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In DC, who is the primary insurance (car / health) required by law to be used first in an auto accident or personal injury case?

Washington, DC |

I would like all of my medical bills to be paid as well as be reimbursed for payments that were made to several of the medical provider’s who were demanding payment.

Attorney Answers 5


  1. It will depend on your health insurance contract., but generally your health insurance pays for your bills and then asserts a right of recovery (subrogation rights) against any recovery. Speak to a personal injury attorney to determine the best way to handle your claim.

    I am licensed in California, therefore, my answers are based on general prinicpals of law or California law, which may not be applicable in your jurisdiction. Answers posted to Avvo are for general information only. Do not conclusively rely on any information posted online when deciding what to do about your case. Every case depends is fact dependent, and responses are limited to and is based on the information you posted. No attorney-client relationship shall be created through the use reading of this response on Avvo. You should never delay seeking legal advice, disregard legal advice, or commence or discontinue any legal action because of information in this response.


  2. Typically the health insurance company first.

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  3. Some health plans say they are secondary to other ins. Some states only permit that type of clause as it pertains to other health plans and not auto med pay. Some auto med pay policies say they are secondary or excess, and only pay what isnt covered by any health ins. Need to get your policies and have local counsel review. Sometimes Im able to get health ins to pay, and then get med pay to pay money for bills to my client (not to providers whoo have already been paid).


  4. Usually the car insurance, such as PIP, med pay, etc., our primary. Once that coverage is exhausted, then you turn to secondary payers such as group health insurance, Medicaid, Medicare etc. If this was an accident for which you were not the cause, you may want to speak with a personal injury attorney to assist you.

    Legal Disclaimer:

    If this information has been helpful, please indicate below.

    Mr. Lundeen is licensed to practice law in Florida and Vermont. The response herein is not legal advice and does not create an attorney/client relationship. The response is in the form of legal education and is intended to provide general information about the matter within the question. Oftentimes the question does not include significant and important facts and timelines that, if known, could significantly change the reply and make it unsuitable. Mr. Lundeen strongly advises the questioner to confer with an attorney in your state in order to ensure proper advice is received.

    This ans. does not create an attorney/client relationship.


  5. In DC, PIP is optional and is secondary to health insurance; and, if you elect to use your PIP coverage following an accident, you cannot maintain a separate tort claim for pain and suffering and other compensatory damages, unless your injuries meet the "serious injury" threshold, or if the medical treatment/rehab expenses or wage loss exceed the available PIP coverage. Therefore, if you are a DC resident with a DC auto policy, you have to be very careful how you proceed. DC PIP law is very different from MD PIP law, which is almost the opposite of DC law. When deciding whether to use PIP under your DC auto policy, you have to weigh numerous factors, such as the nature of your injuries, how strong your case is against the other driver, the amount of your medical bills and lost wages, and the existence and amount of insurance coverage of the at-fault driver. If, on the other hand, you are a MD resident with MD issued auto insurance, then you can utilize your PIP as primary coverage and still file a tort claim against the other driver, even if the accident happened in DC. Hire an experienced personal injury lawyer who is familiar with both DC law and the law of the state where your auto policy is issued.

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