These are all valid questions, particularly the last. A car accident victim should be able to focus on recovering without the added stress of financial worry. However, finances are an honest and valid concern for anyone injured in a car accident.
Research from the Centers for Disease Control and Prevention (CDC) shows that the average cost of an emergency room visit is $3,300, and the average cost of an inpatient hospital stay is $57,000.
Additional expenses occur if there is an extended stay or time in the intensive care unit. Also, there may be costs for outside care, such as physical therapy and rehabilitation. Prescription drugs, medical equipment, at-home care, and other expenses need to be considered under the medical cost umbrella as well.
These numbers are alarming, but the car accident victim may be responsible only for part or none of their costs, depending on the circumstances and the type of insurance they have.
With an average of three million injuries from car accidents reported each year throughout the United States, it is wise to understand how insurance typically covers medical bills.
What is a No-Fault State?
Pennsylvania is a no-fault state. That means that the driver’s own insurance company is the insurer that is immediately responsible for medical bills, no matter who was at fault.
No-fault laws can be reassuring to drivers; they know their medical bills will be covered regardless of the circumstances. No-fault also means that accident victims get paid quicker because fault is not a primary consideration in paying medical bills.
Under Pennsylvania insurance policies, drivers receive benefits through the personal injury protection (PIP) portion of their policies, up to the limit they selected at the time of purchase. The insured will need to pay deductibles and co-pays.
Meanwhile, they can contact an experienced car accident lawyer to begin the process of suing another driver, depending on the type of insurance they hold.
Can I Sue the Other Driver for Damages?
A Pennsylvania driver who is injured in an accident can indeed sue the other party for costs incurred. However, in most circumstances, they will need to use their own insurance first to cover medical bills, then sue the other driver to recover the costs.
Pennsylvania gives its drivers a choice of two types of insurance, full or limited tort:
- Full tort: More expensive than limited tort insurance, but policyholders are free to sue another driver for damages related to their accident, including medical bills.
- Limited tort: Less costly than full insurance but contains thresholds regarding when the insured can sue another driver for damages. For example, limited tort policies specify the types of serious impairment a person must have before suing another party for damages. The injured party also must have substantial proof of their injury.
When deciding whether to sue, accident victims need to be aware that Pennsylvania has pure comparative negligence laws to collect damages. This means that a driver can only collect compensation proportionate to their fault in the accident. Therefore, if they are 75 percent at fault, they can only collect 25 percent of costs from the other driver’s insurer.
Someone is always at fault in an accident. To determine fault or percentage of fault, courts will rely on Pennsylvania laws, police reports, witness statements, circumstances of the accident, and the drivers’ testimony.
The other driver’s insurance company will not pay a medical provider directly, nor will they allow the plaintiff to submit claims. The first order of business is for the victim’s lawyer to convince the insurer that they must pay, that their insured was partly or wholly at fault.
Once that is accomplished, an insurer will generally make an offer that in no way covers all the victim’s medical bills, pain and suffering, and other costs. Although it is tempting for many accident victims who have bills piling up to take the first offer they receive, it is not prudent for them to do so.
Instead, they should let their car accident lawyer negotiate skillfully to get the compensation they deserve. Negotiation can be a lengthy process that could take a long time, and an experienced professional should guide the process.
If the parties cannot reach an agreement, the lawyer can take the case to court. Victims must be advised that car accident lawsuits can take months or years to settle, so an accident victim should be prepared to shoulder costs until then.
Frequently Asked Questions about Pennsylvania Insurance
What happens if I do not have car insurance to cover medical bills? When someone is hurt in an accident but does not have car insurance, they can submit bills to their private medical insurer, Medicare, or Medicaid.
Later, suppose the other party’s car insurer agrees to or is forced by the court to cover the victim’s damages. In that case, their health insurer can then collect from that insurance company.
What if I am not a named insured on a car insurance policy? A person who is not specifically named on a car insurance policy may still qualify as an insured driver in Pennsylvania. This is often the case when a driver lives with a relative who is a named insured. Their costs would be covered the same as the named insured.
What happens if I am in an accident while driving someone else’s car? If a driver is not a named insured or an insured on a close relative’s policy, the car owner’s policy will cover medical costs stemming from an accident.
Am I covered if I am hit while riding a bicycle or as a pedestrian? Bicyclists and pedestrians who do not qualify for car insurance benefits are entitled to medical coverage through the insurance of any vehicle involved in the accident.
What happens if my medical costs exceed my auto policy limits? Health insurance will usually pay the remainder of the costs. If the victim does not have health insurance and the accident was 100 percent the other person’s fault, the victim can recover medical expenses from the at-fault driver’s insurance. This occurs through legal processes such as negotiating a settlement or taking the case to court.
What is the average stay in a hospital after a car accident? Of course, the answer depends on the nature and extent of the injuries. A broken bone may require just an overnight stay, whereas a brain injury could keep someone in the hospital for months.
Every insured motorist should understand their policy limits because most insurers will cover only a certain number of days in the hospital or rehabilitation center.
What should I do if hospitalized after an accident? After the driver reports the accident to their car insurance or health insurance, the following steps can help them heal financially and recover damages from another party’s insurer if necessary:
- Follow doctor’s orders: Failure to do so could comprise healing as well as a future claim against the at-fault party.
- Document injuries: Take pictures and videos of injuries; keep every piece of paper or report generated about the injuries, healing, and prognosis.
- Understand limitations: Ask the doctor for precise instructions about what activities are permissible and when.
- Record and keep everything: Beginning with the accident, keep a comprehensive file of accident reports, insurance information, police reports, doctor and hospital records, receipts, and anything else related to the accident that can verify injuries, pain, suffering, property damage, and lost wages.
- Do not sign anything, say anything, or accept an offer of any kind: Sometimes insurance adjusters will try to get the victim to make statements that could be harmful to their claim. Other times, an insurance company will take advantage of an ill or recovering person to pay out lower than actual expenses. Victims should never sign or accept anything without the counsel of a car accident lawyer.
- Contact an experienced car accident lawyer.
Philadelphia Car Accident Lawyers at McCann Dillon Jaffe & Lamb, LLC Advocate for Victims of Car Accidents
When you or a loved one is injured in a car accident, the primary focus should be on healing. Do not let the added stress of medical bills add to an already trying time. The Philadelphia car accident lawyers at McCann Dillon Jaffe & Lamb, LLC can help you recover hospital costs from another driver’s insurance if you are in an accident. Call us today at 215-569-8488 or contact us online for a free consultation. Located in Philadelphia, Abington, and Media, Pennsylvania; Wilmington, Delaware; and Haddonfield, New Jersey, we serve clients throughout the surrounding areas.