How to Get Medical Bills Paid After a Car Accident in Florida
- Thursday, 07 May 2020
- Written by John Riddle
I'm John Riddle, an attorney with DitPointLAW, a Florida injury law firm.
Today I'm gonna talk about how to get your medical bills paid if you're injured in a Florida car accident, truck accident, or other type of vehicle accident.
The first thing to note, is this article is gonna talk about accident cases in Florida, those where someone else is at fault and caused your injury. Again, Florida has it's own auto insurance laws in regard to getting your medical bills paid.
Every state has different laws, this article only applies if you're injured in Florida. The first thing that's going to happen, or one of the first things that's going to happen when you make a auto accident claim, an insurance claim, with your own insurer, or the PIP insurer, which I'll talk about in a little bit, is they will send you what is called a Notification of PIP Benefits.
It's an explanation of how your auto insurance, the PIP insurer, is going to pay medical bills. Now, that notification is a letter you'll receive.
One of the problems is it takes some time to get that letter, so you want to know immediately after your accident, your car accident, how you get your medical bills paid.
That letter does a very good job, but a very basic job of explaining PIP, the medical payments, portion of your case, lost wages, a little bit about your right to sue, but in my opinion, it's too basic for your needs if you're hurt in an auto accident in Florida.
The first thing to note is, if you're injured in Florida, in most car accidents, PIP, also known as no fault insurance, is going to apply, regardless of fault.
In Florida, there's minimum limits of PIP. Meaning, the PIP insurance, personal injury protection insurance, can be greater than these minimal limits, but these are the limits, that if you have PIP, they have to be a certain limit.
They are $10,000 for medical bills, if you've sustained an emergency medical condition. If you haven't sustained an emergency medical condition, the limit, the PIP insurer has to pay $2500. Another one of the minimal PIP limits in Florida is for your lost wages. The limit is $10,000, I'm gonna get more into that in a little bit, but this video is primarily on getting your medical bills paid.
Now whether you are insured with PIP, or if you're not, you're gonna want to send a letter to the PIP insurer. This is a form letter that we have, and you should be able to find online, it's on our website, I'll put a link in the description to this video below, where you're going to ask the PIP insurer, amongst many other things, if they have any defenses for why they would not cover you with PIP insurance.
PIP may still pay your medical bills even if you don't own a car in Florida. You're gonna want to give your PIP information to every single medical provider you treat with. The hospital, and all your doctors. If you fail to do that, and you also have health insurance, in addition to the PIP not paying your medical bills, PIP may not have to reimburse or pay back the health insurance lien, which if someone else caused your accident, would result in a smaller settlement.
Now, PIP pays 80% of reasonable medical bills related to your accident. If you do not get treatment within 14 days of a Florida accident, PIP does not have to pay a dollar, a penny, zero.
PIP does not pay for massage or acupuncture. Again, if you don't have an emergency medical condition, If a doctor does not say you have an emergency medical condition, PIP will pay no more than $2500. The formula is right here, PIP pays 80% times your total medical bill.
We're gonna take an example assuming you have a $5000 medical bill. In that case, PIP would pay 80% of $5000, which would be $4000. $5000, 80% times $5000 is $4000. Now, PIP would only pay that amount if you had emergency medical condition.
So, let's say that State Farm was your auto insurer the PIP insurer, and there's this $5000 bill, with an emergency medical condition, State Farm would pay the hospital $4000.
Now, even if you have a $5000 medical bill, and assuming State Farm pays $4000, you're left with a thousand dollar bill. How do you get that money?
You would need to sue the at fault parties to get them to pay that outstanding medical bill.
You can also sue for additional things, such as pain and suffering, and mental anguish, and things of that nature, but this video is focused on your medical bills. If we take that same $5000 medical bill example, but assume you did not have an emergency medical condition, PIP would only pay $2500.
Now, even though $4000 was based on the calculations, 80% of $5000, they only have to pay up to the $2500.
We'll look at another example. Assume your medical bill was $15,000. 80% of $15,000 is $12,000. But PIP generally speaking, there's exceptions,
generally speaking, if you have basic PIP, it's gonna pay only up to $10,000.
So even if your hospital bill is 15, and 80% would be $12,000, PIP is only gonna pay up to $10,000, that $5000 you would have to sue the responsible parties for.
Now, you may have a PIP deductible, which I'm really not gonna get into that now, there'll be another video on that. But understand, just because you believe there's PIP, sometimes an insurance company will assert a coverage defense. Such as, when the application was filled out, somebody lied, or something of that nature.
So just be aware of that, and that's one of the reasons why you want to send a written letter, certified, to the PIP insurer, asking them for their defenses.
Another insurance that is on an auto insurance policy, yours or someone else's that would cover you, is called Medical Payments Coverage. It is different from PIP, it pays medical bills, it's also known as MedPay.
Now, MedPay will pay the amount that PIP did not pay, up to the limit of the MedPay coverage. Also, if you have Worker's Compensation, if you are injured during the course and scope of your employment, while you are working, and there's Worker's Compensation Insurance available, that can also pay your medical bills.
There's many other types of insurance coverage that may pay your medical bills as well. We have health insurance coverage, which generally in Florida pays secondary to PIP.
That means your auto insurance, or the auto, the PIP auto insurance should be billed first, the health insurance company, if they get billed before PIP,
and they know that it's a car accident, they can deny payment, rightfully.
You're going to want to give your health insurance, and any other insurance information, to the hospital or doctors you treat with immediately. It's gonna result in getting your medical bills paid faster. If you wait to give your health insurance to the hospital, for example, and you just give your PIP, the PIP insurer is gonna get billed, you may be trying to settle your case with the at fault party, and you need to get those bills to your health insurer so they can then pay them, and you can find out how much you have to repay the health insurer.
You may have Medicare. If Medicare pays some of your bills, they're entitled to get paid back. If you have an attorney, the amount of money that Medicare is entitled to get paid back, and when I'm saying paid back, I mean it from a total settlement against any other responsible parties that caused your accident.
The same is true with Medicaid. If you have Medicaid, and Medicaid pays bills, Medicaid is entitled to get paid back. Medicaid will reduce for your attorney's fees and costs, which is one of the many benefits of hiring an attorney.
Hospitals, unfortunately, do not have to bill Medicaid. Bills that PIP does not pay, you're gonna want to go after the responsible parties whose
carelessness caused your accident. And just remember, just because someone gets a ticket in the accident, doesn't mean they're automatically responsible.
In fact, in a civil trial, the jury will never be allowed to hear that a ticket was issued. That being said, most often, the person who receives a ticket is generally at fault.
Now I've talked a lot about getting your bills paid. In particular, the bills that PIP does not pay. And I've said you go after the responsible party. If the responsible parties are uninsured, or underinsured, that means they don't have enough insurance to pay for your injuries, or they have no insurance, you're gonna want to make a claim against any uninsured motorist insurance that exists.
It could be your own, it could be someone who you lived with, it can be the car that you were in at the time of the accident. And again, this video focuses on getting your medical bills paid, you also may have a claim against the responsible parties, or your uninsured motorist insurer for any other damages, such as lost wages, pain and suffering, mental anguish, scarring, anything of that nature.
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