Gary Bruce discusses when to use personal health insurance to pay medical bills after sustaining an injury in a car wreck or other incident. The reason for have health insurance is to cover your medical treatment, regardless of the cause of the injury. It is more important to get the medical care needed and to get well than it is to wait and figure out who needs to pay.
In a lawsuit arising out of injury, if the injured person prevails at the end, they may have an obligation to reimburse the healthcare provider. A liability insurance policy will not pay until the end of the case in a lump sum, so hopefully, the healthcare provider is submitting the bills to health insurance or the med pay carrier. If you are injured, you should utilize every insurance product that is available to you in order to get adequate medical care. If a lien is filed or a health insurance carrier legally seeks reimbursement, this issue is something dealt with after a trial or resolution and is not something a jury is even allowed to consider. If you have been injured or if you have questions about reimbursement or subjugation claims by a healthcare provider or insurance carrier, call or email the Law Offices of Gary Bruce 706-596-1446 to schedule a free consultation to review the facts of your case.
Narrator: Now answering your questions about the law and legal issues. This is Legal Break with attorney Gary Bruce.
Maureen: I’m Maureen Akers here with Gary, thanks so much for joining us today.
Gary: Good to be here again, thank you.
Maureen: We are talking about personal health insurance. So, if you’ve been injured, should you use your personal health insurance to help pay for your medical bills?
Gary: Well, in a situation that I’m involved in, generally when people are injured after a collision, or a fall, or something yes. I mean that’s what you have it for. And so there are two terms of art that come into play Maureen; one is reimbursement, and one is subrogation. And you’ll hear these things, what do they mean? They mean, if at the end if you prevail, you may have an obligation to reimburse your insurance company, or TRICARE, or whoever’s paying the bill. So, your insurance- your personal insurance, really is not to determine whose fault it was, or where there might be a way to collect. I mean there’s just so many variables there you can’t predict that. So, the health insurance was paid for, their premium is paid. It is there to provide service, or pay for your services that you need, and then if you do collect, if you do prevail, then you have to deal with that obligation to reimburse.
Maureen: Yeah, I mean you definitely shouldn’t sit and wait on your health care though, and in a lot of cases: you can’t. It’s serious enough that you’re taken care of first.
Gary: Surprisingly, people run into problems going to see their primary care physician and other health care providers. Sometimes he’ll say, “oh we can’t use the insurance, you have to pay cash, or we don’t see you if you’ve been involved in a motor vehicle wreck because we don’t know how we’re going to get paid.” The way to get paid is to use the same health insurance that they’ve always used. And then, we do have an obligation as lawyers to deal with that issue at the end. We have to we have fiduciary duty, we have a legal obligation to deal with reimbursing Medicare, Medicaid, your health insurance, TRICARE, all of these organizations.
Maureen: So, does the person get reimbursed by the insurance company, or no? We’re saying that the insurance company just gets reimbursed if they’re not the ones responsible.
Gary: Well it depends on what insurance company you’re talking about. So, if you’re talking about the liability insurance company that may pay for your damages, they’re not gonna pay for you to go to the doctor, they don’t want you to go to the doctor, they don’t want you to be seen, they won’t pay until the end in a lump sum. So, how do you deal with it in the meantime? Hopefully, your healthcare provider is submitting the bills to your personal health insurance carrier, or medical payment coverage, which we may have through your automobile policy- we’ve talked about that in the past. So, there are lots of options and ways to make sure you utilize everything that’s available to you. That’s part of what we do: we coordinate your options, make sure these things are paid for, make sure you get the care.
Maureen: All right very good. So there you go your personal health insurance, possibly when you’ve been injured. Thanks so much for joining us today, Gary, we look forward to seeing you on the very next Legal Break.
Read our frequently asked questions– and understand if you can will have to pay back health insurance companies for medical bills after an injury.