Countless injured accident victims struggle with paying for auto accident related medical treatment. Many do not have health insurance. Others have health insurance but do not know if they should file their accident-related medical treatment charges with their health insurance provider or pay out of pocket. Read on for more information.
Should you use your Health Insurance when paying for auto accident related medical treatment?
Whether you have private or government issued health insurance, most people use their health insurance to keep their out of pocket costs as low as possible. So, what happens when you incur medical expenses for medical treatment due to injuries caused by someone else’s fault in a car accident?
In North Carolina, the at-fault party is responsible for paying an injured accident victim’s accident-related medical expenses that resulted from the at-fault party’s negligent actions. However, receiving reimbursement for accident-related medical treatment from the at-fault driver’s insurance company can often times be a lengthy process, and medical providers want to be paid immediately for their rendered services. That’s when injured accident victims file their accident-related medical treatment on their private or government issued health insurance. There are no laws in North Carolina that prevent people who have been injured in an automobile accident from filing their accident-related medical treatment with their own health insurance company. In many cases an accident victim’s health insurance company will pay some, if not all of their accident-related medical expenses. If they do pay for the accident-related treatment, what happens next?
What is Subrogation or Right of Reimbursement?
When a health insurance company has paid some or all of an accident victim’s accident-related medical expenses, often times they will claim a right of reimbursement or subrogation to any recovery proceeds paid to the accident victim from the at-fault driver’s insurance company for accident-related medical expenses. Most health insurance companies state a right to reimbursement in their plan’s language. However, North Carolina Department of Insurance regulation states in its language,
“Life or accident and health insurance forms shall not contain a provision allowing subrogation of benefits.” 11 N.C. Admin. Code 12.0319.
This North Carolina regulation does not allow health insurance plans to recover any of an accident victim’s settlement proceeds. However, it is extremely important to note that there are many exceptions to this North Carolina regulation, therefore allowing some health insurance plans to seek reimbursement from an accident victim’s settlement proceeds. For example, Medicare, Medicaid, and different types of self-funded health insurance plans are allowed to seek reimbursement for any payment of an accident victim’s accident-related medical expenses. These types of health insurance subrogation matters can become complicated and have dire consequences if not handled by an experienced NC car accident attorney.
The Bishop Law Firm can help you decide how to proceed when paying for auto accident related medical expenses. We handle car accident injury cases in Raleigh, Cary, Durham and surrounding areas in North Carolina. Give us a call today, (919) 615-3095!