What Do I Do About My Spouse’s Accident Medical Bills?

Your husband was in a serious car accident recently. It wasn’t his fault—he was hit by a drunk driver. He had to go through surgery, and for a while, you weren’t sure he was going to make it. Now, it looks like he’s going to be okay, but meanwhile, you’ve got bills piling up. How are they going to get paid?

Insurance Companies Require Treatments to be Finalized Before Paying

The good news is that if the car accident was the other driver’s fault, his or her insurance company and/or his or her employer’s insurance company (if the driver was “on the job” at the time of the accident) will likely be responsible for your husband’s medical bills.

The bad news is that it will take time to settle the claim with the insurance company (or companies). The insurance companies will likely want to wait until your husband has been discharged by his doctors and has reached “maximum medical improvement” before gathering all the expenses together to pay the claim. In other words, they won’t pay your medical bills as you incur them. (There are exceptions if you live in a “no-fault” state like Pennsylvania. See below for more on that.)

In the meantime, there are bills to be paid, which means you will have to take other steps to pay them. If you don’t, the unpaid bills may go to collections, which can negatively affect your credit. If the insurance company ultimately denies your claim, you may be responsible for paying the entire amount owed on the bill.

The answer is: send your medical bills to your health insurance company as you always would.

Your Health Insurance Will Cover Your Doctor and Hospital Bills

Most health insurance providers will pay for your car injury treatment under your regular health insurance policy. You simply submit your doctor and hospital bills to your insurance or Medicare. They should pay the bills, but then if you get your settlement from the insurance company, your health insurance company will expect to be reimbursed for their pay-outs.

It is important to check your auto insurance policy. In some cases, your policy may  include “medical payment” (also called med pay) coverage. If so, that part of your auto insurance should pay your doctors or reimburse you for health insurance co-pays and deductibles up to a certain limit.

What About No-Fault States?

If you live in a no-fault state (like Pennsylvania or New York), the rules are different. The no-fault law does not assign blame in a car accident and requires your insurance company to pay for your injuries even if the accident was someone else’s fault.

This allows you to get your medical claim set up faster, and you won’t have to wait to get your medical bills paid. If your medical bills exceed the state’s no-fault limit, however, you will be responsible for those bills. In that case, you’d again submit those bills to your health insurance provider. You should also pursue  a personal injury lawsuit against the at-fault driver, but as that will take time, you’ll still need to submit your medical bills to your regular health insurance.

How a Personal Injury Attorney Can Help

In a case like this, a personal injury attorney can help you get more out of your claim. Let’s say your husband’s medical treatments included an ambulance trip, hospital visit, surgery, several doctor’s visits, and a month of physical therapy. While all this is going on, you submit all of the bills to your health insurance provider (or to your auto insurance if you have med pay).

Once your husband is recovered, which takes months, your personal injury attorney negotiates with the “at-fault” driver and prepares a settlement package. After some back and forth, you and your husband agree to the settlement. It includes compensation for all medical bills, your husband’s lost wages, pain, and suffering.

Your personal injury attorney then notifies your health insurance company of the settlement. The health insurance company requests reimbursement. Your attorney may be able to negotiate with them to reduce their reimbursement request. If that negotiation is successful, you and your husband would keep the rest of the settlement money, minus any attorney fees and any costs.