When you sustain serious injuries in a collision with another motorist, the first thing you may wonder is “who pays medical bills in a car accident?” Considering that you likely have medical expenses to pay and have missed time from work, it’s certainly a legitimate question. It’s also one that doesn’t always have straightforward answers. Who pays medical bills after car accident depends on many factors, including whether your injuries are significant enough to meet New York’s serious injury threshold and therefore bypass its no-fault system.
Medical Bills & No-Fault Insurance in New York
New York is a no-fault state when it comes to auto insurance. This means that your own insurance company should pay your medical expenses regardless of who caused the accident. If you were the passenger in someone else’s vehicle and sustained injuries in an accident, his or her auto insurance carrier should pay your medical expenses under the no-fault statute. When you’re hit by a vehicle while walking or riding a bicycle, the insurer of the driver who struck you is responsible for paying your medical expenses. This also applies to other non-motorized forms of transportation, including rollerblading, skateboarding, and riding a scooter.
In all cases, the typical maximum payout for medical care lost wages, and other costs associated with the accident is $50,000. Some people purchase additional coverage under their insurance company’s no-fault coverage but this isn’t mandatory. Unfortunately, the thought of your insurance company capping your payout at $50,000 is little comfort if you have sustained serious injuries that require extensive medical care and time away from work. When your car accident claim exceeds policy coverage, you would be responsible for paying the rest out of your own pocket.
Many seriously injured people consider filing a personal injury lawsuit when they realize that they will need to pay significant expenses themselves due to injuries caused by the negligence of another person. It’s important to note that personal injury protection (PIP), also known as no-fault, doesn’t provide you with compensation for things such as pain and suffering or emotional distress.
To learn more about no-fault insurance, visit FAQ: How Does No-Fault Insurance Work?
Does Health Insurance Cover Car Accidents?
Most health insurance carriers will pay towards your medical expenses associated with a car accident once you have exhausted your no-fault coverage. However, each private insurer, as well as Medicare and Medicaid, have their own limits on payment of claims. If you pursue a personal injury lawsuit and win, private and government health insurance carriers have the right to seek reimbursement for claims paid.
One thing to be especially careful about if you do reach a settlement with the other party is that your medical providers may engage in a practice called balance billing. This means that they may attempt to bill you directly for the amount that the insurance company wrote off or forced the hospital or clinic to negotiate. The practice is not only unethical, but states are increasingly passing legislation against it.
Your health insurer can attempt to recover monies it paid on your behalf if you win a settlement. This is called subrogation. However, you should not be responsible for paying the difference between the amount it billed your insurance company and the amount your insurance company actually paid. If you feel that medical providers are intimidating you or treating you unfairly, you have the right to seek legal representation.
New York’s Serious Injury Threshold
New York is one of 12 no-fault states that allows people to bypass the system in the case of serious injury. State law defines serious injury as one or more of the following:
- Significant Disfigurement
- Loss of a Fetus
- Permanent loss of a body member or organ
- A significant limitation of a bodily system or function
- Any non-permanent injury that prevents the injured person from performing his or her typical daily responsibilities and routines for at least 90 days in the 180 days immediately following the accident
While the state does provide a list, it can sometimes still feel vague to injured people. If you feel you meet the definition of serious injury and desire to move forward with a lawsuit, it’s in your best interest to speak with a personal injury attorney as soon as possible. Among other things, he or she can help clarify whether your specific injuries fall into the state’s serious injury threshold or not.
Learn More About Your Rights After A Crash
Knowing who is responsible for paying medical bills after a car accident can be a complex issue, especially when a hospital, insurance company, and third parties are involved. A knowledgeable automobile accident attorney can protect you from unintended outcomes as well as help you understand your legal rights and options when it comes to paying for care due to a motor vehicle accident.
If you’ve been involved in a crash and have questions about you pays medical bills after a car accident or would like to discuss your legal options to recover compensation, contact our personal injury law firm today for a free consultation. Complete the contact form online or call 212-268-3222 to speak with a New York accident attorney about your claim.