Who Pays Medical Bills in a Car Accident?

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by Samantha B.
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If you’re injured in an accident that is not your fault, you may wonder who is responsible for paying for your medical treatment. In the long term, the negligent driver is responsible for paying your medical bills through their insurance company. However, in the short term, you are responsible for your medical bills before the negligent driver’s insurance company will reimburse you. 

Who Pays The Ongoing Medical Expenses?

Even if the negligent driver is clearly at fault, the law does not require him or her to pay your medical bills on an ongoing basis. The only thing the law requires is that, if the other person is found at fault in court, he or she must pay your damages in a personal injury case. But the negligent driver is not legally required to continuously pay your medical bills as they come in. That responsibility lies with you, but there are ways to avoid the high cost of medical treatment.

Do Car Insurance Liability Policies Offer Medical Expense Coverage?

Liability policies are facets of car insurance coverage that are required by law in all states except New Hampshire. If a negligent driver causes a car accident, or is “liable,” liability coverage helps them pay for the other person’s expenses. Liability insurance covers property damage, but also covers medical injury through Bodily Injury Liability Coverage (BI). BI liability covers medical expenses, funeral costs, and lost income. Though you may rely on a negligent driver’s insurance company to pay for medical expenses, they often will not do so until all medical treatment is finished and the total expense is calculated.

What Role Does Your Health Insurer Have?

When you are injured in a car accident, it’s important to notify your health insurance company as soon as you can. Depending on your coverage, they may be able to get immediate help with medical bills. It should be noted that if a health insurer pays the medical bills you incur from your car accident, they are entitled to be reimbursed for what they paid your health care, should you receive a personal injury settlement.

What is Personal Injury Protection Insurance?

Personal Injury Protection (PIP) is a type of auto insurance that reimburses drivers and their passengers for medical expenses incurred after a car accident. Unlike other forms of auto insurance, PIP does not require drivers to prove fault in accidents, hence its other common name, ‘No Fault Insurance.’ Because there is no “fault” reported for the car accident, PIP insurance covers medical bills quicker than traditional cases where fault is a factor.

What Does PIP Insurance Cover?

PIP Insurance covers the following:

  • Ambulatory services
  • Medical and surgical treatment
  • Medication
  • Lost income due to an inability to work
  • Funeral expense

PIP benefits and coverage will vary depending on the state you live in. There is a PIP limit for every state that considers it mandatory, and the values range drastically. For instance, New York has a limit of $50,000, offers to pay 80% of lost monthly wages, and gives $2,000 for funeral services. In other states, PIP coverage levels can be much higher or much lower, like Michigan’s unlimited coverage or Utah’s $3,000 limit. Ask an insurance agent or your insurance company for specific details about how much your PIP insurance covers.

What is Medical Payment Insurance?

Medical Payments Insurance, or MedPay, is an addition to auto insurance that covers medical expenses incurred from car accidents. Similar to PIP, MedPay does not require drivers to prove fault before costs are covered. The difference between the two is that MedPay is not required by law as PIP is in some states, and it does not cover lost wages.

What Does MedPay Insurance Cover?

MedPay Insurance covers the following:

  • Ambulatory services
  • Medical and surgical treatment
  • Funeral services
  • Health insurance deductibles and copayments]

MedPay Insurance has coverage limits that are decided by the policyholder beforehand. You have the option to choose how high your coverage limit is, but that price will reflect in your monthly auto insurance quote. Limits vary state-by-state, but are typically less than $10,000. Coverage amounts should be chosen based on your personal financial situation and health insurance, along with the total cost of your auto insurance when MedPay is included.

Health Insurance VS. PIP VS. MedPay

If you do not have PIP or MedPay coverage on your car insurance, you can use your health insurance to pay for any medical bills resulting from a car accident. But you should remember that traditional health insurance plans have out-of-pocket maximums or deductibles that are paid by the insurer. When you file a claim with your health insurance, you will still be responsible for your bills until your insurer will cover the rest of the expenses. With PIP and MedPay, coverage usually does not require a deductible. 

PIP and MedPay are similar with a few key differences:

  • MedPay does not cover lost income or rehabilitative services, as PIP does
  • MedPay is optional everywhere except 2 states – 
  • PIP is required by law in 17 states (NY, NJ, FL, HI, KY, KS, ND, MA, MN, MI, PA, UT, AK, TX, MD, DE, OR), and is provided as an optional add-on in 6 (NH, SD, VA, WA, WI, D.C.).

Which Type of Coverage Is Right for You? 

The three types of health coverage overlap, and the answer of which to choose depends on the coverage provided by primary health insurance and the state you live in. It is possible to have a combination of either PIP or MedPay and your health insurance to get the best possible coverage.

PIP or MedPay can possibly be essential, as some health insurance policies will not cover injuries sustained in car accidents. Depending on the severity of the accident, a lack of health insurance coverage can leave you with extremely high out-of-pocket costs. MedPay insurance could offset those expenses by reimbursing you for the deductibles and copayments you may have to make for your primary healthcare. PIP offers the most coverage for car-related accidents and can be combined with MedPay in states where PIP is required. What’s most important when choosing which type of insurance you want is determining what your financial situation allows and how much financial protection you’ll need in the event of a car accident.


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