Massachusetts personal injury attorney James M. Lynch reviews how medical bills are paid after a motor vehicle accident.
Who pays your medical bills after you’ve been in an automobile accident? The answer is not as clear as you may think. Massachusetts residents are required to have health insurance so you might expect your health insurer to pay. If you have been in an auto accident, however, your health insurance carrier does not usually pay for all your treatment and this may be good news for you.
Generally, medical bills are first paid by the auto insurance carrier that provides insurance coverage for the automobile you were riding in during the accident. This coverage is called Personal Injury Protection (“PIP” for short) and it is included in all automobile insurance policies sold in Massachusetts unless the policyholder specifically excludes it. PIP is a “No-Fault” benefit which means that it is a benefit you are entitled to under the insurance policy regardless of who was at fault in the accident.
PIP is a valuable benefit. It provides coverage worth at least $2,000.00, but up to $8,000.00 in certain circumstances to pay medical bills or, alternatively up to 75% of your lost wages or a combination of the two. A lawyer will assist you in maximizing your benefit under PIP.
Not everyone is eligible for PIP coverage. For example, it is not available to people who were riding on a motorcycle at the time of an accident. It also does not provide coverage to people who are entitled to workers’ compensation benefits for the same injury. There are also some other limited circumstances when the insurance company can deny the PIP benefit. You should consult with an attorney at Lynch & Owens to find out if any such circumstances apply to your case.
Even after the auto insurance company has paid its limit under PIP, you may still be entitled to have additional medical bills paid by your auto insurance company if you purchased optional insurance coverage called MedPay with your policy. MedPay is optional because the vehicle owner does not have to have the coverage, but it is available and he/she may purchase it when purchasing the policy. MedPay will pay medical bills that result from an automobile accident up to the limit you’ve purchased once PIP is exhausted regardless of who was at fault in the accident. You should consult with a lawyer soon after an accident to discuss what insurance coverage is available to you and how you can best use these benefits to get your medical expenses and other losses paid as quickly as possible.
Your health insurance policy will pay the medical bills remaining after PIP and MedPay(if applicable) have been paid up to the limits of coverage. While it may not seem that it is all that important who pays, it actually is because your health insurance company is given a lien by law against any future recovery you receive for your injuries. This means that your health insurance company is entitled to be repaid the money it spent on your care out of the money (whether from settlement or verdict) you receive to compensate you for your injuries. The amount of this lien can be substantial so you need to work with your lawyer to make sure that you maximize your benefits under the auto insurance policy to, in turn, minimize the amount of your own health insurance company’s lien.
About the Author: James M. Lynch is the managing partner at Lynch & Owens, located in Hingham, Massachusetts and East Sandwich, Massachusetts. He is also a mediator at South Shore Divorce Mediation.
Schedule a consultation with James M. Lynch today at (781) 253-2049 or send him an email.