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Old 05-24-2004, 01:53 PM   #1
RigdenZW
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Question Question about accident related injury and insurance..

After being injured in a car accident, a person with a PPO health insurance plan is expected to initially pay out of pocket any medical costs? Then when fault is determined, they either get reimbursed from the auto insurance company or file a claim with their health insurance company??

What kind of crap is that?!? Are there any other options other than paying out of pocket?
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Old 05-24-2004, 01:57 PM   #2
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Thats your only option, also you will need a good attorney. Trust me I have been fighting insurance companies for 6 years. I had over $200,000 in medical expenses, and I pretty much gave up on getting rest of my body fixed because of how complicated the system is.



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Old 05-24-2004, 01:58 PM   #3
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A person with a PPO should have very little out of pocket costs.

IIRC, it may be state-specific, but an injured can actually double-recover. Once from their own insurance company and again from the responsible party (RP). The idea being, the fact that someone has health insurance that pays their medical costs does not mean an RP should not have to pay. However, I thought that some states let the insurance company recover from the RP. Then, the victim has still recovered, the RP has still paid up and the insurance company hasn't paid for something for which someone else is responsible.

If you really think you'll recover from someone else, get a rewards credit card and throw the medical bills on it.
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Old 05-24-2004, 02:01 PM   #4
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What kind of ****ed up system is that?? I mean, the point of having health insurance is to cover possible medical costs. I mean.. if I fell off of my roof and hurt myself, they would cover it. (I think - I hope).. but because it's an auto related accident you're expected to come up with the cash? I thought that was the point of insurance. You pay small amounts spread out over time so you don't have to come up with large amounts unexpectedly.
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Old 05-24-2004, 02:04 PM   #5
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I let all the bills pile up and had collections agencies calling and threatening me everyday. I had no other choice, I was 17 and lived alone. I had 5 shoulder surguries, physical therapy 2-3 times a week for 3 years, and was at the doctors at least once every 2 weeks. I still have 5 slipped disks in my back that need taken care of, and a dislocated jaw.


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Old 05-24-2004, 02:05 PM   #6
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Because your auto insurance has a medical cost component. Policies are carefully structured so that it tried to keep a clear distinction which policy covers which instance. When multiple policies can apply to the same occurrence, it can get very ugly. It may be inconvenient but ultimately it will make it easier to determine who compensates whom.

Question: why isn't your own auto insurance covering your medical costs?
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Old 05-24-2004, 02:15 PM   #7
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Quote:
Originally posted by sonicblue
Question: why isn't your own auto insurance covering your medical costs?
Thats the question of the day.

I spent 7 years doing medical billing for doctors offices and physical therapy offices, along with a shorter stint working for a medical insurance company.

In a normal accident situation, where the other driver is at fault, medical bills are paid by YOUR auto insurance (PIP=personal injury protection) and are later recouped from the other insurance company. In the event that you have no PIP, some medical insurance companies/policies will pick up the rest of the bill on the agreement that they will be recouped at settlement time.

If for some reason neither of those is an option for you, you need a lawyer to deal with it or you will get screwed.
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Old 05-24-2004, 02:17 PM   #8
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Eric SS is another good person to ask about this.


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