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Who Will Pay My Medical Bills? Deborah Nelson+ January 27, 2014

One of the first things that people worry about after they have been injured is “who will pay my medical bills?”  The answer might surprise you.

According to Washington law, the insurance company that insures the person who injured you does NOT have to pay for your medical treatment until you are ready to settle your case.  Since you should not settle your case until you have recovered from your injuries and know whether you will need future medical treatment, this leaves most people in a bind.  What do they do between the time they are injured and the time they are ready to settle their case – especially since this gap may be months or even years?

If you were injured as a result of an automobile collision (regardless of who was driving or was at fault) or a car hit you while you were a pedestrian or riding your bicycle, your Personal Injury Protection (“PIP”) insurance should pay your bills.  Everyone who has a car should have Personal Injury Protection (“PIP”) insurance.   If you do not have PIP insurance (or if you aren’t sure whether you have it), RUN, don’t walk, to the phone and call your insurance agent!!  PIP insurance is one of the best types of insurance you can purchase.  There are different levels of insurance you can purchase.  We strongly recommend that you purchase at least $35,000 worth of PIP insurance.

PIP is extremely inexpensive and will pay for your medical treatment if you are injured as the result of an automobile collision, regardless of who was driving and regardless of who was at fault.  Unlike health insurance, there is no deductible, no co-pay, no-preauthorization requirement, and you can choose your own healthcare providers.  The only requirements are that (1) the treatment is received within three years from the date of the collision; (2) the treatment is provided by a licensed healthcare provider; (3) the cost of the treatment is reasonable; and (4) the treatment is necessary to treat injuries you suffered as a result of the collision.  In addition, it provides a small reimbursement for funeral expenses, lost wages, and loss of services (childcare, lawn care, household care, etc.).

If you do not have PIP insurance or were injured as a result of something other than an automobile incident, your health insurance should pay your medical bills.  However, you will have to pay your deductible and co-pays when you receive your medical treatment.  In addition, your health insurer will still require that you reimburse it, but those laws may be much less favorable to you that PIP reimbursements, depending on your insurance plan.  In some cases, your health insurer is entitled to demand that you pay for 100% of the benefits it paid, regardless of whether you are fully compensated for your injuries.  For this reason alone, it is important that you purchase PIP insurance so that you can use that if you are injured as the result of an automobile collision.

If you are injured at someone’s home or on someone else’s property, you may be eligible for limited payment of medical bills under the property owner’s liability insurance, even before your case is settled.  Most property owners automatically carry something known as “Med Pay.”  This insurance will usually pay for a relatively small amount (often $5,000) of medical treatment if you are injured on someone else’s property.  However, receiving these benefits is not an admission of fault by the property owner.

We hope this article has answered your questions about how you will afford medical treatment.  At Nelson Boyd, we have years of experience in dealing with all types of insurers and injuries.  We know how to maximize our clients’ recovery while helping them get the medical treatment they need.  If you have been injured, give Nelson Boyd a call at (206) 971-7601. Contact us today!