When you are injured in an automobile accident, one of the first questions asked is: Who will pay for my bills? In Pennsylvania, the primary source of payment for your medical bills is through your own automobile insurance carrier. If you do not own a motor vehicle and do not have automobile insurance, the second source of medical benefits coverage would be through the automobile insurance carrier of a relative with whom you reside. If neither apply, a medical claim can be made through the vehicle that you occupied or, if you are a pedestrian, the vehicle that struck you. If you are the owner of a currently registered and uninsured motor vehicle, you will not be eligible to receive medical benefits through any of these sources.
This order of priority is regardless of fault and is applicable even if your car or your relatives’ car was not involved in the accident. Many people assume that their rates will automatically go up if a first party medical claim is made. This is not true as section 1799.3 of the Pennsylvania Motor Vehicle Financial Responsibility Law prohibits such an increase.
When purchasing your insurance, you choose a maximum limit for medical benefits coverage. If that limit is not enough to cover all of your medical expenses, the secondary source of medical coverage is through your own health insurance whether a private plan or a government plan. Your automobile insurance carrier will notify you if your maximum limit has been reached. Thereafter, the remaining bills should be submitted to your own health insurance company for payment. If you are not at fault for the accident, the other person’s insurance company will not automatically pay your bills.
However, the insurance carrier of the at fault person, is responsible to pay for and/or reimburse you for medical expenses not covered by insurance, co-pays, deductibles and eligible “subrogation” (certain private health insurance plans such as HMOs, employer funded health plans or government programs have a right of “subrogation” which means that your health plan may have a right to recover out of your settlement) claims asserted by health insurance carriers up to the applicable limit of liability insurance coverage. These expenses become part of your general damage claim, which includes out of pocket expenses in addition to compensation for pain and suffering. This is all subject to available coverage.
You should choose your medical coverage wisely. Purchase higher limits of medical coverage if you do not have health insurance or if you have a health insurance plan that is entitled to reimbursement from any personal injury recovery. AFTER you have been involved in a serious accident is not the time to find out that you have insufficient coverage to pay for your necessary medical expenses.
If you have been seriously injured in a car accident you will have questions about your medical bills. The attorneys at Berger and Green can help you through this difficult process.