Injured in an Accident – Who Pays My Medical Bills?

If you are injured in an accident, one of the first questions you will likely have is “Who will pay my medical bills?” The answer depends on whether the accident happened at or outside of work and whether a vehicle was involved in the accident.

Work Accidents

If you are injured in an accident at work, your employer’s Worker’s Compensation insurance will pay your medical bills.  This obligation applies regardless of whether or not you caused the accident through your own negligence. The obligation to pay for medical expenses is for the rest of your life.  There are no deductibles or co-pays.  For the first six months after your injury, you can be required to treat with only employer-approved medical providers.  After that, you have free choice of doctors.

Vehicle Related Accidents

If you are injured in an accident involving a vehicle, car insurance will pay your initial medical bills.  The following rules define what car insurance policies cover medical bills, and they apply regardless of who caused the accident:

• For someone who owns car insurance, their own car insurance pays the medical bills;
• For someone who does not own car insurance, but resides with a relative that does, the relative’s car insurance pays;
• For someone who is uninsured and does not reside with an insured relative and was involved in an accident while a driver or passenger in a car, that car’s insurance pays; and
• For an uninsured, non-occupant of a vehicle, like a bicyclist or pedestrian, the insurance of any vehicle involved in the accident pays.

Car insurance policies must pay medical bills up to the limits of coverage.  The Pennsylvania State Minimum Medical Coverage is $5,000.  There are no deductibles, co-pays or limits on what providers can provide treatment.

When car insurance medical payment limits are reached, public or private health insurance must begin to pay medical bills.  If a lawsuit arises out of the accident, some private health insurance companies and all public companies are entitled to be reimbursed for their payments out of any recovery.  Claims for payment of future medical expenses can be asserted in the lawsuit.

Other Accidents

If you are involved in a non-work related and non-vehicle related accident, like a slip and fall or other accident causing injuries, medical bills will be paid by your public or private health insurance.  If you do not have health insurance, you will need to pay out of pocket.

If the accident was not your fault, you can bring a lawsuit against the responsible party to recover past and future medical expenses (as well as compensation for lost wages and pain and suffering).  Usually, if you do recover compensation in the lawsuit, your contract with the health insurance company will require you to reimburse public or private health insurance for the accident related medical bills paid on your behalf.

The following article is informational only and not intended as legal advice. Speak with a licensed attorney about your own specific situation. © Copyright 2011 MacElree Harvey, Ltd. All rights reserved.