After an accident, you should seek immediate medical attention. The most important thing is to get the treatment you need and do not let issues of insurance and payment prevent you from getting the proper treatment. Your safety and health will always be top priority!
If given the option, you should insist on using your own personal health insurance for all of your medical treatment, even if the accident was caused by another person.
Understandably, many people are hesitant to use their own health insurance to pay since their injuries were caused by someone else—shouldn’t the responsible party’s insurance have to pay? The answer is yes, they should!
Important Reasons to Use Your Personal Health Insurance After an Accident
One of the most common questions that I get asked in my personal injury practice is whether I should use my personal health insurance to pay for medical treatment after I've been in an accident that was caused by someone else.
The answer is, yes, every time. and here's why.
Anytime you've been in an accident, one of the main goals is going to ensure you don't have any lingering bills or ongoing debts after the accident. Using your personal health insurance is the best way to do that.
#1 – There could be a dispute as to who was at fault.
After an accident. you may think the other person was at fault. But you never quite know if there is going to be a dispute as to who caused the accident. It is not uncommon for there to be an argument as to who actually caused the accident. And since most of your medical treatment is going to take place soon after the accident. You should never assume that there's going to be that insurance to cover you because that may not be determined until a much later time. If you use your personal health insurance you eliminate the risk that that bill could go unpaid.
#2 - The other driver could be uninsured or underinsured.
You don't know if the accident was caused by an uninsured or underinsured driver. This is true even if the police report shows the other driver has insurance. Often times those listed policies have expired, so you can’t rely on the insurance provided to the police at the scene. Even if the other driver caused the accident, they may not actually carry the minimum insurance required because in New Mexico we have a very high rate of uninsured drivers – in fact, the third-highest in the United States. So you never quite know if there is insurance to cover your injuries, even if the other person was clearly at fault. You also don't know if they're going to have enough insurance to cover all of your bills. So again, use your personal health insurance to completely eliminate that as a possibility.
#3 - Health insurers pay discounted rates.
Your personal health insurance company – for instance, Blue Cross Blue Shield, Medicaid, Medicare, and virtually all health insurers—have contracts with medical providers that allow them to pay a reduced rate, called a “contract rate” for your medical treatment. This means it is in your best interest for your health insurer to pay those bills at a reduced contract rate, as opposed to the other drivers auto insurance company paying your medical bills, because the auto insurer will pay the full amount of those charged bills. This will help put more in your pocket when your claim is finished.
#4 – You can negotiate with your health insurer.
If you do ultimately receive a settlement and your health insurance has paid out on your behalf, you will have a legal obligation to pay them back. That's part of your contract agreement with them. But there are also some benefits under the law that allow you to negotiate down what you potentially have to reimburse to your health insurance company. Therefore, it will be in your best interest to negotiate the reimbursement owed to your health insurance company versus getting stuck with an unpaid medical bill.
IMPORTANT BONUS TIP - Don’t be surprised if the medical provider does not want to bill your personal health insurer and they instead want to bill the auto insurance for the person that hit you. This has to do with the economics of how much they make off of that medical treatment. My advice is to be persistent and insist the provider bill your health insurer—it may be the single most important step you can take to maximize your take-home pay from a settlement.
A Note of Caution: Do Not Delay Medical Treatment
Since medical treatment is typically required immediately after an accident, you do not want to delay medical treatment while the legal issues of the accident are sorted out. This is where New Mexico law provides the appropriate remedy.
Medical Payments Paid By Your Insurance Must Be Reimbursed
Keep in mind: New Mexico law provides reimbursement rights to your health insurer for benefits paid out on your behalf that were caused by another person’s negligence. That means if your health insurer pays for your medical expenses for treatment caused by someone else’s negligence, and you ultimately recover monetary damages from that negligent person, your health insurer has a right to be reimbursed (these are called rights of subrogation) from you out of the accident money you received.
Quick Example:You are driving and a negligent driver runs a stop sign and hits you. An ambulance arrives and transports you to the hospital. You remember reading something from The Injury and Disability Law Center that said to use your personal health insurance if you are in an accident. The hospital bills your personal health insurance for payment for your treatment. It is later determined that the other driver was at fault for causing the accident, and carried auto insurance. The negligent driver’s insurance company then pays you for your bodily injury damages from the accident, which include your medical bills. Your receipt of payment from the responsible party’s insurance for your damages triggers the legal right of your health insurance company to be reimbursed what they paid out for your treatment caused by the negligent driver.
Financial Burden is on the Wrongdoer
As you can see in the example, the law ultimately is designed to place the financial burden on the wrongdoer. In this example, the negligent driver. Even though your health insurance paid out initially, the wrongdoer paid for those damages through a settlement with you, and you are then able (and required) to pay your health insurer back. This process ensures there is no improper shifting of the financial burden unfairly to your health insurer, while at the same time allowing you to receive the timely medical treatment you need.
Contact Our Roswell Injury Law Office for Help
Our team would be happy to talk with you if you have additional questions about using your personal health insurance, ensuring your medical bills get paid, or any other questions you may have following a car wreck or other accident in New Mexico. Give us a call at (575) 300-4000 or fill out our contact form so we can discuss the details of your specific situation in a free consultation.
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