Who will pay my medical expenses for my Illinois personal injury suit?
When our office is contacted by an accident victim shortly after a car accident, a slip-and-fall, or any other accident, the question above is probably the single most frequently asked question I hear. I will try to answer this question and dispel a few myths about handling medical expenses in accident cases.
As a starting point, if you were hurt on the job, this article does not apply to you. You have an Illinois worker’s compensation case, and one of the benefits your employer is required to provide you is payment of your medical expenses. If your employer is telling you that they do not want to put it through worker’s compensation because their rates will go up, that is not your concern. Virtually all health insurance policies exclude work-related accidents from coverage, so you will not be able to use health insurance even if you have it, and health care providers know that they are entitled to bill worker’s compensation for prompt payment of medical expenses, so if you are hurt on the job, using worker’s compensation is the right thing to do, even if your employer doesn’t like it.
First, a let me dispel a few myths about medical bills and personal injury accidents:
• The insurance company is not required to pay all of your medical bills, regardless of the outcome of your case. First, if you lose, they are not required to pay anything. Second, many insurers dispute the extent of the injury and the relationship of care to the accident. For example, if you have a back injury from a car accident, the insurer may claim that your back problems are pre-existing or due to old age and not the trauma from the accident.
• Insurance companies are not required to pay your bills as they are incurred. In fact, they almost never do. When a case is resolved, whether by verdict or settlement, you receive a single check at the end of the case which should include money to cover your medical expenses.• Your doctor does not have to wait until the end of the case to get paid. Many people believe that since the accident was not your fault, you should not be responsible for paying the bill when it comes due. This is not true.
Where should you look to have your medical bills paid after an accident:
• If you have health insurance, you should submit your bills to health insurance where possible. This is because you have a good chance of having your bill paid promptly. Also, your health insurer has negotiated a significant discount for medical care with most health care providers. If your bills are paid by your health insurer, they will look to be reimbursed what they have paid. In the meantime, you are allowed to claim the full amount of your medical expenses as damages. The discount can result in you putting substantially more money in your pocket.
• No-fault medical expenses coverage is another option for bill payment. Many auto insurance policies, homeowner’s policies, and business policies provide limited no-fault coverage for medical expenses which will pay bills due to an accident up to the low limits. These policies frequently max out at $5,000 or less, so this will not go far.• Your health care providers can place a lien on your settlement. This gives them a legal right to be paid out of the proceeds of your settlement. There are a few downsides to this. One is that even when they put a lien on your settlement, they are not precluded from putting you into collections before the settlement of your case or even after your case is the amount of the settlement is inadequate. Second, they are entitled to be paid the full amount billed, even when they would not be paid that if you had private health insurance.
Between all of these options, relying on health insurance to cover your bills is your best option. Some people feel that since someone else is responsible for the accident, their heath insurance should not have to pay. However, using your health insurance helps guarantee prompt payment of your medical bills and avoids you being stuck with your bills if there is an unsatisfactory conclusion to your case.