Car Accident Medical Bills
If you are hurt in a car accident and require medical treatment your car insurance policy is designed to provide you with medical benefits. However, a new option has developed wherein car insurers are offering you the option of making your health insurance primary for car accident medical bills. The upside to this is that it lowers the cost of your car insurance, the downside is that it might cost you more money if you are injured in a car accident. Depending upon your health insurance plan, you may not be entitled to medical benefits in a situation where another person causes your injury. You must confirm with your plan that you would have coverage in the event of a car accident. Additionally, many health plans have higher co-pays and deductibles than those in the standard car insurance policy. You should compare your plan’s co-pays and deductible against that of the PIP coverage. Finally, and perhaps the biggest risk that you run if you select your health insurance to be primary, is the plan’s assertion of a lien.
If your health plan has lien rights and you pursue a claim for a personal injury that you suffered in the accident, you may have to pay your health insurance company back for any money that they spent on your medical bills, if you receive compensation for your injuries. PIP is not entitled to a lien against any recovery that you receive for your injuries. Whether or not you will have to pay your health insurance company generally turns on their status as either an ERISA qualified plan or a non-ERISA plan. Figuring out their status is not as easy as asking as many plans assert that they are ERISA qualified when they may not be. We have had instances where health insurers have demanded substantial reimbursements as the medical treatment in the cases was extensive.
Many insurance companies are urging their agents to counsel customers to make their health insurance primary. This is because the profit margin on the PIP premiums that insurers collect is not as substantial as on the liability coverage premiums. This issue has become so significant that New Jersey’s Dept. of Banking and Insurance issued guidelines on its website, which may be found at http://www.state.nj.us/dobi/division_consumers/insurance/pipoption.htm
If you have a personal injury case or if you have questions about your PIP benefits please contact us for a free consultation.
If you have been injured because of the wrongful act of a doctor, nurse or other medical professional, an accident lawyer can help. For a free initial consultation, contact us by e-mail or call our offices, in New Brunswick at 732-247-3600 or in Somerville at 908-448-2560.