If you were injured in a car crash or other type of accident and received medical treatment for your injuries, you may be confused about who is responsible for paying your medical bills related to the collision. Logically, you would think that the at-fault driver (and his or her insurance company) is responsible for paying for your medical bills.
This is a complex question. Unfortunately, the other driver’s insurance company doesn’t have to pay you anything, now or later, unless you force them to pay by bringing a civil lawsuit against their insured client. However, if a valid claim exists a lawsuit is usually not necessary if you accept the carrier’s determination of what the claim is worth.
Thus, if you agree with the other person's insurance company on how much your case is worth then you’ll be able to settle the claim fairly quickly and with ease. But the at-fault carrier will often intentionally undervalue the claim in an effort to save the money it has to pay out.
When it comes to your ongoing medical bills, the at-fault carrier typically will not want to pay for ongoing medical treatment unless it can settle the claim in full. The carrier knows that if it agrees to ongoing payments to your healthcare providers, then the claim will likely drag on while the total value of the claim continues to rise (generally the more treatment received, the higher the value the claim).
Insurance Companies Have a Business Interest in Your Claim
The at-fault carrier usually wants to pay just one lump sum to settle the claim so it can move on. By making a one-time lump sum payment, the claim is closed and the carrier’s exposure to paying out more later is terminated. That's the goal of the at-fault carrier is to settle the claim quickly and efficiently so it can pay less money out and increase its profit.
There's a specific type of auto coverage that will pay for an accident victim's medical bills called personal injury protection or "PIP." This type of coverage is “no-fault." You’re entitled to this coverage regardless of who was at fault for the accident. PIP is mandatory coverage unless you reject it in writing. PIP pays for medical bills as they are incurred.
There are special laws in place that require the PIP carrier to pay the medical bills when due so they are not turned over to collection. PIP also provides wage loss benefits, but this coverage is usually capped at $200/week and/or 85% of your regular wage.