Who Pays for Medical Bills After a Car Accident? 20 Facts to Know

Most states have a legal process for deciding who’s liable for your car accident injury costs. In fact, liability is the most important factor in deciding how much money your injury deserves in damages after a car accident, including accident medical bills. Insurance companies look at four concrete factors to determine who’s at fault for auto accidents — and thus, who pays for medical bills after a car accident.

Who’s Liable for Your Car Accident Injury Costs? Key Takeaways

• Liability for medical bills depends on the at-fault party, state laws, and insurance coverage, including the fault driver’s insurance.
• Police reports provide critical evidence to establish fault and determine liability.
• Insurance companies often dispute claims to minimize payouts.
• An attorney can help navigate disputes and maximize compensation for victims.
• Knowing your rights ensures fair treatment during the claims process.

Not Sure Who’s Liable? Look At Your Police Report

When someone’s injured in a car wreck, the police often arrive on-scene soon afterward to protect other motorists. Once there, officers can determine whether anyone broke local traffic laws. Next, police determine which driver to hold legally liable for damages. (Note: This only applies to collisions in at-fault states.)

In most cases, they’ll give all affected drivers an auto accident report number written on a small slip of paper. You can request a copy of the full report for your records after seeking medical care for your injuries. (In some states, you may have to pay for your copy of this report.) While the police may assign fault to one specific driver, car insurance companies don’t always agree. It is crucial to file a claim with the fault driver’s insurance company to seek compensation for your injuries and damages.

Whether the police assess the scene or not, insurers use their own car accident formula to determine who’s liable. Then, they’ll assign each driver a percentage number showing how responsible they are for causing the wreck.

4 Factors for How Insurance Companies Decide Who’s Liable for Accidents

Car insurance companies use a specific formula to perform a “negligence analysis” for all drivers involved in the crash. They’ll review four distinct elements to determine which driver is most responsible for causing your injuries. For example: Let’s say you stop at a two-way intersection at night. Drivers on the cross street automatically have the right-of-way, because there’s no stop sign or red light. It’s very dark, and you don’t see anyone coming after coming to a full stop and looking both ways. You slam into another car with the headlights turned off driving under the legal speed limit.

You might think the other driver is 100% liable for your accident, but how can you be sure? To help you better understand the formula for determining who’s liable, we’ll explain the four things insurers look at below. Documenting car accident injuries is crucial for ensuring proper insurance claims and compensation.

Factor #1: Driver Duty

Think back to when you finished driver’s education classes to earn your learner’s permit. No matter how long ago that was, you probably heard that driving is a big responsibility. In fact, driving often has life-or-death consequences. This is 100% true! Licensed drivers agree to take on certain duties every time they hit the road.

As a responsible driver, your duties include:

• Paying attention to everything that goes on in and around your vehicle
• Obeying all state and local traffic laws, such as not driving under the influence or while distracted
• Using defensive driving techniques to avoid an accident, even if others go out of turn or break the law

In other words, all drivers have a responsibility to put safety above convenience or speed while behind the wheel.

Factor #2: Determining Who Breached That Driver Duty

To assign responsibility for an accident, car insurers must find that a driver breached one or more duties listed above. If a breach didn’t happen, then no driver can be found at fault. If the insurer finds at least one breach of duty, however, that driver is at least partially liable for causing your injuries.

So if you’re driving 5 mph over the speed limit when the accident occurs, you may be found partially responsible. Even if the other driver did something much worse (like running a light), speeding is still a breach of driver duty.

Factor #3: Causation

While the example above makes it seem obvious who’s liable for your injuries, insurers might not always agree. The insurance provider must show another driver’s breach of duty caused your injuries and property damage. Once an insurer finds causation for the accident, it assigns negligence, and this step usually happens very quickly.

Factor #4: Calculate Damages

Damages can refer to either physical injuries or property damage. An insurer working through the liability determination process must carefully examine the accident. A valid determination directly ties all damages to the at-fault driver’s breach of duty. If you have two distinct injuries from one accident, the insurer must complete this analysis twice — once for each injury.

Once all four criteria are satisfied, an insurer may assign blame to a particular driver.

No-Doubt Situations Where One Driver Is Usually Found Legally Liable

If two drivers break the law when the crash happens, knowing who’s legally liable is less obvious. However, there are some “no-doubt” situations where one driver is always found liable for causing the accident. In these situations, the insurance company will assume fault with the other driver almost 100% of the time.

• Rear-end collisions: One driving rule says that staying a safe distance behind another vehicle allows you ample time to stop. If someone hits another vehicle from behind, the insurer assumes that the driver followed too closely or didn’t pay attention. The only way to avoid 100% fault in a collision like this is if the other driver’s brake lights weren’t functional.
• Unprotected left turns: If you crash into someone driving in the opposite direction, whichever motorist turned left is almost always at fault.

10 Common Costs After a Major Car Accident

Car accidents often result in a wide range of medical and recovery expenses. These costs can add up quickly, depending on the severity of the car accident, the injuries, and the necessary treatments. Car accident injury treatment is a critical aspect that can lead to significant medical expenses. Below are 10 common medical and care-related expenses accident victims may face:

