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How Are My Medical Bills Paid after an Accident?

08.04.2017 by | Insurance

how are medical bills paid by pip

When I first meet new clients, the most common concern voiced is about the payment of medical bills—who is going to pay said medical bills, to be exact. At the Dolman Law Group, we’ve written extensively about Florida’s No-Fault Laws and how Personal Injury Protection in the state of Florida works, so I won’t go too in-depth on that topic.

But to be clear, Florida Personal Injury Protection (PIP) or “No-Fault” medical insurance is coverage that all drivers with Florida automobile insurance policies are required to purchase. This policy covers the insured’s medical bills following a car accident (typically up to a limit of $10,000.00). This means that, regardless of who is at fault or where “liability” lies in the car crash, each individual is meant to be covered, at least initially, by their own PIP insurance. The purpose behind this construct is to allow “expeditious medical treatment without having to wait for a Court of Law to determine and opine of liability.”

[Click here to view some answers to Frequently Asked Questions regarding PIP.]

PIP Coverage only Goes so Far

The coverage provided by PIP insurance can be helpful in the days and weeks immediately following a car crash, but many people find—especially those that went to the Emergency Room or the Hospital following the crash—that $10,000.00 can be spent fairly quickly. While there is a limitation on what medical providers can be paid for their services through PIP, many of my clients use up the entirety (known as “exhaust benefits”) before they’ve seen a medical specialist of any kind.

Follow the Health Insurance Road

After PIP is exhausted, many of my clients find themselves choosing between having their medical providers bill their personal health insurance or providing their doctors with a Letter of Protection. Letters of Protection allow people without health insurance to get medical treatment by having a doctor agree to forgo any collection efforts and instead agree to be paid for their services once the case has been settled.

When clients ask me if they should allow their medical providers to bill their health insurance for treatment, I advise them to do so. I do this because it eliminates a great deal of financial risk for the client. When a health insurer pays the bills from a personal injury case, they typically notify the attorney and the client of their intent to pursue a lien against the personal injury case. Essentially, health insurers ask to be paid back out of the proceeds of the case.

The benefit to the client is that they profit from the contractual rates previously negotiated between the health insurance company and the medical provider. Further, should the client’s case lose for any reason, their medical bills (that were covered by health insurance, at least) are paid and there is no lien to pay back. While this last situation is exceedingly rare (and unfortunate when it occurs), it is important to us that our clients are able to walk away from the case without a large quantity of medical bills looming over their heads.

Additionally, treating under health insurance eliminates one of the most powerful tools the Defense has should the case proceed to trial. In cases where health insurance is not used, Defense attorneys do everything in their power to imply that the Plaintiff’s treating physicians are only testifying to the seriousness of the client’s injuries for financial gain. They are able to do this because the doctor, in those situations, has not been paid yet. However, when a client has their doctor bills paid by health insurance, this factor is eliminated.

Again, Letters of Protection serve a very important purpose in that they allow those without medical insurance to receive care for their injuries. However, they do open the door for the insurance company to plant the seeds of doubt in a jury’s mind.

The Big Misconception

The biggest misconception that I see about how all of this works, is that many of my clients believe their bills are being paid as they are treating. This misconception is created, I believe, by how health insurance and PIP insurance operate. With those two types of insurance, bills are submitted in a timely fashion and then paid within some reasonable amount of time (at least in a perfect world). However, with a personal injury claim (at least one in which the client does not have health insurance), bills are not constantly being paid by an insurer as the case proceeds. Instead, there is one final settlement with the insurance company that is meant to satisfy all outstanding medical bills, future medical bills, lost wages, loss of future earning capacity, and any other components of a Plaintiff’s claim.

Allowing medical bills to pile up unpaid can be daunting for some people, but it’s important to realize that the ultimate outcome should be more than enough to satisfy their medical bills (assuming the case is legitimate).

Contact a Clearwater PIP Attorney with Questions

If you were injured in a Florida car accident and have questions about the nature of your rights, contact the Dolman Law Group, the premier personal injury lawyers in the greater Tampa Bay area. We can advise you as to what steps you need to take after an accident under Florida law. Contact us today online or at (727) 451-6900 for a free, no-risk consultation.