Who Pays The Medical Bills?

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Haverhill Massachusetts and New Hampshire Car Accident Injury Lawyer

To protect your rights to compensation for injuries suffered in a car accident, you should contact a personal injury attorney as soon as possible after your car accident.

The following provides information about how medical bills are paid if you are injured in a car accident while occupying a care insured in Massachusetts or New Hampshire.

If You Are Injured in a Massachusetts-Insured Car

If you were injured in an automobile accident while you occupied a Massachusetts-insured car, the law requires procedures for payment of your medical bills.

Every car insured in Massachusetts carries as part of its insurance a benefit known as Personal Injury Protection (P.I.P.). These PIP benefits will pay the medical bills, up to a certain limit, of anyone occupying that car-even when the driver of that car is not at fault. The insurance company paying these benefits then is reimbursed by the insurance company of the driver who was at fault.

Some of the rules regarding PIP coverage are complicated, and we encourage you to ask questions. In general, PIP benefits provide payment of your medical bills as follows:

  • If you have no health insurance: If you are not covered by any health insurance at all, or if you are covered by Mass Health or Medicare, then the PIP benefits will cover $8,000.00 of your medical bills. Part of that $8,000.00 may be used to reimburse you for lost wages instead of being applied to medical bills.
  • If you have health insurance that does not require a referral or authorization for medical treatment: Where you have health insurance that does not require a referral or authorization in advance of medical treatment, PIP will pay the first $2,000.00 of your medical bills regardless of whom the medical provider is. After that, you are required to submit the remaining medical bills to your health insurance provider. Any amount your provider does not cover will generally be covered by PIP benefits until you have exhausted $8,000.00 in PIP benefits.
  • If you belong to an HMO or have health insurance which requires an authorization for medical treatment, or a referral or approval by a primary care physician, before obtaining medical benefits: In this situation PIP again will cover the first $2,000.00 of medical bills regardless of who the provider is. HOWEVER, AFTER THAT, YOU MUST COORDINATE YOUR MEDICAL TREATMENT THROUGH YOUR HEALTH INSURANCE PLAN. If you obtain medical treatment outside of your plan, it MAY not be covered either by your medical insurance or by PIP. The ultimate result will be that your settlement will be reduced because your medical bills will have to be paid out of settlement.

The first step is to check with your health insurance immediately to see if they require prior approval, authorization, or referral for medical treatment. You need to find out what they require and tell us as soon as possible. Also, if the doctor treating you refers you to other doctors, you should first check with your health insurance to get a referral so that any tests, procedures, and exams are covered.

The goal is to get as much medical treatment covered as possible, either by pip or through your health insurance.

If You Are Injured in a New Hampshire-Insured Car

Payment of bills in this situation is much easier. Usually, an Automobile insured in New Hampshire carries medical payment insurance which covers the medical bills of occupants up to a stated limit. You should discuss this with your attorney in order to maximize your recovery and protect your rights.

Free Initial consultation: Contact a car accident lawyer at Finbury & Sullivan, P.C. today for a free case evaluation. We offer home and hospital visits.

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If you have been injured in an auto accident, denied Social Security Disability, injured at work, or if you have other legal concerns, our attorneys are ready to talk to you. The initial consultation is free. Our law firm has provided experienced, caring, responsive service in the Merrimack Valley since 1946.

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