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Does health insurance cover car accidents?

It happens in the blink of an eye. One minute, you’re safely going about your day. The next, you’re in the emergency room, maybe fighting for your life. Once you fully recover, you may think that the battle is over, and you can continue on with your life. However, taking care of medical bills after a car accident can be a struggle, even if it wasn’t your fault.

Even the safest of drivers can’t avoid collisions with other vehicles. In the 2017-2018 period, the CDC reported that approximately 3.4 million emergency room visits occurred due to motor vehicle crashes. 

Car accident injuries dip into two of the most common types of insurance: health and auto. It’s understandable if you’re not sure who to file a claim with or what to do next.

Keep reading to learn about the interrelationship between your health insurance, your automobile insurance, the negligent party’s liability insurance, which insurance provider pays first, and when you need a personal injury lawyer.

What Type of Car Insurance Covers Injuries?

In Missouri, you aren’t required to get auto coverage for medical bills you incur from a car accident outside of standard liability insurance. Missouri requires motorists to have liability coverage, which pays the other driver if you were at fault in the accident, and uninsured coverage, from which you can claim your injuries and damages if the other driver doesn’t have automobile insurance.  

You can add medical payment coverage, known as MedPay, to your policy to pay for medical costs up to a limited amount. MedPay usually covers between $1,000-10,000 of car accident-related medical expenses depending on your policy. 

It will cover you and usually any passengers in your vehicle regardless of who was at fault in the accident. If you were a passenger in someone else’s vehicle and are involved in an accident, regardless of whether it was their fault or not, you may ask your driver if they have MedPay coverage and make a claim to their policy if they do.

It’s essential to remember that MedPay only covers medical bills from your car accident. It doesn’t include coverage for lost wages or ongoing care costs.

Medical Cost Coverage: Which Insurance Pays First?

The answer to this often depends on the auto or health insurance policy. These policies contain language to determine how the insurance companies will coordinate between the various plans. Normally, the first payments for medical bills will come from your health insurance or your MedPay coverage.  

Health insurance or MedPay coverage pays first because they are contractually obligated to make these payments. There is no need to determine who was at fault in the accident to trigger their obligation to pay. 

Some policies will have Coordination of Benefits language, which will attempt to place an order on which insurance pays first. Some MedPay policies try to avoid duplicating payments made by your health insurance.

There are a lot of specifics on these issues that we can’t cover in one article. However, the attorneys at Eng & Woods resolve this issue for clients frequently. You can start a chat with us in the lower right corner to get in touch.

Can I Use Health Insurance to Cover Auto Accident Injuries?

Yes, and you should use it. Clients often ask why they should use their health insurance or MedPay coverage when someone else is at fault. There are several reasons for this:

1. Make Your Insurance Do Its Job.

Most importantly, it’s your coverage. You paid for it. Make use of the insurance you’ve been paying a premium on for years. 

2. The At-Fault Insurer Doesn’t Pay Until the End of the Case.

The at-fault insurer won’t pay your bills as they are incurred. Rather, they will make one lump-sum payment at the end of the case to compensate you for all your damages, including your medical bills. 

Most medical providers want payment for the medical treatment they provide when the services are rendered. Most won’t provide treatment if the patient has no means of payment. Using your health insurance allows you to get the medical care you need when you need it. 

This helps your case as insurers often view lack of treatment as proof that a person was not injured, when in reality, it may only reflect that the person doesn’t have health insurance.  

3. Using MedPay or Health Insurance Makes the Most Financial Sense.

This route makes the most sense because the negligent party that caused your injuries doesn’t benefit from your health or MedPay insurance. If your health insurance pays for your medical bills, the insurer for the negligent party cannot refuse to pay those bills by arguing that they’ve already been paid. This is called the Collateral Source Rule. 

In theory, if you went to the emergency room following an accident, you could have that bill paid by your health insurance, who would pay to satisfy the hospital. You could submit that same bill to your MedPay coverage, and they would send you a check for the amount of the bill (subject to your policy terms and limits). 

You can then submit that same bill to the negligent party’s insurance, and they’ll include it as part of your final settlement or judgment. In essence, you may be paid three times for the same bill.  

There’s nothing fraudulent about this process. You’re the one who pays a premium for both health and MedPay insurance, so you’re the one who is allowed to benefit from overlapping coverage.  

When Does the At-Fault Party Pay? Getting Maximum Compensation for Your Case

The at-fault party’s insurance isn’t responsible for ongoing medical expenses. They ultimately will be responsible for paying your medical bills, but it comes as a lump-sum settlement or jury verdict at the end of your case. Normally, this doesn’t occur until after you have completed your medical care. 

The at-fault party’s insurance may try to get you to settle quickly and agree to pay your ongoing medical bills up to a certain amount. This is a bad idea as you may not know at that point how much your medical bills may be, and you have now capped the liability of the insurer without being fully informed of the nature and extent of your medical condition. 

If I Use My Health Insurance and Then Get a Settlement, Do I Have to Pay My Health Insurer Back?

You may need to repay your health insurer. Generally, it depends on the type of health insurance you have. This repayment is called subrogation. 

Medicaid, Medicare and Veteran’s Benefits Programs

If your insurance is under a Medicaid, Medicare or Veteran’s Benefits program, your health insurer will be entitled to reimbursement from your settlement for benefits they have paid.  They may reduce what you owe by providing you with a credit for any attorney’s fees or expenses that you incurred in reaching your settlement. 

Private Health Insurance

The general rule for private health insurance in Missouri is that subrogation is not allowed, and you don’t have to pay back your health insurance. If your health insurance plan is self-funded through your employer, they will claim and are most likely entitled to reimbursement.  

Subrogation is an issue that the attorneys at Eng & Woods address in many of our cases. We’re wellversed in the best practices to address an insurer claiming a subrogation interest. We often negotiate with these entities to minimize any amount that has to be paid back to them to maximize what our clients receive.

Eng & Woods Attorneys at Law- Getting Help When You Need It

It’s essential to have someone in your corner to help you get the compensation you need to recover from your injury. 

A personal injury lawyer with experience in car accident cases can help you understand your case’s worth and fight for fair compensation.

If you’re looking for a personal injury law expert who can help you navigate the complicated intricacies of car accident injury insurance and compensation, contact Eng & Woods Attorneys at Law today to see if we could be a good fit for your case. 

To learn more about us and our work, check out our attorney profiles and verdicts and settlements page.

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