts totaling more than $30 Million. In countless situations he has obtained policy limits settlements for his clients - meaning he has obtained 100% of the liability and/or UM/UIM coverage available to pay medical bills and other damages. If you have been injured in a car accident then call David today at (949) 945-6233 for a free consultation. David represents clients on a contingency fee basis, meaning you pay no fee unless he obtains a verdict, award, or settlement on your behalf.

3. Your Health Insurance 

If you have health insurance then your medical bills will be paid by that policy. There are certain situations where the medical facility will refuse to bill your health insurance if it believes third-party liability coverage will pay the bill. For example, you are in a car accident and are taken by ambulance to the nearest emergency department at the local hospital. The hospital administrators and billing personnel learn that you were injured in a car accident and decide NOT to bill your health insurance. Instead, the hospital may place a lien on any settlement you obtain from the at-fault party's auto-liability coverage. In this situation, you have to pay the hospital directly from your settlement or recovery. 

Also, an unfortunate yet all-to-common situation is occurs when the at-fault driver is uninsured and you don't have Med-Pay or UM coverage. In that situation, the only applicable insurance would be your health insurance policy, which obligates you to pay deductibles, co-pays, and co-insurance amounts. Although you can seek reimbursement from the individual legally responsible for the accident, if they do not have insurance then their ability to pay will be based on the financial circumstances. If they have income, property, and assets then perhaps they will pay you. If they have none of those (which is more likely given they did not care to buy auto insurance) then you are likely on your own.   

Contact David today for a free consultation. No fee unless and until we make a recovery on your behalf. (949) 945-6233.

Nothing on this website is intended as a promise, guarantee, or warranty of a particular outcome. Case results vary and depend on a variety of factors unique to each case. The material and information on this website is our opinion and does not constitute legal advice. It is recommended that you speak with an attorney about the specific facts of your case.