Handling Car Insurance Claims

For many people, they may need to file two, or three, or maybe more, car insurance claims if they are hurt in a car accident.

The first kind of insurance that many of us have is our own personal health insurance.  For a lot of reasons, you are best off if you can have any medical bills from a car accident sent to your health insurance company for payment.  Unfortunately, some doctors and hospitals refuse to submit car accident bills to health insurance if they think that they can recover from a car insurance payout.  Why?  Because most insurance companies have negotiated discounts with most hospitals and doctors.  So if you have Blue Cross/Anthem insurance, and you have a CT scan done after you hurt your neck in a car accident, the basic cost of that CT scan might be $1,000.  But Blue Cross has negotiated a lower price — say, $600.  If the hospital is paid by Blue Cross, they only receive $600; if they can collect from car insurance, they can collect $1,000.  So many health care providers will refuse to submit your bill to Blue Cross, figuring that they might have to wait longer, but if they get paid by State Farm, they can get paid $1,000.  For them to do this actually violates their contract with Blue Cross, but Blue Cross isn’t about to complain if they are not required to pay a bill.  And the hospital certainly won’t complain — they get paid more.  Who loses?  You do. Fortunately, the Virginia General Assembly recently passed a law that requires that they submit everything to your health insurance carrier first. Unfortunately, many health care providers don’t follow the law, and need to be reminded to do so.

The second kind of insurance coverage that comes into play is the liability insurance of the person that caused the accident.  If the other driver rear-ended you, and the accident is the other driver’s fault, his insurance company will be looking to settle the claim with you, preferably (for them) at pennies on the dollar, hoping that you don’t know enough to recognize when they are conning you.

The third kind of coverage that many people have is called medical payments coverage.  This is insurance that you buy, and it pays medical bills if you or someone in your family is hurt in a car accident.  This is money that you are entitled to regardless of whether the bills have been paid by your health insurance, and regardless of whether they have been or will be paid by the liability insurance carrier.  People are sometimes concerned that it is somehow unfair or unethical or illegal for them to collect on their medical payments insurance when health insurance has paid the bill; it is not.  The Virginia courts have made it quite clear that if you have paid a premium for medical payments coverage, you are entitled to the benefits provided for in the contract.  You bought them, you paid for them, you are entitled to them.  If you don’t apply for medical payments coverage, you lose and the insurance company shareholders win.

You are entitled under your insurance contracts — contracts that you paid for — to collect under each of the three kinds of car insurance.  Let’s say that you have a fairly simple whiplash claim.  You have medical bills related to the accident of $5,000, and you have health insurance and $2,000 of medical payments coverage.  The other driver had insurance.  If the doctors to send the bills to your health insurance, you will have most of the bills paid by Blue Cross.  Then you can file your medical payments claim, and collect $2,000 yourself.  This can be used to pay any amounts still leftover to pay (co-pays or deductibles), and you can pocket the rest, legally.  Finally, you will be able to settle the claim with the liability insurance carrier — let’s say that you settle for $15,000.  If you had the health insurance pay the bills when they were incurred, you would be able to keep the $2,000 in medical payments coverage and the $15,000 from the liability carrier.  Bottom line — you receive $17,000.  If you did NOT have the health insurance company pay the bills when they were incurred, you will receive $17,000 just as before, but now you have to pay the $5,000 in medical bills, so you receive $12,000.  In this scenario, a big chunk of your final settlement goes to pay off the hospital.  And in the year or so since the accident, the hospital has been calling YOU, trying to get you to pay the bill that they should have submitted to Blue Cross.

Make sure that the hospital sends the medical bills to your health insurer.

We have experience in dealing with all 3 types of insurance (plus a few others that might come into play that we haven’t talked about here), and we will make a claim for all that you deserve.  Call us at 434-293-8185.