No one wants to think about being in an accident, but it happens all too often. If you are injured in an accident, and your insurance doesn’t cover all of your medical bills, you may be wondering if you are still responsible for paying them. The answer to this question is not always clear-cut, but we can help!
North Carolina is an at-fault state. That means the driver who is determined to be at fault for the accident is responsible for all accident-related damages. This includes property damage, medical bills, and any other losses resulting from the accident.
Because coverage is determined by fault, you will have to pay your medical bills while the case is pending. If your health insurer rejects the claim, you will be responsible for paying your medical bills out of pocket. However, other options are available to you, depending on your insurance and what else you have.
Why Would My Health Insurance Claim Get Denied in Greenville, NC?
There are a few reasons why your health insurance claim could get denied. One reason is if you have not met your deductible yet. If you have not met your deductible, your insurance will not cover any of the costs associated with the accident until you have paid a certain out-of-pocket amount.
Another common reason for denial is if your insurance company does not consider the accident a “covered event.” This means that they do not believe that the accident was covered under your policy and, as such, they are not responsible for any of the costs.
What Are My Options If My Insurance Claim Is Denied in Greenville, NC?
If your insurance claim is denied, you have a few options.
Personal Injury Protection Insurance (PIP)
PIP is no-fault insurance and is not required in North Carolina. PIP covers medical expenses regardless of who is at fault for the accident.
With PIP insurance, the claims process is generally quicker than filing a liability claim with the at-fault driver’s insurance company. PIP is meant to offer prompt payment for medical bills so that you can get the treatment you need without delay.
PIP insurance may also cover a portion of your lost wages if you cannot work because of your injuries.
Medical Payments Coverage (MedPay)
Medpay is similar to PIP insurance in that it will pay for your medical bills regardless of who is at fault for the accident. Typical medpay coverage plans vary depending on your policy. You can use your policy to help cover medical expenses up to your limit, whether it is $500 or $5,000.
Like PIP insurance, medpay is meant to offer quick payment for medical bills to get the treatment you need without delay. Medpay will cover:
- Doctor’s visits
- Hospital stays
- Lab work
- Deductibles and copays
- Ambulance fees
Medpay does not apply to lost wages if you cannot work because of your injuries. It is not required in North Carolina; however, insurers offer it and if you do have it on your policy, you should use it in the event of a collision.
Uninsured/Underinsured Motorist Coverage
Uninsured motorist coverage is required in North Carolina. Auto insurance policies with the minimum bodily injury and property damage limits must also include uninsured motorist coverage. However, you can choose to have a policy limit greater than the minimum liability amount and elect combined uninsured/underinsured motorist coverage. This type of coverage can be a lifesaver if you are in an accident with an uninsured or underinsured driver.
An uninsured motorist (UM) policy will help pay for injuries suffered by you and any other passengers riding in your car with your permission at the time of the car accident. If you are not driving, UM coverage should still pay for the injuries of the person driving your car, up to your policy limit.
Underinsured motorist coverage (UIM) will pay for injuries suffered by you and your passengers that exceed the at-fault driver’s insurance policy limits.
For example, suppose you are in an accident with a driver who only has $30,000 in bodily injury coverage (the minimum required in North Carolina), and your medical bills come to $50,000. In that case, if you have a $50,000 UIM policy, you would be entitled to an additional $20,000 for a total recovery of $50,000.
It is important to note that these coverages may not cover all of your medical bills. If your medical expenses exceed your policy limit, you will be responsible for whatever remains. That is why it’s important to have an experienced attorney on your side who knows how to maximize and uncover all available coverages.
If you have a health insurance plan, it may help cover some of your medical bills. Be sure to check with your insurer to see what is covered and what is not.
Some health insurers will only cover treatment that is considered “medically necessary.” This means that the insurer will only pay for treatment that they believe is necessary to treat your injuries from the accident.
Other health insurers will only cover treatment that is considered “pre-approved.” This means that you must get approval from the insurer before you receive treatment. This may happen if your family doctor refers you out to a specialist, like an orthopedist.
Some health insurers will not pay for any treatment related to a car accident, regardless of whether it is considered medically necessary. In these cases, you may be responsible for the entire bill.
It is important to check with your health insurer to see what coverage you have before you receive treatment.
What Happens If I Don’t Have Insurance?
If you don’t have any of the above insurances, your next best option could be to negotiate your medical bills with insurance and health care providers. You may be able to work with them to negotiate an interest-free payment plan, a discount, or another solution that will help you pay your bills without damaging your credit.
Appealing Your Medical Bills in Greenville, NC
If you have insurance, but your provider denies your claim or only pays a portion of the bill and you cannot negotiate a payment plan or get your bills discounted, you have the right to appeal their decision.
To do this, you will need to contact your health insurer and ask for their appeals process. This may include providing written notice and evidence to support your case.
This process can take several months, so patience is important. But it is also likely time-sensitive, so don’t delay or ignore it.
What Should I Do If I Have Been Injured in an Accident in Greenville, NC?
The best thing to do if you have been injured in an accident is to seek medical attention as soon as possible. Once a doctor has seen you, you should reach out to an experienced personal injury attorney. At The Law Offices of Jason E. Taylor, we can help you with your insurance claim and ensure that you get the compensation you deserve.
Contact an Attorney at The Law Offices of Jason E. Taylor
Car accidents and their expenses can take a serious toll on your bank account, and paying medical bills should be the last thing on your mind after a car accident. If you have been in an accident, it is important to speak with an experienced car accident attorney in Greenville, NC. They can help you understand your rights and options and will fight to get you the compensation you deserve.
At The Law Offices of Jason E. Taylor, we have a team of experienced attorneys who are ready to help. We will review your case for free, and there is no obligation to hire us. We serve clients in Greenville, NC, and throughout North Carolina.