Written by attorney Jason Garrett Epstein

Getting Medical Treatment and Coverage after an Auto Accident

If you were injured in an auto accident, it is critical to get necessary medical treatment and coverage for two reasons. First, it will help you physically recover as quickly as possible. Second, it will help document your injuries, symptoms, and complaints as you experience them. That will be important evidence if you choose to make a claim in order to pay for your medical bills and injury-related damages.

Getting medical treatment

If you need immediate medical help, go to the emergency room or an urgent-care center.

As quickly as possible after the accident, notify your auto insurance provider that you have been in an accident. Ask to open a Personal Injury Protection (PIP) claim (if PIP is part of the coverage you selected). In some situations, you may be eligible for PIP benefits from someone else's insurance policy; for example if you were a passenger in a car, or you were a pedestrian struck by a car. You will then need to complete a PIP application, which will generally include the facts of the accident and the type of injury you suffered. Once that application has been processed, the insurance company should begin paying PIP benefits up to the amount the policy covers (usually $10,000 but it can be more). PIP will pay for all medical bills that are reasonable, necessary, and caused by the accident.

PIP will pay for your medical treatment as you get the bills. You can select whatever medical provider you want. PIP is separate and distinct from your health insurance, so you do not need to see your primary doctor first.

The limitations of Personal Injury Protection (PIP)

Even a first-party (your own) insurance company is in business to make a profit. Insurance companies do not want to pay your medical bills any longer than they absolutely have to. The law states that PIP has to pay your reasonable, necessary bills until the insurance company has a medical opinion stating that your treatment is not reasonable, not necessary, or not related to the accident. In order to stop paying, insurance companies obtain this medical opinion by sending you to a doctor of their choice. This process is called independent medical examination. These reports usually come back in favor of the insurance company, saying that you are not injured and don't need any more treatment.

At that point, your PIP carrier is permitted by law to stop paying claims under your PIP coverage. This is another point where it is crucial to consult with an attorney who focuses on personal injury cases. Remedies are available for this situation, and an attorney can help you hold the insurance company's feet to the fire if possible.

Using your health insurance

Once PIP coverage has either been exhausted or cut off, your regular health insurance will start covering your medical bills. Your health insurance company will process the bills as usual, meaning that you now need to comply with the terms of your health insurance contract. If it requires you to see your primary doctor before going to a specialist, then you must do so. If it only covers a certain amount of chiropractic or massage therapy per year, for example, then those limits will apply to what it covers.

If insurance is not available

If you do not have PIP or health insurance, and the accident did not happen while you were on the job (in which case you may have been eligible for Labor and Industries workers' compensation insurance) , then you will have to either pay for your medical bills out of pocket, or find a treatment provider who is willing to hold your bills until they can be paid out of a personal injury settlement.

If you find yourself in this situation, speak to an attorney as soon as possible.

Most attorneys give free consultations for personal injury cases, and if you decide to hire an attorney, most will work on a contingency fee. This means that the attorney only gets paid if they get you money, and then the attorney fee is a percentage of the compensation you get. This allows you to hire an attorney without having to pay anything up front.

Additional resources:

Rocky Mountain Insurance Information Association: What If I'm Hurt in an Auto Accident? (

Chiro-Active Health & Rehab Center, Inc.: After an Auto Accident: What You Should Know (

Related Legal Guides:

Vehicle-Related Injury Guide (

Determining the Value of Your Personal Injury Case (

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