Who Pays Medical Bills While Awaiting a Personal Injury Settlement?

by Gina Corena

Last Updated on September 25,2023

Who Pays Medical Bills While Awaiting a Personal Injury Settlement?

The Personal Injury Claim Process

Addressing any personal injury claim and the resulting bills, requires injured persons to follow the following recommended process. 

Seeking Medical Attention

An injured person should always seek medical attention after an accident. Although a person may not experience any pain or discomfort from a simple fender-bender or falling on a wet floor, the human body can develop various pain and injury hours, days, weeks, or months after the fact. By seeking medical attention early, the person that has experienced the accident can be treated for medical issues and create a paper trail for future medical claims.

Furthermore, if medical issues arise in the future, it may be difficult for the injured person to prove their ailments were directly related to the accident. This occurrence is common in head, neck, shoulder, and back injuries after an automobile accident.

Filing a Claim

After seeking medical attention, the injured person should consider filing a claim with their automotive, health, or home insurance policy (depending on the nature and location of the accident). For most health insurance policies, the person need only visit their health care provider to commence the claims process. However, if the injured person files a lawsuit against another party, the health insurance company that has sold the policy may want to recoup some or all of the expenses related to treatment. 

Collecting Documentation

Plaintiffs should always collect and maintain any related documentation from their accident or injury treatment to prove their case and calculate damages. Documentation can include medical bills, insurance policies, the contact information of the parties involved, witness information, police reports, pictures of the accident, and surveillance footage.

Contacting an Attorney

Although not every accident requires filing a lawsuit, everyone who experiences an accident should consider contacting an attorney for advice. Some may need the counsel of an experienced Nevada personal injury attorney to navigate the insurance claims process, investigate the incident, correspond with relevant parties, and seek settlement for outstanding claims.

Medical Bill Statistics

Medical bills account for one of the largest forms of household debt, next to credit card and student debt. According to research conducted by the Kaiser Family Foundation (KFF) for 2019:

  • 1 in 10 U.S. adults owes some form of medical debt. 
  • 11 million U.S. adults owe more than $2,000, and 3 million owe $10,000 or more. 
  • 32% of single-person households with private insurance could not pay a $2,000 medical bill. 

Further, data cited by the U.S. National Institute of Health (NIH) has found that the average fatal injury cost patients approximately $6,880 for non-hospital emergency department care and $41,570 for hospital emergency care.

Types of Medical Costs Covered Under a Personal Injury Claim

Anyone that has suffered any illness or injury, from a sprained ankle to open-heart surgery, knows the immense cost of healthcare. Fortunately, a person that was harmed in an accident can recover costs from a gauntlet of treatment, including:

Co-pays and deductibles from health insurance policies.

  • Emergency room visits.
  • Transportation in an ambulance.
  • Intensive and outpatient surgery.
  • Hospital admissions.
  • Diagnostic testing and imaging.
  • Lab testing.
  • Specialist consultations.
  • Physical therapy.
  • Occupational therapy.
  • Psychiatric treatment.
  • Prescription medication.
  • Medical equipment like wheelchairs and lifts.
  • Hospice, in-home care, and other nursing care.

Seeking Treatment for Medical Claims Before Settlement

Although the prospect of having to pay associated costs with medical care as a result of another party’s actions may seem unfair, the reality is that a person’s health should always come first in these situations. Thus, an injured plaintiff should always seek the appropriate medical care before, during, and after filing a lawsuit against another party.

Keeping Track of Medical Expenses

Anyone who has ever sought medical treatment after an accident and later earned a settlement knows the value of quality recordkeeping. Any and all medical costs should be saved and organized for future use.

Virtually all personal injury cases require a showing that the injured party has suffered monetary damages due to the accident. Thus, plaintiffs can use medical bills associated with treatment to address injuries and illnesses stemming from an accident to determine the final damage calculation. That means the injured party and their insurance company can recover from these expenses.

Plaintiffs with Health Insurance

Plaintiffs with the fortune to have comprehensive medical coverage should use their health insurance to pay for many medical expenses, including hospital and emergency room visits, prescription medication,  physical therapy, psychiatric treatment, and other related medical costs.

While many factors can influence the outcome of a personal injury claim, certain circumstances, such as not wearing a seatbelt during a car accident, can have a significant impact on the compensation you may receive. Learn more about the implications of not wearing a seatbelt during a car accident and how it can affect your claim.

In most cases, the insurance company that has funded all or a portion of a plaintiff’s medical treatment may file a medical lien against the policyholder to recoup some of the funds. If a settlement is reached, some of the funds may have to be paid to the insurance company. This includes medical coverage provided by Medicare and the U.S. Department of Veterans Affairs (VA).

Some insurance policies also contain a personal injury protection (PIP) clause, which allows a policyholder to use their health insurance even if their injuries were caused by personal injury. A PIP policyholder can have their medical costs covered until a settlement has been reached. In addition, many Nevada insurance policies offer consumers the ability to purchase MedPay, a type of coverage that will pay for injuries resulting from an automotive-related accident before settlement.

Plaintiffs Without Health Insurance or Exhausted Coverage

Unfortunately, medical coverage is not only guaranteed for all Americans but can be outrageously expensive depending on multiple factors, including age, geographic location, and income. Thus, even with the passage of the Patient Protection and Affordable Care Act (PPACA), many Americans still cannot afford quality medical coverage

If a plaintiff cannot afford or has lost coverage due to a change in employment circumstances, some may be eligible for Nevada Medicaid funding. Although Nevada Medicaid may still file a lien for outstanding medical costs associated with an accident, those without coverage can still seek medical attention until a settlement has been paid.

If Medicaid is not an option, a plaintiff awaiting a personal injury settlement can still partially or fully fund their medical care through several avenues. First, a plaintiff may be able to negotiate a payment plan with healthcare providers to pay monthly installments for their care. Alternatively, some medical providers allow patients to sign an assignment agreement, which allows the patient to receive care on the condition that outstanding medical bills be paid before the patient receives settlement funds.

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