It should be pretty obvious that the leading cause of personal injury is a car accident. Injuries range from whiplash and minor contusions to broken bones and permanent paralysis.
As an injury victim steps out of the urgent care or emergency room, the thought of how he or she is going to pay his medical bills. Who is responsible for paying for your medical treatment, x-rays, MRI or emergency surgery? What is the role of the other guy’s insurance? For what will your insurance pay?
Is Determining Who to Pay Complicated?
Determining who will pay your medical bills and in what order is best is important, complicated and confusing. Each individual accident victim’s situation is different and what is good advice for one injury victim may not be sound advice for another.
Medical Payment Insurance: No-Fault Insurance Coverage
No-fault insurance is insurance that pays for medical treatment and it doesn’t matter who is at fault. In New Mexico, the most common type of no-fault insurance is Medical Payment Coverage. This is sometimes called “Med Pay.” This type of insurance will pay medical bills up to a certain amount depending on the amount of coverage purchased from the insurance company. Policies are usually sold in the following increments: $1,000, $2,000, $5,000, $10,000, $25,000, $50,000 or $100,000. Note that some out of state companies sell Personal Injury Protection or PIP coverage. PIP coverage works in a similar way to Med Pay Coverage.
Medical Payment Coverage can be used to pay for any type of medical bill related to the motor vehicle crash. It will cover any type of reasonable treatment for car accident related injuries. This may be acupuncture, chiropractic treatment, urgent care visits, emergency room visits, surgery, physical therapy, massage therapy or even for reimbursement of co-pays that are required by your insurance.
It is important to note that Med Pay usually reimburses the injury victim and this means the victim may have to come up with some form of payment before requesting reimbursement.
Using Personal Health Insurance to pay Car Accident Related Medical Bills
Many individuals think that it is best to have your treatment provider bill your medical expenses to the other guy’s car insurance. Nothing could be further from the truth. It is usually best to try to have your bills paid by your health insurance if possible. This may be Medicaid, Medicare, Blue Cross Blue Shield, Presbyterian, Lovelace etc… There are three principal reasons for this.
First, if the treatment provider sends a bill to the other guy’s insurance, then the bills will go unpaid until it is time to settle the entire claim. The car insurance carrier will not pay as you go and most treatment providers will submit your bills to collections long before the car insurance company is willing to pay. This can damage your credit and be very stressful.
The second reason to use your personal health insurance is to secure the payment discount. When your health insurance pays your bills, it will be at a reduced rate. This means that the health insurance company will pay much less than the actual billed amount. For example, a $20,000 bill may be paid at around $7,000. In New Mexico, you will still be able to collect the medical bill of $20,000 from the insurance company but your subrogation liability will only be $7,000.
The third reason is that your personal health insurance will usually have to pay part of your attorney fees.
Subrogation Rights of Health Insurance Carriers
It is important to remember that if your health insurance carrier pays your medical bills, then you may be liable to pay them back out of any insurance proceeds you receive. In other words, your health insurance has a right of subrogation. However, if you have an attorney, the health insurance carrier may have to pay part of his attorney fee.
Third-Party Liability Insurance
New Mexico law requires that all drivers carry third-party liability insurance. It requires that the minimum amount of insurance is for $25,000 per person injured in a car crash and a minimum of $50,000 in insurance for all of the combined injuries arising from a car crash.
Of course, the most common way to get your bills paid is by making a claim with the other guy’s insurance carrier. This means setting up a claim and negotiating with an insurance adjuster. The other guy’s car insurance is responsible for paying for almost all types of compensatory damages. These may include medical expenses, loss of enjoyment of life, loss of consortium, scarring, disfigurement, future medical care, pain and suffering and wrongful death. It will also be liable for other types of losses related to these injuries like lost wages, loss of earning capacity, diminished value of your vehicle and loss of household services. This list is not exhaustive.
It is important to note that most third-party liability insurance policies don’t cover punitive damages arising from a motor vehicle crash. This means that if the other driver was talking on his cell phone, drinking and driving or texting while driving, the insurance company can excuse coverage for these types of damages.
Uninsured Motorist Coverage
Uninsured motorist coverage comes into play when the other driver has no insurance or is not covered for punitive damages. This insurance will pay for the damages that the other driver caused. This will include physical injuries, medical bills, pain, and suffering etc. However, the uninsured motorist will also pay for punitive damages. They will pay this even if the other driver is insured for compensatory damages.
Underinsured Motorist Coverage
Underinsured motorist coverage is considered a subcategory of uninsured motorist coverage. The only difference is that it covers losses that exceed the coverage provided by a third-party insurance carrier. In other words, it will pay for damages above and beyond the amount of the insurance coverage of the other guy’s policy.
For example, if the injury victim’s damages are $45,000 and the liability carrier pays out policy limits of $25,000, this means that the defendant was underinsured. If the victim is covered by underinsured motorist coverage in the amount of $50,000 or more, then the underinsured motorist insurance carrier would pay the additional damages in the amount of $15,000.
Whitener Law Firm Can Help
The attorneys at Whitener Law Firm regularly deal the issue of getting medical bills incurred as the result of a car crash paid. We know how to deal with these insurance companies and how to best use the resources available to you to ensure that you receive the maximum compensation available in a particular case.
We have the experience you need to navigate the complex world of insurance claims. We know what insurance to look for and how to ensure that the insurance companies pay a fair amount to compensate injury victims.
We can help you get the most compensation for your insurance claim.
If you were injured due to someone else’s negligence, call Whitener Law Firm to find out what we can do to get you the money you deserve. For a free consultation regarding a personal injury claim, contact us at 505-883-7877.
There is NO FEE unless we win your case.