Health insurance is supposed to be there for you when you get sick or injured, right? So why would they deny claims for car accident injuries?
Well, it turns out the world of insurance can be quite tricky. When there's a car accident, you might be covered under auto insurance for your medical bills instead.
This might seem confusing. Is auto insurance really equipped to handle the medical bills and other damages from an auto accident injury? And whose insurance will you be using, anyway?
We're here to answer all those questions and more. Once you understand how the insurance system works, you'll be well-prepared for whatever life throws at you.
Health Insurance vs. Auto Insurance
Auto insurance is generally the first go-to in the case of an auto accident injury. This can lead to limitations if you would prefer your health insurance to cover it. Your health insurance company might deny a claim because it expects your auto insurance company to cover the costs instead.
There are some alternative methods you can try if you need to pay off a medical expense sooner rather than later. You might be able to work out a solution where your health insurance does cover the medical bills and then is reimbursed by the auto insurance.
Insurance can be confusing in the case of a multi-car collision. If someone else's insurance is paying for your damages, it will be their auto insurance, not a health insurance company. In order to know whose insurance you'll be using, you'll have to know which driver was considered the at-fault driver.
Which Driver Is at Fault in Car Accident Injuries?
The driver officially at fault will be the one who needs to use their insurance to cover most or all of the damages. This can include damage to vehicles as well as people.
Based on your state laws and the amount of blame assigned to you, you may be relying on someone else's auto insurance to cover the bulk of your medical bills.
The decision over who was at fault will be a discussion between your insurance company and the other driver's insurance company. They assign blame based on negligence. Basically, how would a reasonable person react in the situation—and did you fail to meet that expectation?
Insurance companies can assign blame in percentages. But then the higher percentage can determine the at-fault driver.
In this way, the at-fault driver doesn't have to be the only one who is to blame. The way this plays out is different from state to state.
Check your state laws to see whether your state uses comparative negligence, modified comparative negligence, or contributory negligence to determine payouts after an auto accident. These may sound similar, but there are important differences in assigning each potential source of insurance to a set of damages.
Do you live in a state that uses comparative negligence? Then the amount of blame will determine how much their insurance will cover. For example, if the at-fault driver was 70 percent to blame, their insurance company would pay 70 percent of the damages, including medical bills. The other driver would still have to use their insurance to pay the remaining 30 percent.
What makes this different from other interpretations of negligence is that even the at-fault driver can request and receive a payout from the other driver's insurance—as long as the blame was somewhat shared.
Let's go back to the same example of an at-fault driver who carries 70 percent of the blame. Because the other driver carries 30 percent of the blame, the at-fault driver can still receive assistance with 30 percent of their medical and repair expenses.
Modified Comparative Negligence
States with modified comparative negligence align with part of the previous example but differ in an important way. An at-fault driver who carries 70 percent of the blame will still be responsible for 70 percent of the other driver's damages. But they cannot receive damages from the other driver.
Under modified comparative negligence, a driver who carries more than 50 percent of the blame would not be covered under the other driver's insurance.
In states that use contributory negligence, also called pure contributory negligence, only drivers who carry 0 percent blame can collect damages from another driver's insurance. Here, it will not really matter which driver was at fault as long as both drivers share some portion of the blame.
If you are involved in an accident in one of these states, you may have to use your own auto insurance to cover your medical expenses even if you carried just a small portion of the blame.
States that follow contributory negligence include Virginia, North Carolina, Maryland, District of Columbia, and Alabama.
Even if your health insurance company is open to covering injuries from auto accidents, it may use certain tactics to discourage you from filing a claim. There are at least two ways a health insurance company might question your injuries—and possibly deny it in the end. The company can request to see your medical records, or they might require you to meet with an approved doctor.
Understandably, this can be a hassle. For some people, the prospect of having to jump through these hoops is enough to make them back down from their original claim to the health insurance company.
Here at Jefferson Spine and Injury Center, we can give you a free, friendly injury evaluation for insurance purposes. This might be health insurance or third-party insurance, as we'll explain below.
What Can Third-Party Insurance Cover?
If you are using someone else's insurance for your expenses (for example, if you're considered a no-fault driver or are otherwise entitled to damages from another driver who carries some blame), you might be confused as to what the insurance can actually apply to.
Often, the auto insurance that would cover your damages will be liability coverage under an auto insurance package.
This type of insurance is called third-party insurance because it covers people who aren't on the auto insurance itself. If you are using another driver's insurance, you would be the third party.
In terms of healthcare for auto injuries, third-party insurance can cover a few things. For example, it can cover medical expenses as well as loss of income as you're recovering.
Jefferson Spine and Injury Center is an example of a medical center that accepts third-party insurance claims. So if you've been involved in an accident and are wondering whether you can get your fees covered for treatment, we're an excellent option.
Now You Know!
Being in a car accident can be an overwhelming situation. And trying to figure out whether your medical bills will get paid is another stressor on top of that.
So now, if you ever find yourself in a situation like this, you'll know what to do. Look up the definition of negligence your state uses. Then figure out whose insurance will cover the damages and find centers like ours that will accept third-party insurance.
If you have suffered an injury due to vehicular collision near Arlington, VA, it is vital you contact a professional clinic that specializes in car accident injuries like Jefferson Spine and Injury Center.
Unlike many clinics, Jefferson Spine and Injury Center accepts ALL 3rd party insurance claims. That means their doctors can directly bill the at-fault party's insurance company.
Wouldn't you rather focus on your health and recovery rather than stressing about medical bills?
Don't delay any longer. Schedule a Free Injury Evaluation and begin your recovery process by clicking the button below today.