Health Insurance Payments

If I submit medical bills to my insurance company, do I have to agree to pay it back if I recover other damages such as lost wages, pain and suffering from at-fault driver’s insurance?

One of the many problems after a car accident with injuries is you will start to get medical bills within a few weeks of your treatments. As the envelopes start to show up in the mail, it can be alarming. How will you pay for them?

In Oregon, drivers are required to have Personal Injury Protection or PIP insurance that will cover at least the beginning of the medical bills up to $15,000. Even if you were responsible for the accident, your PIP will pay for your medical bills up to the policy limit. Generally, PIP will cover 80% of reasonable medical bills for things such as initial injury treatment, surgery, X-rays, dental repairs, rehabilitative services and so on. PIP in Oregon will also compensate you for up to 70% of your lost wages up to $3000 per month.

If you settle with the other driver and the accident was their fault, you may need to pay back your insurance company from the settlement for the PIP benefits it paid.

An issue that comes up is after PIP is exhausted. Who pays your medical bills then? It is a misconception that the client’s attorney covers the medical bills until the settlement check comes. This is not true. After your PIP benefits run out, your own health insurance will pay for your medical bills according to your policy. You still may be responsible for paying co-pays and part of the bill, though. If your health insurance policy covers your bills and you are awarded money in a settlement for that bill, the health insurance company will ask for it back. This is known as subrogation and it is meant to prevent you from being compensated two times for the same injury. This also can occur if your private health insurance policy pays for a bill and then PIP covers it.

Most medical bills that are not covered by PIP in Oregon are paid when the case settles. This can take several months. During that time, you may have bills piling up. You need to make sure your attorney has a copy of every bill. Do not lose track of the bills you receive because they can still be sent to collections and damage your credit.

You may need to talk to the medical provider and have them put the account on hold until you receive your settlement. Some healthcare providers may allow you to make small payments to prevent the account from going to collections.

Just remember that you are still responsible for paying your medical bills even if you are waiting for your settlement check to pay them. Your attorney can help you through this confusing and stressful process. Your attorney is accustomed to working with healthcare providers and insurance companies who want to get paid. He can assist you in keeping track of all the medical bills and accounts that need to be satisfied when the case settles.