Although you can use your personal medical insurance to get treatment after an accident, filing a personal injury lawsuit is usually the best course of action if you sustained injuries due to someone’s negligence. However, since your health insurer likely includes a subrogation clause in the terms of your policy, the company may come after your settlement when it arrives.
The personal injury attorneys at Gacovino, Lake & Associates, P.C., can help with your case. Call us at 631-600-0000 today to set up a free consultation with an attorney in New York.
Will My Health Insurance Cover My Injuries After an Accident?
Your health insurance will pay for your medical treatment for injuries you sustain in a car accident, slip and fall, dog bite, or any other accident that occurs because of someone else’s negligence. In fact, for many victims, this is the only way they can get their medical care needs handled in the hours, days, and weeks after an accident.
You will still have to pay your co-pay or co-insurance, just as you do whenever you see a doctor or go to the hospital, however.
Why Do I Still Need to File a Lawsuit?
While you may not have to file a lawsuit, you definitely need to file a claim with the at-fault party’s insurance. If your injuries resulted from someone’s negligence, they are responsible for your damages.
Although your health insurance will get you the most important medical treatment you need in the short term, it will not pay for your lost wages to date or in the future. Your medical insurance may not, in fact, pay for all of the rehabilitation, physical therapy, mental health treatments, or other needs you may have in the future.
A personal injury claim settlement will include all of your current and future treatment needs, your current and future lost wages, property damage, out-of-pocket expenses, pain and suffering, long-term disability, and compensation for your loss of life enjoyment.
However, if you used your personal medical insurance to cover your injuries, it could endanger your settlement due to a legal process known as subrogation.
What Is Subrogation in a Personal Injury Lawsuit?
Subrogation is a legal process that allows your medical insurance company to go after any funds you receive for the bills they paid. This process exists because of the theory that you should not be able to collect twice—once from your insurance company and again from your settlement.
For example, if you sustained a concussion in a car crash, you might go to the emergency department for treatment and use your medical insurance to pay the bills. We would include those hospital bills in your personal injury lawsuit as a part of your accident-related losses. Your eventual settlement will compensate you for those bills, even though you did not pay them originally.
Consequently, your medical insurance company can subrogate to claim those funds, since they paid them out originally.
If you had any balance left at the hospital, they can also attempt to recover a portion of the settlement. In some cases, hospitals even try to claim you owe extra funds, representing the difference between their negotiated services rate with your medical insurance company and their published rates. This is a practice called “balance billing.”
To collect these funds, your insurance company and medical services provider can file a lien against your eventual settlement.
How Can I Protect My Settlement?
The best way to ensure that your medical insurance company does not take more of your settlement is to let us handle the communication and coordination of your payout.
We can protect your settlement using a legal strategy called the “made-whole doctrine.” The made-whole doctrine limits the amount your insurance company can claim if your settlement did not cover your total loss—or make you whole. If your settlement was less than the amount of your total claim, it did not legally make you whole.
In addition, New York law bars medical service providers from balance billing. We will also ensure that any hospitals or doctors you saw do not try to claim any portion of your settlement they have no legal right to.
We can negotiate with the insurance company, doctors, and hospitals to get them equitably repaid. More importantly, we can work to ensure they do not try to claim any additional funds from your settlement.
It is imperative that we review a copy of your medical insurance policy as well as all of your medical bills. Do not sign agreements with your insurance company or any medical provider without talking to us first.
We can also refer you to doctors and other treatment providers in the medical community who regularly work with personal injury accident victims. Many of these medical professionals will agree to await payment until you receive a settlement.
We Can Help You Recover Compensation After a Personal Injury in New York.
If you sustained injuries in an accident in New York, contact Gacovino, Lake & Associates, P.C., at 631-600-0000. Our personal injury lawyers can help you pursue fair financial compensation for your injuries.
