HOW WILL MY MEDICAL BILLS GET PAID?

 

     The first question many people ask when they are in a car accident is, "How will my medical bills get paid?"  In Pennsylvania, we have what I like to call a "partial no-fault system".  That means that medical bills are initally paid by an insurer without regard to who is at fault. 

 

     Unfortunately, navigating your way through this issue is more difficult and complicated than you might imagine, and for this reason most people hire a lawyer to help them.  Please feel free to contact our office for a free, no obligation consultation by either calling Mike Colarusso or Herb Cohen at (412) 261-1380 or sending us an email.  Our lawyers have over 50 years experience helping victims of careless drivers to get their medical bills paid and more. 

 

     For more information on this topic, click here.

 

Which insurance company pays depends upon the answers to four basic questions:

 

(1)  "For a named insured, the policy on which he is the named insured."  This means that if you own a car and have insurance, the insurance company insuring your car must pay your medical bills up to whatever limits you have selected.  For example, if you are driving your own car and are injured, your own insurance company pays your bills.  If you are a passenger in someone else's car, your own insurance company pays your bills.

 

(2)  "For an insured, the policy covering the insured."  This means that if you are not a "named insured", but you reside in the same household as someone who is related to you by blood or marriage and that resident relative owns an insured car, the insurance company insuring that resident relative's car must pay your medical bills up to whatever limits they have selected.  For example, if a you don't own a car and are injured while a passenger in someone else's car, if you reside in the household of a relative who owns a car, that relative's car insurance company pays your bills.

 

(3)  "For the occupants of an insured motor vehicle, the policy on that motor vehicle."  This means that if you are not a "named insured", and you are not an "insured", then the insurance company for the vehicle you are occupying at the time of the accident must pay your medical bills up to whatever limits they have selected.  For example, if you live alone and don't own a car, but you are a passenger in another person's car, that other person's insurance company pays your bills.  This is common when people are occupants of a bus.

 

(4)  "For a person who is not the occupant of a motor vehicle, the policy on any motor vehicle involved in the accident."  This means that if you not a "named insured", not an "insured", and not an "occupant of a motor vehicle", then the insurance company for any car involved in the accident must pay your medical bills up to whatever limits they have selected.  For example, if you live alone and don't own a car, and you are injured while riding a bicycle or as a pedestrian, the insurance company for the person who injures you must pay your bills. 

 

If you are not a "named insured", you are not an "insured", you are not an "occupant", and the person who injures you has no insurance, there is a state fund that pays your medical bills called the Pennsylavania Assigned Claims Plan.

 

Pennsylvania law requires that every auto insurance policy provide for at least $5,000 in medical benefits.  The amounts paid by insurers is tied in to Medicare fee schedules.  The important thing to know is that doctors and hospitals must accept those payments as payments in full--you should not have any co-payments or deductibles.