Author: Timothy J. Reuland
The personal injury attorneys at Speers, Reuland & Cibulskis, P.C. frequently receive calls from people who have been in accidents and wonder how their medical bills will get paid? People often feel that the person responsible for the accident should be responsible for the bills. That feeling is generally consistent with the law, but it ignores a practical problem: the other person is not legally responsible until a court or jury says so, or until that person or his or her insurance company agrees to be responsible. Neither of those is likely to happen before the hospitals and doctors start pressing for payment. So, what’s the injured person to do?
In many, but not all situations, the injured person should tell the hospitals, doctors, and other medical service providers to submit the bills to the injured person’s own insurance provider (health insurance carrier, Medicare, Medicaid, etc.), just as if the bills were for an illness, rather than for accident-related injuries. This suggestion is contrary to the feeling that “I’m not the wrongdoer here. Why should my insurance have to pay for this?” But, getting medical bills promptly paid avoids some potentially big problems. Those problems include unpleasant calls from collection agencies. More importantly for an injured person’s well-being (and even for their legal case), prompt payment encourages medical providers to continue to provide care and treatment. You don’t want doctors to stop treating you because the doctors are not getting paid. That can happen, and when it does, it can be bad for the injured person both medically and legally. So, most often, our advice to an injured person is to promptly submit all medical bills to your health insurer.
Some medical providers refuse to let that happen. For example, some hospitals refuse to submit their bill to an insurance company if someone other than their patient might be responsible for the medical treatment. Instead, they will mail a “Lien Notice” to the possibly responsible party, that party’s insurance company, and the patient. Some medical providers take this approach thinking that, if they submit their bill to a health insurance company or to a government program like Medicare, they will be forced to take a deep discount on their bill (because of their contract with the health insurance carrier or Medicare regulations). Rather than suffer that discount, these medical providers hope to be able to recover 100% of their bill by waiting and claiming a lien on any recovery the injured person eventually makes. These providers think: better 100% later, than a deep discount now.
What if I Don’t Have Health Insurance?
What if you do not have health insurance or if your health insurance denies coverage of your medical treatment? If you were injured in a motor vehicle crash, you may want to submit your medical bills to your automobile insurance company. Many automobile insurance policies include medical payment coverage which will pay medical bills up to the limits stated in your policy. Your insurance agent or insurance company can inform you of the amount of medical payment coverage available to you. Some homeowner’s insurance policies also provide medical payment coverage for injuries that occur at someone’s house or business.
Finally, some hospitals provide financial assistance programs to patients who have difficult paying medical bills. This is often the case with not-for-profit medical providers. These medical providers may request that you complete an application to determine whether you qualify for free or discounted medical services. Many medical providers are also willing to set up a payment plan for patients with no insurance coverage.
The “bottom line” is that people should generally take advantage of insurance, particularly the insurance most readily available to them, before expecting the at-fault party to take care of their bills. If you were hurt at work or on the job, different advice is most likely appropriate. And, there could be something unusual about your particular case that makes the bottom line advice different for you. The safest course for any injured person is to talk to a lawyer at Speers, Reuland & Cibulskis, P.C. who is knowledgeable in personal injury law and can advise you what is best for your particular circumstances.