Would accepting payment from ins company of the other driver for medical liability affect my own insurance claims?

Asked about 2 years ago - Orlando, FL

I was crossing a street on my bike when struck by a truck. I have auto and health insurance, both whom agree the cost of accident falls under their coverage. The accident was 100% my fault but the drivers insurance company has agreed to tender their policy limit (100k) in light of my hospital time and injuries in exchange for a release of future claims. If I sign this will I have to use it to repay the expenses I am insured for ( my hospital bill, 4 doctor visits, damage to his truck, etc?) ? I did not seek legal action or make any claim, they just offered me the payment and now I am unsure if I should mention this to my insurance companies as well. Thanks!

Attorney answers (4)

  1. Peter Scott Van Keuren

    Contributor Level 12

    8

    Lawyers agree

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    Answered . There a number of issues herein. First, your PIP coverage is responsible for payment of your medical bills up to the PIP limits (typically $10,000). Bills are paid at the rate of 80% unless you also have medical payments coverage under your auto policy.

    Your health insurance carrier will have a lien upon your settlement for any amounts they have paid prior to the date of settlement. If you are still treating you can still submit your bills to them without repercussion.

    If you have uninsured/undersinsured motorsit coverage and you wish to claim damages beyond the $100,000 being offered, you need to notify your insurance carrier and request that they either wiave subrogation or pay you the $100,000 being offered.

    You really need an attorney to help you through this, however, you probably should not agree to pay the attorney a 1/3 fee on the $100,000 already offered. Negotiate an hourly rate or let them handle the UM claim in exchange for their help.

    Do not accept the $100,000 and sign a release to the at fault party without consulting an attorney.

  2. Julie S Luhrsen

    Contributor Level 14

    3

    Lawyers agree

    Answered . I'd strongly encourage you to still consult a personal injury attorney, as there may well be issues that you are not familiar with that could affect your recovery! For instance, if the owner of the truck is different than the driver,there may be additional insurance coverage that could be pursued. With regard to your question, to the extent your health insurance paid for claims related to this accident that you obtain a recovery for, your contract of insurance likely requires that they be reimbursed for expenses that a third party pays for.
    Teh bottom line is that an experienced personal injury attorney can explore these options for you, as well as ensure your interests are being protected as fully as possible. Most offer free initial consultations & most work on a contingency (in situations where a client comes to us with an offer already extended, we typically agree to only charge a contigency on the additional amount we are able to recover for teh client).

  3. Lars A. Lundeen

    Pro

    Contributor Level 20

    1

    Lawyer agrees

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    Answered . There may be some liability issues that you have missed here. No insurance company tenders money when you were clearly at fault and the other party was not at fault.

    Before you decide to accept anything, it behooves you to have a free consultation with a personal injury attorney in your area to see if anything has been overlooked.

    In all likelihood, your insurance policies that have paid on your medical bills have subrogation clauses, which require you to repay them for moneys advanced on your injury bills. If you get a payment from the other party, you need to satisfy your contractual obligations. You need to be sure that you comply with your insurance l agreement, otherwise you can find yourself sued for the money.

    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.

  4. S. David Rosenthal Esquire

    Pro

    Contributor Level 18

    3

    Lawyers agree

    Answered . It sounds like your health insurance paid some of your medical expenses, but did your auto insurance pay some as well? Typically any kind of medical insurance (auto and health) has a right of reimbursement written in the contract. Basically, these say that if you are injured and you receive a liability settlement, the insurance company is entitled to be reimbursed from the settlement for accident related medical expenses it paid. However, your insurance company is not entitled to be reimbursed for any property damage claim it paid to the other party for your liability.

    If your health insurance company has not sent you a letter indicating that it is pursuing reimbursement, it's possible that it never will. That doesn't mean the contractual right doesn't exist - it just means that they company didn't recognize the situation as one where it could seek reimbursement. There may also be state laws or equitable doctrines that would prevent or limit the amount of reimbursement even if the claim were made. The same is true for any medical payments reimbursement claim made by your auto insurer.

    If reimbursement claims are being made, you may need to seek the assistance of an attorney. The most economical would be by the hour.

    Good luck.

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