Does Medical Insurance Cover Car Accidents? Here's What You Need To Know
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If you’ve been injured in a car accident, you may assume your health insurance will automatically cover your medical bills. Unfortunately, that’s not always the case. Between first-party insurance, liability insurance, and health insurance coverage, figuring out who pays for your medical care can get complicated.
Below, we’ll break down how medical insurance applies after a car accident in Texas, why some doctors refuse to treat accident victims, how subrogation works, and when a Letter of Protection (LOP) can help you get the treatment you need.
How Health Insurance Covers Car Accident Injuries
After a car crash, your regular health insurance can help pay for emergency room and urgent care visits, even if another driver caused the accident. Most health insurance plans will cover diagnostic tests, follow-up treatment, and referrals to specialists just as they would for any other injury.
However, your health insurance carrier may limit what’s covered and may require pre-approvals for ongoing therapy. In Texas, you also have to consider how your health insurance coverage interacts with your auto insurance policy and the other driver’s liability insurance.
What Health Insurance Typically Covers After a Car Accident
Your health insurance plan may cover:
- Emergency room or urgent care treatment
- Diagnostic imaging and lab work
- Follow-up care with specialists, if approved
- Prescription medication
What’s not covered are your copays, deductibles, and out-of-network charges. Those costs can add up quickly, especially if your injuries are severe.
Why Some Primary Care Doctors Refuse to Treat Car Accident Victims
It’s common for auto accident victims to find that their primary care physician won’t provide medical treatment related to a car accident injury.
Many doctors refuse these cases because they don’t know who will pay, whether that’s your health insurance company, your car insurance company, or the at-fault driver’s insurer. Others simply don’t want to get dragged into court to testify about your injuries. They’d rather spend their time treating patients, not sitting in depositions or waiting to testify.
The Payment and Legal Concerns Behind These Decisions
Doctors are often concerned about:
- Delayed payments if an auto insurance claim is still under investigation
- Confusion over whether health insurance or auto insurance should pay first
- Being subpoenaed to testify about your treatment in a personal injury lawsuit
These concerns are valid from the doctor’s perspective, but they can leave injured people without access to the medical care they need.
The Role of Auto Insurance in Paying Medical Bills
In Texas, which is an at-fault state, the driver who caused the accident is responsible for paying damages. But that doesn’t happen overnight. You may have medical bills due long before a settlement is reached.
That’s where your own auto insurance coverage can come into play. Two important types of coverage can help: Personal Injury Protection (PIP) and Medical Payments (Med-Pay) coverage.
PIP and Med-Pay — Two Key Auto Coverages
- PIP coverage pays for medical expenses and lost wages, regardless of fault.
- Medical Payments coverage only covers medical expenses, but it functions similarly.
These coverages are optional, but they can help bridge the gap until your car accident claim is resolved. Instead of calling your insurance company yourself, contact Allbee Law Firm. We’ll determine if you have PIP coverage and make sure your rights are protected before any insurance adjuster can trap you with a recorded statement.
What Happens If Health Insurance Pays First?
If your health insurance company pays your medical expenses, it usually has the right to be reimbursed later when you receive a car accident settlement. This process is called subrogation.
It ensures the at-fault party, not your health insurer, ultimately bears the cost of your medical treatment. But there are exceptions under Texas law.
Exceptions to Subrogation in Texas
You may not have to repay your health insurance provider if:
- Your claim involves uninsured or underinsured motorist (UM/UIM) coverage
- Your health insurance plan is a non-ERISA plan that provides a discount or “contingency-style” reduction upon repayment
- Your case falls under Chapter 140 of the Texas Civil Practice and Remedies Code, which limits subrogation rights
An experienced Dallas car accident attorney can review your health insurance policy to determine whether you’re obligated to repay your health insurer.
When Health Insurance Limits Your Treatment Options
Private health insurance companies often impose strict limits on the number of therapy or chiropractic sessions you can receive after a car accident. They may require multiple pre-approvals or deny continued care if they think your progress has plateaued.
These restrictions can delay recovery or prevent you from getting the medical care you need. That’s where a Letter of Protection (LOP) comes in.
How a Letter of Protection Can Help
A Letter of Protection is an agreement between your attorney and your medical provider that guarantees payment from your settlement. This allows you to receive treatment without paying anything up front.
Unlike health insurance, an LOP doesn’t cap the number of therapy visits or require pre-approval. It also gives you access to doctors who specialize in treating car accident injuries. Your personal injury attorney coordinates payment once your case settles.
What If the Other Driver’s Insurance Refuses to Pay?
If the at-fault driver’s insurance provider refuses to pay your medical bills, you still have options. Don’t deal directly with their insurance adjuster. Adjusters are trained to minimize your claim, and even something said innocently can be used against you later.
Instead, contact Allbee Law Firm immediately. We’ll communicate with the auto insurance companies on your behalf, handle the accident claim, and make sure you’re protected every step of the way.
Understanding No-Fault and At-Fault Rules
Texas operates under an at-fault insurance system, meaning the driver who caused the accident pays for damages. Some states use no-fault coverage, where each driver’s insurance pays their own medical expenses regardless of fault.
Because Texas is an at-fault state, you must prove liability before the insurance companies will pay for your injuries from a car accident. That’s one reason it’s crucial to gather evidence and contact a Dallas injury lawyer early.
Do You Have To Repay Your Health Insurance Company?
Whether you have to repay your health insurance company depends on your health insurance plan type and the settlement details.
ERISA plans typically require full reimbursement, while private or non-ERISA plans may offer discounts. A car accident lawyer can often negotiate with your health insurer to reduce the amount you owe, maximizing your take-home recovery.
How To Handle Medical Bills After a Car Accident
If you’re injured in a car accident, focus on two things: getting proper medical care and protecting your legal rights.
- Seek emergency treatment if needed.
- Contact Allbee Law Firm before speaking with any insurance company or giving a recorded statement.
- Let your attorney handle communication with all insurance providers.
- Keep copies of your medical records and bills for your case file.
Getting legal help early keeps you from saying something that could damage your injury claim and ensures all available insurance coverage is properly used.
When To Contact a Car Accident Lawyer
If you’re injured in a car accident, contact a personal injury attorney as soon as possible. An attorney can:
- Review your insurance policies to identify all available coverage
- Help arrange Letters of Protection with qualified doctors
- Handle all communication with insurance companies and manage your insurance claims
- Negotiate reductions on repayment to your health insurance carrier
At Allbee Law Firm, we provide a free consultation and work on contingency, meaning you never pay out of pocket for our services. Our goal is to ensure you receive the medical care you need and the compensation you deserve.
Final Thoughts on Health Insurance and Car Accidents
Your health insurance may cover some medical expenses after a car accident, but every case is different. Between auto insurance, PIP coverage, and potential subrogation claims, the process can be confusing and time-consuming.
Before dealing with insurance companies on your own, talk to a lawyer who handles motor vehicle accidents every day.
If you’ve been hurt in a car crash, call Allbee Law Firm today at (972) 848-4848 for a free consultation. We’ll explain your options, coordinate your medical treatment, and fight to make sure the right insurance pays your bills.