Who Pays My Medical Bills While My Case Is Pending?

If you’re injured in an accident, the at-fault party may be liable for your medical expenses, but you are responsible for paying your bills while your case is pending. You must work with your doctors and insurance providers and find ways to ensure you get the care you need until your case settles or goes to trial.

In no-fault states, your PIP or MedPay covers your injuries, regardless of fault. In other states, your policy may cover your injuries, but the insurer may seek reimbursement through subrogation or a medical lien. To understand who pays for your medical bills while your case is pending, contact a local personal injury attorney for legal advice.

Financial Responsibility for Medical Bills

Throughout your case, many parties may share financial responsibility for your medical bills. Financial responsibility is balanced between:

• The injury victim
• The at-fault party
• Insurance companies
• Healthcare providers
• Government benefit agencies

If you have private health insurance, your health insurance company must pay for covered medical treatment, but they will expect reimbursement after your case settles. You can ask your health care providers to delay collection with a medical lien, so they can collect after you settle your claim.

Injury victims generally get the initial bills for their medical care. Even if a negligent driver, dangerous product, or slip-and-fall accident caused your injury, doctors and hospitals will still send their bills to you. If you prove your personal injury claim, the at-fault party must compensate you for your injuries, but that can take time.

Your attorney can also negotiate a Letter of Protection (LOP) with doctors and medical providers so they can provide care while delaying collection until your personal injury case settles. Medical professionals may also need an LOP if the medical costs exceed the insurance policy limits.

Until you receive a jury award or settlement proceeds, your attorney can help you work with your insurance company and healthcare providers to pay your medical costs or delay collection until you resolve your case.

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Letter of Protection from Your Attorney

A letter of protection (LOP) is an agreement between you, your attorney, and your healthcare provider that the doctor will be paid for your medical care after you resolve your personal injury claim.

An LOP is a legal contract that guarantees your doctor will be paid for their services even if you cannot pay at the time. After your case settles or you recover compensation, the doctor can use the LOP to ensure you pay for the care you already received.

Your doctor is not required to accept or agree to an LOP. Your attorney can negotiate with the doctor to agree to the LOP, based on assurances that you will recover enough in your case to cover your medical needs. Your attorney generally works on a contingency basis and asks the doctor to make a similar commitment.

Who Pays First in Personal Injury Cases

The party that pays first may not be the one that ultimately covers the cost of care. Your car insurance or health plan may pay first for your care but seek reimbursement if another party is liable for your damages.

Medical care coverage generally falls under primary or secondary insurance. The primary insurance provider pays first in an injury claim. The secondary insurance can cover additional costs not covered by the primary provider, including deductibles, copayments, and medical expenses that exceed the primary insurance coverage limits.

For example, older workers may have both employer-provided insurance and Medicare. The employer’s insurance company may be primary and pay first for medical treatment, depending on the employer’s size and the policy terms. Medicare is secondary and covers many remaining costs not paid by the primary insurer.

MedPay and PIP Coverage

The party that pays first in a personal injury accident case varies by state. In no-fault liability states, drivers generally carry personal injury protection (PIP) or MedPay. PIP and MedPay pay for your medical expenses regardless of who caused the accident. If you have PIP or MedPay, your own car insurance policy will generally pay first while you file your personal injury claim.

In at-fault states, the at-fault party pays for damages. However, resolving disputed car accident claims takes time. The at-fault driver’s insurance company generally won’t pay out until your case is resolved in court or through a settlement. In the meantime, you are responsible for your own medical costs.

Health Insurance Coverage for Medical Expenses

Your health insurance will cover your medical expenses temporarily while your case is pending. When you receive medical care after an accident, the hospital or doctor will generally ask about the cause of the accident and whether another party may be liable for your injuries.

Your health insurance will cover your hospital bills but pursue reimbursement from the at-fault party’s insurance company through subrogation.

Subrogation Claims by the Insurance Company

Subrogation is common in car accident, slip-and-fall, and other personal injury claims. When parties dispute who caused the accident, insurance companies protect their interests through subrogation.

One insurer may pay out a claim but reserve the right to be reimbursed if another party is liable.

What Is a Medical Lien?

A medical lien is a claim filed against you to recover part of your settlement or personal injury award. Your healthcare provider, health insurance company, car insurance company, or government benefits agency can file a medical lien to secure their right to recover costs for your medical treatment.

When you agree to a settlement offer, lienholders can assert their claims against your award to recover reimbursement for their expenses. This can reduce the amount you recover in your injury claim.

However, your attorney can negotiate with the lienholders to lower their claims so you can get more of your injury award. For more information about medical liens and subrogation, talk to your personal injury lawyer.

Ask Your Attorney About Paying Medical Bills After Your Accident

After an injury accident, you don’t want to worry about your medical bills and out-of-pocket costs while recovering from your injuries. Unfortunately, injury victims in most states are responsible for their own care while their case is pending.

Talk to your attorney about how to get the care you need if you can’t pay your medical bills.