• Hospital Bills: Hospital bills include charges for emergency room visits, surgeries, and overnight stays. These costs can quickly escalate for severe injuries requiring intensive care. Patients may also face additional fees for diagnostic services and medications provided during their hospital stay.
• Ambulance Services: Emergency transportation to the hospital can result in significant bills. Ambulance services often include charges for specialized medical equipment and paramedic care en route. These fees are typically billed separately from hospital costs.
• Primary Care Physician Bills: After receiving initial emergency care, follow-up visits with a primary care physician are often necessary. These appointments focus on monitoring recovery and addressing any complications. Primary care bills can add up if multiple visits are required.
• Specialist Consultations: Depending on the injuries, victims may need to see specialists such as orthopedic surgeons, neurologists, or pain management doctors. Each specialist consultation comes with its own fees, which can vary widely. These visits are essential for accurate diagnoses and targeted treatment plans.
• Imaging and Diagnostic Tests: Diagnostic tests like X-rays, MRIs, CT scans, and blood work are crucial for identifying internal injuries. Each test can carry significant costs, particularly for advanced imaging like MRIs. These tests often guide the treatment and recovery process.
• Rehabilitation Services: Physical therapy, occupational therapy, and chiropractic care are common rehabilitation services needed after an accident. These services are aimed at restoring strength, mobility, and function. Long-term rehabilitation can result in substantial cumulative expenses.
• Prescription Medications: Medication costs include pain relievers, antibiotics, and other drugs prescribed during recovery. Long-term prescriptions for chronic pain or ongoing conditions can add to the financial burden. Without insurance, these costs may be out of pocket.
• Follow-Up Visits: Regular follow-up visits help doctors track recovery and adjust treatment as needed. These appointments are critical to ensure proper healing and prevent complications. Multiple follow-ups can increase medical expenses significantly over time.
• Assistive Devices: Injuries may necessitate assistive devices such as crutches, braces, or wheelchairs. The cost of purchasing or renting these items can vary, and maintenance or replacement may also be required. Such devices are crucial for mobility and independence during recovery.
• Home Health Care: For severe injuries, patients may require in-home nursing care or assistance with daily tasks. These services can include wound care, physical therapy, or help with personal needs. Home health care is often one of the most expensive ongoing costs for accident victims.

In addition to these major expenses, you may suffer from lost wages from being unable to work, which can further impact your finances. Many common car accident injuries can put you out of work temporarily, making it all the more important that you’re compensated for your injuries.

4 Options to Help Pay Your Medical Bills

After a car accident, paying for medical bills can be overwhelming. Fortunately, several services and coverage options are available to help ease the financial burden. These include auto insurance, at-fault insurance, health insurance, and third-party liability coverage. Additionally, medical payment coverage can play a crucial role in covering medical expenses.

Auto Insurance

Your auto insurance often provides the first line of financial support for accident-related medical expenses. Personal Injury Protection (PIP) or Medical Payments (MedPay) coverage can cover immediate costs regardless of who is at fault. These policies typically pay for emergency care, follow-ups, and sometimes rehabilitation services, depending on your insurance coverage and the policy limits. Additionally, medical payment coverage can help cover medical expenses after a car accident, especially for those without health insurance, by offsetting costs not covered by health insurance, such as deductibles or copays.

At-Fault Insurance Company

If another driver is deemed responsible for the accident, their liability insurance should cover your medical expenses. This coverage includes costs for hospital stays, specialist consultations, and other necessary treatments. Payments from the at-fault driver’s insurance often depend on the policy limits, which may not fully cover extensive injuries. In such cases, a health insurance company can help manage the remaining medical bills, reducing out-of-pocket expenses and aiding in financial recovery.

Health Insurance Coverage

When auto insurance benefits are exhausted, health insurance can help cover the remaining costs. Policies vary, but most health plans cover a significant portion of medical bills, including surgeries, diagnostic tests, and rehabilitation. However, deductibles, co-pays, and other out-of-pocket expenses might still apply. Additionally, a health insurance provider may cover subsequent medical bills but could seek reimbursement if an auto accident settlement is received.

Third-Party Liability

In cases where another party or an uninsured driver is responsible for the accident, third-party liability insurance comes into play. This may involve suing the at-fault party or negotiating with their insurer for compensation. While helpful, these claims can be complex, and some healthcare providers may not accept third-party insurance directly. Health insurance providers may seek reimbursement from the at-fault party’s insurance for medical bills they initially cover.

Should I File An Injury Claim After an Accident?

Filing an injury claim after a car accident can be a critical step in ensuring financial protection and securing fair compensation for your medical bills and other damages. Without filing a claim, you may be left covering the costs of hospital stays, specialist visits, and rehabilitation services on your own.

An injury claim allows you to pursue compensation from the at-fault party’s insurance, which can cover immediate medical bills as well as future expenses related to your injuries. It can also provide financial relief for lost income and other economic losses. Personal injury attorneys can assist in negotiating medical bills with healthcare providers and insurance companies, alleviating financial stress during the recovery process.

The process includes reporting the accident, collecting evidence, and documenting all expenses, including medical bills and vehicle repair costs. Consulting a personal injury attorney ensures that your claim is filed correctly and that you receive the maximum compensation possible. Filing an injury claim is often the best way to protect your financial and physical recovery after a car accident.

Work With a Car Accident Attorney if You Were Hurt in a Wreck

A car accident attorney can be an invaluable ally if you’ve been injured in a crash. They specialize in handling the complexities of insurance claims, medical liens, and settlement negotiations, ensuring that you don’t face the burden of navigating these processes alone. Attorneys are skilled at maximizing compensation, which can make a significant difference in covering your medical bills and other damages. Seeking prompt medical treatment is crucial not only for your recovery but also for documenting injuries, which can be vital for personal injury claims.

By working with an attorney, you gain access to their expertise in gathering evidence, communicating with insurance companies, and calculating the full extent of your damages, including lost wages and pain and suffering. Their representation prevents insurance companies from offering low settlements that fail to account for the true cost of your recovery.

Car accident attorneys can also negotiate with medical providers to reduce outstanding bills or liens, leaving you with more funds from your settlement. If your case goes to court, they will represent your interests and fight for a fair judgment. Having a trusted advocate on your side ensures that you receive the compensation you need for a full recovery.