It is an incalculable benefit to have health insurance if you are injured in any kind of accident — whether it is an auto accident, a slip and fall injury, or an industrial or construction accident. At first, I suppose this seems obvious. You want your medical bills paid, right? That’s what health insurance is for, right?
But when someone else is at fault for the car accident, the question becomes, “Shouldn’t he pay for it? After all, he rear-ended me!!! Shouldn’t his insurance cover it? Why does my insurance have to pay? Won’t my rates go up?”
The answer is that, if the other guy is at fault, then, in the end, he will have to pay. But the payment comes only on the back end — not upfront. He pays only when you are done treating and have recovered at best you can. In the meantime, YOUR health insurance (if you have it) pays the bills.
This arrangement whipsaws those unfortunate accident victims who don’t have health coverage. They can’t pay for treatment until they recover something from the other driver, but he won’t pay until the victim has had the treatment. The treatment, in a sense, documents the injury, for the insurance company, and they won’t pay without proper documentation.
Moreover, at the end of the case, if you do have health insurance, you have to pay back less, and therefore, get to keep more from your injury claim. Remember that part of your claim of damages from an injury case is your medical bills. But you have to pay back your insurer for what they paid out in medical. This works very favorably for you if you have health coverage.
Let’s say, for example, that you have an Emergency Room bill of $10,000. The other driver’s insurance company has to reimburse you for your medical bills — that is, the full $10,000. But you only have to repay your insurer $2000, because that’s what they actually paid, due to their discounting leverage in the industry. That leaves you with the $8000 difference.
Again, this system works against injured victims who don’t have health coverage. Their bill is $10,000 and they have to pay back the full amount to the hospital because they don’t have a discounter at work and they have no leverage to negotiate.
That is why it is so helpful to have a good attorney in any kind of accident case, especially if you don’t have health insurance. He can help you negotiate your way through getting doctors who will treat you in exchange for a claim on your settlement funds, and then negotiate down the bills you get for your treatment.
