Who pays for your medical bills after a Virginia Car Accident?
We often get asked who is responsible for paying a client's medical bills after that client has been in an accident. Unfortunately, there is a lot of misinformation out there about this, and a some of that misinformation is a very common fallacy that can endanger clients' recoveries. We hope to set the record straight, and explain exactly how this process works.
Does the at-fault party pay my medical bills?
It is not as simple as that, but if you want a yes or no answer, then the answer is no. What happens is you claim your medical expenses against the person who is responsible for your accident. This is not a distinction without difference.
For example, if you go to the hospital, and the hospital bill is $5,000, your health
insurance may pay your contracted rate (and because of the contract between
the hospital and your health plan, they take an adjustment), and
you may have a $500 deductible. So that $500 comes out of your pocket.
Does that mean that your expenses are only $500? Absolutely not! If you believe that letting the other insurance give you $500 is paying for your hospital visit, you are absolutely wrong!
In this scenario, the hospital bill has been paid for by the health insurance. Health insurance is what is known as a collateral source, meaning that a medical expense has been paid for by some funding source that has nothing to do with the car accident. You have your health insurance whether or not you were in a Virginia car crash!
Collateral Source information is inadmissible as a matter of law, and the insurance companies do not get credit for it! The at-fault car insurance is not only responsible for reimbursing you for the money that directly comes out of your pocket. They are responsible for the whole bill, regardless of what your health insurance paid, and what the hospital wrote off as a result of the contractual adjustment.
In the above scenario, the hospital bill was $5,000, and you had to pay $500 out of your pocket. Because of the collateral source rule, the at-fault car insurance does not get to know who paid what. They owe you the full $5,000!
Always use Your Health Insurance!
Health insurance is a guaranteed source for you to ensure that your medical expenses are paid for after a car accident. You should always, always, always use your health insurance to make sure that your bills are paid.
Most hospitals, and even some doctors offices, will try very hard to go around your health insurance. When you are in the emergency room, someone will come to you and ask you about the car accident, and want to get a lot of information - but they will waive off and ignore your health insurance card. They are doing this on purpose. They are specifically trying to assert a lien on the car accident case, because they know that they will get paid more by the car accident carrier, than they will by the health insurance
This is actually illegal in Virginia! Virginia Healthcare providers, from doctors offices to hospitals, are controlled by Virginia Code 8.01-27.5. This law places a duty on the health care provider to submit their bills to the health insurance carrier. If they are in network for the health insurance, this is their obligation. It is not something that you can sign away - it is a duty, placed on them by the legislature.
Even though this is the law of the land, from Alexandria to Albemarle, most hospitals will go around it continually, and intentionally. They know that 1) most people don't know about this law, and 2) most people who are in car accidents will never speak to an attorney. Unfortunately, some people who do hire attorneys hire the wrong kind of attorneys: attorneys who are simply interested in pushing a case along rather than zealously representing their clients' rights.
At Blaszkow Legal, we review every single bill that comes into the office, and we make sure that all of the providers submit their bills to the health insurance of record. This includes:
Private Health Insurance
Exchange Health Insurance
Governmental Insurance Plans, such as Blue Cross Blue Shield Federal Employee Plan
The law makes very clear that if a provider does not submit the bill to a health insurance carrier, they don't get to get paid at all. They don't get any collections rights, or anything like that, and they definitely do not get a lien (See 8.1-27.5 (B)).
Doesn't This Make Your Health Insurance Go Up?
No, not at all. You have health insurance, and you have the right to use it, whether you are in an accident, or you just fall getting out of the shower in the morning. You should always use your health insurance, because our job as your attorney is to get you the most money possible, not to put money in the pockets of doctors and hospital corporations.
How the Claims Process Works
After a Virginia car accident, we submit a demand package to the at-fault insurance carrier. This demand package includes your medical bills, and the relevant medical records. However, the medical bills themselves are first redacted. All of the collateral source information that has anything to do with health insurance is removed. The car insurance companies are not entitled to this information. Whether you have great health insurance, or no health insurance at all, your claim is for the full amount of any medical expense that you have incurred. These car insurance companies do not get credit for health insurance payments, reductions, contractual adjustments, or amounts that you negotiate when you call the billing office. If you had not been involved in the accident, you would not have this medical expense, and that is what the law recognizes.
One of the many reasons that you want to hire a Virginia Car Accident Lawyer after having been involved in a crash, is because the health insurance carriers data, can sometimes be in odd places in the medical records themselves, and it can be repetitive.
The car insurance companies use very sophisticated software to find this information, if it is available, to further reduce the value of claims of those people who don't have lawyers. Because self-represented parties often do not know their rights, the insurance companies will readily offer to reimburse you for your deductibles - and if you take their money, you may have settled the case.
A car insurance company has not duty to tell you your rights. That is why you need a lawyer.
Does This Billing Law Apply to All Accidents?
Absolutely, and not just car accidents. It applies to wrongful deaths, slips and falls, and all manner of motor vehicle collisions. Even if there is no crash at all, and a millionaire walks into the ER, if that millionaire has health insurance that the hospital participates with, the hospital is required to submit the bill, not stand there with their hand out for a cash payment.
The at-fault car insurance carrier, on behalf of their insured (the tortfeasor) is responsible for the entirety of your claim, not just bits and pieces of it. The health car providers are banking on the fact that people who file Virginia car accident claims themselves, do not know all of the laws that operate for the claimants' benefit. They are making the same bet that the car insurance carriers are making, that you will not call an attorney, and you will remain ignorant of the law. Don't let that happen to you.
Call a team of professionals who will use the law for your benefit, and put the most money they can into your pocket. Call Blaszkow Legal today for a free consultation: 703-879-5910
Virginia Duty of In-network Health Care Providers: https://law.lis.virginia.gov/vacode/title8.01/chapter3/section8.01-27.5/