Using Health Insurance After an Accident to Pay Medical Bills

Using health insurance for crash-related injuries: what you need to know

If you’ve been injured in a car crash, your Oregon Personal Injury Protection is the first place to get your medical bills paid. Even if you don’t have auto insurance, you may still have PIP, because there are situations in which the PIP of the driver who hit you must pay your medical bills.

Unless you have paid for higher coverage, PIP will only pay up to $15,000 worth of medical bills. PIP only pays for one year, so if your medical treatment surpasses one year, or if your medical bills add up to more than $15,000, your health insurance will have to start paying.

Unfortunately, if you have to use your health insurance after an accident to pay for medical care related to car-crash injuries, their payments will not be seen as much more than a loan to you. Almost every health insurance policy in Oregon contains a clause which stipulates that if you are hurt in an accident that is someone else’s fault, and you get money for that accident either by settling the case yourself or by hiring a lawyer to settle or go to trial, you have to pay back your health insurance for all the medical care that they paid for. To add insult to injury, some health insurers have been “recovering” even the copayments that they didn’t pay in the first place!

Here at DuBois Law Group, we believe that this is a shameful situation that needs to be corrected. Unfortunately, the reality of the situation is that almost all Oregon health insurance policies include this clause in the contract that you sign when you purchase a given policy.

To summarize: if you’re in an accident and your health insurance pays $20,000 toward your medical care for an accident-related injury, and then later you get $50,000 from the insurance company of the person who hit you, your health insurance company will want their $20,000 back. Sad, but true.

A good personal injury lawyer can often negotiate with your health insurance company and get them to reduce that amount, so that they take back less than the full amount they paid. In our example, they might be bargained down to $15,000 or $12,000. You will have to pay them back in the future, so if you don’t negotiate hard you’re going to have to pay them back every penny.

For more information on this, and other topics critical to anyone who has been in an Oregon Auto Accident, get our book, Seven Common Mistakes That Can Wreck Your Oregon Car Crash Case. It costs $16.95 on Amazon. But if you’ve been in an accident in Oregon, we will rush you a copy for free.