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When You’re Injured: Will Health Insurance Cover Your Medical Costs?

If you’ve been injured in an accident caused by someone else’s negligence, one of the first questions that may cross your mind is whether your health insurance will cover your medical expenses. The answer is not always straightforward, as it depends on various factors, including the nature of your injuries, your particular health insurance plan/coverage, and the potential for a personal injury claim against the at-fault party.

Understanding Your Health Insurance Coverage

Your health insurance policy is designed to provide coverage for medical expenses related to illness or injury. However, it’s essential to understand the limitations and exclusions of your particular plan. Most health insurance policies have deductibles, copays, and coinsurance requirements that you’ll need to meet before the insurance company starts paying for your medical expenses.

Additionally, your health insurance may not cover all types of medical treatments or services, such as long-term care, rehabilitation, or specialized therapies. In these cases, you may need to explore other options to ensure that your medical needs are fully covered.

Finally, most health insurance policies today contain language permitting the health insurer to be reimbursed for medical payments made due to a third party’s negligence (aka, “subrogation”).  In other words, while your health insurance may cover medical costs following an accident, your health insurer will likely expect to be reimbursed from the at-fault party or his/her liability insurer.

The Role of Personal Injury Claims

If your injuries were caused by someone else’s negligence, you may be entitled to file a personal injury claim against the at-fault party or their insurance company. A successful personal injury claim can help you recover compensation for various damages, including:

1. Medical Expenses: This includes past and future medical bills, hospitalization costs, rehabilitation expenses, and any other medical expenses related to your injuries.  Again, depending on your health insurance policy language, you may be required to reimburse your health insurer for past medical expenses they covered relating to the accident from your personal injury recovery.

2. Lost Wages: If your injuries have prevented you from working, you may be able to recover compensation for lost wages and future earning potential.

3. Pain and Suffering: Depending on the severity of your injuries, you may be entitled to compensation for the physical and emotional pain and suffering you’ve endured.

4. Other Damages: In some cases, you may also be able to recover compensation for property damage, loss of consortium, or other damages related to your accident.

The Role of a Personal Injury Attorney

Navigating the legal process of filing a personal injury claim can be complex and overwhelming, especially when you’re dealing with the physical and emotional aftermath of an accident. This is where the expertise of a skilled personal injury attorney like those at AW Smith Law can be invaluable.

With respect to your medical bills, the attorneys at AW Smith Law will examine your health insurance policy language to determine whether or not reimbursement is required, ensure charges are properly submitted/processed, fight any unrelated charges, and negotiate down any claimed right of reimbursement.

The attorneys at AW Smith Law have decades of experience handling personal injury cases and have recovered over $100 million in verdicts and settlements for their clients.  They understand the tactics insurance companies use to minimize payouts or deny claims altogether, and they will fight tirelessly to protect your rights and ensure you receive the full compensation you deserve.

If you or a loved one has been injured due to someone else’s negligence, don’t hesitate to contact AW Smith Law for a free consultation. Their team of dedicated attorneys will work closely with you, exploring all available options to ensure you receive the best possible outcome and the compensation you deserve for your injuries and losses.

Remember, insurance companies, including your own, may try to minimize their payouts or deny claims altogether. Having an experienced personal injury attorney on your side can make a significant difference in protecting your rights and ensuring that you receive the full compensation you deserve for your injuries and losses.