THE MCMILLIAN LAW FIRM - PROVIDING AGGRESSIVE AND COMPASSIONATE REPRESENTATION FOR CAR ACCIDENT VICTIMS OF CHARLESTON, SC AND SUMMERVILLE, SC
On many occasions, I find myself in a consultation with an accident victim and the question comes up about whether the medical bills from the accident should be submitted to the victim's own health insurance company. It stands to reason that this is often a source of confusion for the client, especially considering that since the negligence of another driver caused the injuries, wouldn't the appropriate move be to wait on their car insurer to pay all my bills. What purpose could possibly be served by submitting medicals bills caused by someone else to the health insurer of the innocent victim. Well, let me explain why that is exactly what an innocent victim with their own group health insurance should do.
REASON #1: THEY ARE YOUR MEDICAL BILLS!
The most overlooked aspect of medical bills to come about from injuries sustained in car accidents is that, despite who is at fault, they are still your medical bills! The services provided to you and the cost associated with those services are still entirely on you. Doctors, therapists, radiologists, and other service providers, though empathetic to your plight, do not want nor are they required to delay demands in payment simply because you are the innocent victim of someone else's negligence.
Also, is its important to remember that the negligent driver's insurance does not have to advance any payments for your medical bills. The insurer will not pay you for your injuries until they accept liability for the accident on behalf of their insured and offer a settlement or their insured is found liable for the injuries at trial.
It is also important to remember two other factors that apply to medical bills resulting from car accidents. First, the at-fault driver's insurance company will not pay your medical service providers directly. Whether you hire an accident attorney or not, the insurance company will either pay you directly or pay you through your attorney, and then it will be your responsibility or the responsibility of your lawyer to forward payments to your service providers. Secondly, and more importantly, as the bills become older and remain unpaid, your medical service providers will refer these accounts to collection agencies and your credit score and general financial health will suffer. As twisted as this practice seems, insurance companies prey on your financial vulnerabilities to offer low-ball settlements and delay paying out the legitimate claim.
REASON #2: INCREASE YOUR NET SETTLEMENT
The best way to explain this principle is to use a hypothetical car accident:
Lets imagine that you are involved in a car accident that is the result of another driver's negligence. You are carried by ambulance to the Emergency Room, where you are diagnosed with soft-tissue injuries and a broken leg. Surgery will be required on the broken leg, along with a hospital stay, and extended physical therapy. Eventually, your doctor clears you from your medical treatments. Upon being released from care, you learn that your accrued medical bills for all of your medical services is $100,000.00.
So . . . you have $100,000 in medical bills due and you have health insurance . . . WHAT DO YOU DO?
You submit your medical bills to your health insurer . . . and here is why!
Nearly all group health insurance plans that are offered through employers (United Health Care, Aetna, Blue Cross Blue Shield, Humana, etc.) provides you with a benefit called a "negotiated fee plan." This means that your health insurance company will pay the doctors, hospitals, and providers that treated you at pre-negotiated rates. That is the essence of modern health insurance, health insurance companies provide doctors and hospitals with countless customers (patients) and in return, doctors and hospitals provide services to people insured by these health insurance providers at discounted rates . . .
And the best part is . . . the medical service provider accepts the payment from your health insurance company at this discounted rate as payment in full! You do not have any responsibility for the difference between the original bill and the discounted bill.
Not quite understanding, lets go back to the hypothetical:
Using the $100,000 figure from our example, let's say your health insurance company pays $60,000.00. If we safely assume that your deductible/co-pay has been met, your $100,000 in bills have been satisfied in full for $60,000.
How does this benefit you?
Let's say that the negligent driver who struck you had a policy with $100,000 limits and those funds are collected. If you do not utilize any benefits from your health insurer, and considering that most attorneys will take a fee of 1/3rd of the recovery, you are automatically starting at $67,000 to pay the $100,000 in medical bills. Now a proficient car accident attorney will negotiate with your medical providers to get everything paid for with the remaining $67,000 . . . but now the entire settlement is accounted for and you as the victim have no net proceeds to collect.
Now lets assume that you do utilize your health insurance coverage to pay your bills resulting from the accident. The health insurance company has a right to be reimbursed for the money it spent paying for your medical bills since they were the result of third party negligence. So, the insurance company will be owed $60,000 of your $100,000 insurance recovery. (This is called subrogation and I have an article addressing this on the Blog as well) However, most health insurers will negotiate this amount with your attorney and take a reduced amount to satisfy the subrogation lien. The discount often ends up being in the neighborhood of 30%. So, now by utilizing your health insurance the following takes place:
- The medical bills that were originally $100,000 have been satisfied in full for around $42,000; and
- The attorney has collected his fee of $33,000 (1/3rd of the recovery); and
YOU HAVE AROUND $25,000 TO KEEP AS PART OF THE SETTLEMENT!!!
*Remember, in negotiating a settlement with the insurance company of the at-fault driver, the full costs of the medical services can be claimed as the actual "damages" . . . so the $100,000 total for the medical services is the number that is worked from with the auto insurance company.
ALWAYS SUBMIT YOUR MEDICAL BILLS FROM A CAR ACCIDENT TO YOUR HEALTH INSURER!
The lesson to take away from this article is that you always submit the medical bills from your car accident case to your group health insurance carriers for immediate payment.
- Your bills will be paid quickly
- Your bills will be paid at a discounted rate
- You get to claim the entire amount billed by your medical providers in your personal injury case.
THE MCMILLIAN LAW FIRM - DEDICATED TO SERVING CAR ACCIDENT AND INJURY VICTIMS IN CHARLESTON, SC AND SUMMERVILLE, SC
As a Car Accident and Personal Injury lawyer in my solo practice, I will take all necessary steps to protect your rights and earn just compensation for you as a result of your accident. Through my efforts, I can bring about much needed financial relief to a victim who may be suffering from serious injuries and permanent disability. Being a small firm allows you to have direct access to your lawyer during this entire process, with open lines of communication as we work together towards a viable solution to your specific case.
Being an experienced personal injury attorney, I have experience dealing with insurance companies. I also know where the courthouse is and will not be afraid to call the insurance company to the mat in front of a judge and jury if necessary.
If you or a loved one has been injured in a car accident or due to the negligent or reckless acts of another in Charleston, Summerville, Mount Pleasant, James Island, West Ashley, Goose Creek, Moncks Corner, North Charleston, or any of the other fine communities of the Low Country, and need to meet with an experienced personal injury lawyer, please contact me to set up your free case evaluation today. Let me help prevent you from being taken advantage of by the insurance company. I am serious and I am here for you! Contact The McMillian Law Firm today @ 843-900-1306