Commonly, individuals involved in significant car accidents voluntarily (and sometimes involuntarily) go to the hospital for treatment. Upon checking in, one of first questions the hospital (should) ask is: “We’re your injuries as a result of a car accident?” The hospital does not ask this question because they care about why you were injured; they ask this question because they want to know which party to bill for your treatment. This is especially important if you do not have health insurance.
For whatever reason, a decent number of individuals fail to advise the hospital that they were injured as a result of a car accident. This is unwise on many levels. If you receive treatment at the hospital related to injuries sustained in car accident, you should ALWAYS insist that the hospital bill you CAR insurance (through your PIP benefits) as primary and your HEALTH insurance as secondary. If you do not advise them that you sustained injuries as a result of a car accident, the hospital will bill your health insurance as primary. If you do not have health insurance, they will bill you personally for the full freight. The hospital will (almost immediately) file a lien on your outstanding balance.
Florida is a “No-Fault” state. This means that no matter who caused the accident, your car insurance (through your PIP coverage) will pay for 80% of the first ten thousand ($10,000.00) of medical treatment. You are responsible for the remaining 20%. Your 20% responsibility through PIP is almost always less expensive then any monies you would owe if the hospital billed your health insurance. This applies for all medical providers.
Let’s assume you check yourself into the hospital after a significant car accident. The hospital performs a CT scan of your brain and X-Rays of your neck. Let’s give two (2) examples where the hospital charges $5,000.00 or $15,000.00 for your medical care.
If the hospital bills PIP, your outstanding bill will look something like this:
Car Insurance Pays: $1,000.00
Your Responsibility: $250.00 + any PIP deductible (if any)
Car Insurance Pays: $5,000.00
Your Responsibility: $1,250.00 + any PIP deductible (if any)
The hospital can only charge you the statutory PIP balance of 20% of what your PIP paid as a reasonable and customary charge.
If the hospital bills health insurance, your outstanding bill will look something like this:
Health Insurance Pays: $1,000.00
Your Responsibility (if you recover a settlement): $666.66 or $1,000.00 (depending on your health insurance plan).
Health Insurance Pays: $5,000.00
Your Responsibility (if you recover a settlement): $3333.33 or $5,000.00 (depending on your health insurance plan).
Your health insurance will seek to subrogate back the money it paid to the hospital from your settlement. Your attorney has a legal obligation to protect the interests of your health insurance carrier.
As a result, billing through PIP is the preferable option.
The hospital gets paid about the same either way; they do not care who pays them. Oftentimes it’s a matter of poor training or laziness when they input your billing information. As such, it is incumbent on you to make sure you provide the hospital with your CAR insurance information before you leave the hospital. Insisting on the hospital billing your CAR insurance as the primary insurance could save your hundreds if not thousands of dollars.
The Plantation personal injury attorneys at Lyons, Snyder & Collin will work to negotiate down your bills after a personal injury settlement whenever possible. If the hospital fails to bill your car insurance (PIP) we can usually facilitate the hospital billing the proper entity. If you are involved in a car accident where you have questions about your hospital bills or medical bills, please call Marc Lyons or Philip Snyder at 954.462.8035 for a free consultation.