You have health insurance to cover medical costs when you are sick or injured, and you have car insurance to pay for expenses incurred in an auto accident.
But which insurance is responsible for medical costs after a car crash? There is no one-size-fits-all answer. The cause of the accident, the insurance held by the at-fault party and the details of your own insurance policies can all play a factor in determining who pays.
West Virginia uses a fault-based system to determine financial responsibility after a motor vehicle collision. A person who causes an accident — whether by speeding, driving recklessly or disobeying a traffic signal — is considered to be at fault. Fault may be assigned completely to one person or may be divided up among two or more parties.
As long as you are less than 50 percent at fault, you can file a claim with the other driver’s insurance company. As of January 2016, West Virginia requires drivers to have an auto insurance policy that provides at least $25,000 in liability coverage for bodily injury or death of one victim as well as at least $50,000 for total bodily injury or death caused by the accident.
A different type of policy, for personal injury protection (PIP) or Med Pay, can be billed for the driver’s own medical costs. Because neither PIP nor Med Pay is mandatory in West Virginia, however, not all drivers will have this option.
Getting the at-fault driver’s insurance to pay your bills can take some time. The insurance company may try to avoid responsibility by claiming that their driver was not at fault, or it may offer a lump sum payment that fails to cover the total costs of the accident.
Generally, your own health insurance will pay for your medical costs — which may include ambulance care, an emergency room visit, doctor checkups, physical therapy, follow-ups and more — as it receives claims, up to your coverage limit.
After the coverage limit, your PIP or Med Pay (if you have either) will take on the additional costs. Once you receive a settlement from the other driver’s insurance company, your health insurance carrier may seek reimbursement for the payments it has made.
If the other driver does not have car insurance, or if you do not have PIP, Med Pay or health insurance, it may be time to file a personal injury claim against the driver.
Through a lawsuit, you can seek funds for pain and suffering and anticipated long-term care as well as for actual bills that have already accumulated.
Before you accept a payout from the at-fault driver’s insurance company, consult an attorney. Your lawyer can review the proposed agreement and advise you whether or not it is fair. There is a good chance you deserve more than what an insurer has offered.
The personal injury attorneys at Prim Law Firm, PLLC in Hurricane, West Virginia are experienced at helping auto accident victims hold responsible parties accountable for the damage they have caused.