Somebody Else At Fault in Accident? You Still May Pay

It sounds ridiculous, but when someone hits your car and is at fault, hospitals, medical doctors, chiropractors, and physical therapists CANNOT bill the responsible party’s insurance company for direct payment.

There is no Georgia law that requires the liability carrier (at-fault party) to pay your medical bills. The bills first have to go through an optional automobile coverage you should buy called medical payments coverage. With the better companies, there is no deductible with this coverage, and if you were not at fault using it doesn’t raise your rates.

If you don’t have this coverage, you pay cash or turn to any other health insurance you have, with its built-in deductibles, copayments, exclusions and restrictions on who you can see, how often, and for how long. With increasing frequency, group or individual health insurance policies will not pay for auto-accident treatment.

What the liability carrier will do is tell you to let them know when you are through with treatment; then they will offer you a lump-sum settlement. Many times, particularly from one company that advertises a lot, what is offered is less than the sum of your medical bills.

Also, your health care bills can exceed the policy limits the responsible driver had in effect at the time of the accident. Of course the person who hit you may have no insurance. Then if you don’t have collision or uninsured motorist coverage (called UM) you are going to lose the value of your car as well. You can sue the other driver—if they didn’t hit and run, and if they have any assets. In or out of court, the settlement process can be very long; it often takes over a year.

If you have missed income due to injury, lost your car, or incurred unpaid medical bills, you could be in a deep financial hole. Hospitals and surgeons usually will not wait to be paid. This has resulted in many that have had to seek bankruptcy protection. Medical payments coverage of at least $10,000 is a huge safety net.

There are additional scenarios I don’t have the space to cover -- like in the case you or a family member doesn’t make a complete recovery and needs ongoing treatment. Or using your health insurance after an injury, getting a settlement from the liability carrier, and finding out your health insurance company has a legal right to be paid back what they spent in medical bills out of your settlement (subrogation rights), leaving you with nothing.

 The Best Advice Is:

 1] Buy medical payments coverage (med pay) from your auto insurance agent.

2] Discuss other optional coverage like uninsured motorist coverage (UM)

3] Have high liability limits, particularly if you have a teenage driver!

4] Start treatment ASAP after injury. Interruptions in care of over a week in the early stages of treatment are interpreted by insurance companies as “this person must not be hurt very badly.”  Interruptions in care severely damage your injury claim and getting a fair settlement from the liability carrier. They don’t care or take into account how busy you are with other things in your life. If injured get the care you need consistently until well.

Many times, people who think they have "full coverage" do not have medical payments coverage. Check with your agent.

 *All of the above has been reviewed for accuracy by attorneys with years of experience who specialize in this area of law.