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50/50 accident. I have an ambulance bill for over $900. Should I pay it or have it go through my health insurance and pay $100.

Anaheim, CA |

I have an ambulance bill for $900. I spoke with my health insurance and if I go through them I will only owe $100. The thing is, I don't want to "help" out the other guy's insurance simply because I have health coverage. Obviously if it is 50/50, owing $50 looks a whole lot better than owing $450.

Will going through my health insurance to pay for the ambulance help or hurt my claim in any way in terms of a settlement?

If I use my insurance, will I have to reimburse them once I get my settlement?

Thank you for your help I appreciate your time

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Attorney answers 8

Posted

If you have "no-fault" or "P.I.P" ( pesonal injury protection) coverage under your automobile insurance policy, you should be seeking payment under your auto policy and not your private health insurance.

David Lee Fiol

David Lee Fiol

Posted

California does not have a no-fault law. We have optional medical payments coverage which creates a lien on personal injury recoveries, so it is little different from submitting a claim to a health insurer. In California we often use med pay coverage to reimburse for copays, deductibles and care that is not covered by medical policies.

Jeffrey Ira Schwimmer

Jeffrey Ira Schwimmer

Posted

Thank you for that insight.

Posted

All very good questions!

Letting your insurance company pay the ambulance bill is not going to hurt your claim; at least not in the way you are thinking. The claims rep for the other guy's insurance company doesn't look only at what you paid for your care: they look at the total bills, because as you suspect, you will have to pay back your medical insurer if you make a personal injury recovery.

The way that your case might be affected by your own medical insurer paying your bill is through the deals that insurers often get from healthcare providers. While the bill might be for $900, a larger insurance company might pay a significantly lower amount - perhaps $400, and then the other side will look at that reduced amount, rather than the full amount of the bill, in valuing your case.

All in all, I don't think you can gain much by manipulating who pays the bills. If you pay in full a bill that you could have submitted to insurance (and have it paid at a reduced rate), the other side will probably figure this out and argue that they are not responsible for your overpayment.

Posted

dont worry what the other guys insurance pays and worry more about what comes out of your pocket. Besides the other guy probably does not get credit for your health insurance payment under the collateral source rule. So, assuming you got no other treatment and agree with 50/50, make them pay $450 but still use your health insurance to cover the bill. Your health insurance may ask for reimbursement but the amount is like to be less than $450 because health insurance gets discounts....allowing you to keep the difference.

If you did get other medical care or do not agree with the 50/50, go hire an experinced PI attorney who can maximize the amount you get to keep.

Posted

In California, the other side gets to reduce the bills to the amount that health insurance paid and you have to reimbuse your health insurance the full amount (since you do not have an attorney.) I agree that if you have health insurance and do not use it, the other side will figure this out and discount your medical bills anyway. It's up to you which way you go, but I suggest you get an attorney and use your health insurance and get the reduction the attorney gets for a proportionate share of attorney fees and costs, unless it's an ERISSA plan of course. Good luck.

I am licensed in California only and my answers on Avvo assume California law. The above answer is for general information only and is based on the information you posted. Every case is fact dependent, so to get a thorough analysis of your situation, you will need to consult face to face with an attorney licensed to practice in the jurisdiction where the incident took place. Do not conclusively rely on any information posted online when deciding what to do about your case. 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.

Posted

The medical bills from a car accident are generally paid for by your automobile insurance company under PIP provisions. The value of your claim could be effected by how you choose to handle the billings. It is best to consult with a local attorney on these issues so the the attorney and have all the facts and issues in front of him/her. You should make sure you get all necessary medical treatment.

Richard Andrew Harting

Richard Andrew Harting

Posted

this is a California case so there will not be any PIP (personal Injury Protection) coverage for you. You may have what is called medical payment expense on your policy, but that will be reimbursable at time of settlement with the third-party.

Posted

No one should handle any claim (involving a motor vehicle accident with bodily injury) against any insurance company without a lawyer. Claims should be handled by a lawyer - one who will be able to understand and explain the physical damages and injuries from accident. The victim of a car accident really needs to worry about one thing - getting better. That means attending doctor's appointments, attending physical therapy (if appropriate), and taking his or her medication. All of the rest can be handled by a personal injury attorney. An attorney will figure out how medical care can be paid while the case continues forward. An attorney will explain whether a client is liable for medical bills or who else is. We earn our fees (contingent by the way) by taking on the stress and hassle of fighting for money - I dare say some of us actually enjoy the fight, but I realize that most people do not enjoy conflict.

The best part about hiring a personal injury attorney is that we offer free consultations and should we accept a case (and the client accepts us), we work on contingency. Thus, there is absolutely nothing to fear in calling us.

- Paul

Paul J. Molinaro, M.D., J.D.
Attorney at Law, Physician, Broker
Fransen & Molinaro, LLP
980 Montecito Drive, Suite 206
Corona, CA 92879
(951)520-9684
www.fransenandmolinaro.com / www.888MDJDLAW.com

"When you need a lawyer, call the Doctor... Call Paul J. Molinaro, M.D., J.D... Call (888)MDJDLAW."

* This post and all others I make on Internet are for informational purposes only. None of the information or materials I post are legal advice. Nothing I post as comments, answers, or other communications should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing of this information does not constitute, an attorney-client relationship. While I try to be accurate, I do not guarantee accuracy.
** Fransen & Molinaro, LLP practices in the areas of personal injury, medical malpractice, and real estate law.

Paul J. Molinaro, M.D., J.D. ... Attorney at Law, Physician, Broker... Fransen & Molinaro, LLP... 980 Montecito Drive, Suite 206... Corona, CA 92879... (951)520-9684... www.fransenandmolinaro.com / www.888MDJDLAW.com... "When you need a lawyer, call the Doctor... Call Paul J. Molinaro, M.D., J.D... Call (888)MDJDLAW." ... * This post and all others I make on Internet are for informational purposes only. None of the information or materials I post are legal advice. Nothing I post as comments, answers, or other communications should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing of this information does not constitute, an attorney-client relationship. While I try to be accurate, I do not guarantee accuracy... ** Fransen & Molinaro, LLP practices in the areas of personal injury, medical malpractice, and real estate law.

Posted

Bills paid by PIP. You can have one of the above lawyers in your state review this with you.

Only 29% Contingency Fee! Phone: 215-510-6755 www.InjuryLawyerPhiladelphia.com

Posted

use your insurance. they will have to reimburse you for the entire amount paid by you and the insurance carrier. then it is likely you will need to reimburse your health carrier.

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