You didn’t ask for this. One minute, you were driving home. Next, you’re hurt, overwhelmed, and facing a stack of medical bills that keeps growing. It’s hard to know who’s supposed to pay for your medical bills, and when, especially when you’re just trying to recover.
Moreover, in Florida, the driver who received a ticket for causing the crash is not automatically responsible for all of your medical bills. Even if you received a ticket and were deemed partially responsible for causing the accident, you are not necessarily responsible for your or the other driver’s medical bills.
Potentially, negligent drivers or defendants could pay for up to 20% of medical bills for the other driver, which personal injury protection (PIP) doesn’t pay, and up to $10,000 if their negligence caused injuries. Remember, Florida is a no-fault state, and PIP applies regardless of fault.
Let’s break down how medical bills are paid after a car accident in Florida — and what you can do to protect yourself.
How Medical Bills Are Paid After a Car Accident
In Florida, we follow a no-fault system, which means your own insurance company is responsible for paying your initial medical bills, regardless of who caused the crash. If you are insured to drive in Florida, you are required to carry auto insurance. Even if you were at fault (or partially at fault) for causing the car accident, your medical bills will still be covered by your PIP insurance. This coverage helps with immediate medical expenses and a portion of lost wages.
- You will receive up to $10,000 for medical bills.
- If you don’t have an emergency medical condition, you receive $2,400 for medical bills.
- PIP insurance will cover up $10,000 for lost wages.
- There is an additional $5,000 death benefit paid to beneficiaries.
But PIP only goes so far. If your injuries are considered an emergency, you’re eligible for up to $10,000 in benefits, though only 80% of your medical bills are actually covered. If your injuries aren’t classified as an emergency, that amount drops to $2,500. So if you have $5,000 in medical bills, PIP insurance will only cover $4,000 of it — and that’s if your injuries are considered an emergency. If your injuries aren’t considered an emergency, you can only claim up to $2,500 in benefits.
And keep in mind, this coverage doesn’t include every type of treatment. For example, alternative options like acupuncture or chiropractic care often aren’t reimbursed.
So, who pays the rest? That’s where things get complicated — and where legal guidance can make a big difference.
When PIP Doesn’t Cover Everything
If you have health insurance, it can usually be used for your medical treatments after a car accident, just like in any other injury situation. Of course, you will still be responsible for any deductibles and copays, but otherwise, you should be able to use your health insurance policy without much issue. This includes Medicare and Medicaid, as well as private insurance.
Your medical insurance can only be used to cover bills that are covered by your policy. So, for instance, if you take an ambulance ride, but that’s not covered by your policy, you may have to pay for it out-of-pocket. However, if you know you have a settlement coming, you may be able to work with the hospital to make small, minimum payments before you pay the full amount out of the settlement.
In some instances, your insurance provider may require reimbursement after you receive a settlement. They may also go after the other driver’s insurance company for reimbursement if you’re found not at fault. But all of this is secondary to the fact that, if you have insurance, you can use it to cover your bills. That’s why you have insurance, after all!
What If You Have to Pay Bills Yourself?
This is obviously the least desirable way to pay for medical bills, but there are times you may have to pay out-of-pocket. For instance, if you have little or no health insurance, or the other driver’s insurance company refuses to pay because fault hasn’t been established, you could be on your own.
The good news is, you may be able to negotiate a hold agreement with healthcare providers until you get your settlement. This allows to to make small payments (or no payments at all) while you’re waiting for your settlement, without sending the issue to collections agencies.
In some cases, you can also secure a loan to cover your medical bills. However, unless you can get a personal loan at a great rate, it may be better to avoid this scenario. Predatory lenders may offer car accident settlement loans, in which you agree to give them a large part of your settlement, but the interest on these loans is often very high.
If it comes down to it, you may be better off trying to borrow from friends or family, especially if they know a settlement is on the way. However, an experienced car accident lawyer in Miami can negotiate with the insurance companies to help you get a full, fair settlement quickly so you can avoid borrowing money altogether.
When Medical Bills Are Paid after a Car Accident
Once your case settles, your medical bills typically get paid first. If your health insurer paid part of your treatment costs, they may ask for reimbursement — usually a percentage, not the full amount. The rest of the settlement goes toward covering lost wages, pain and suffering, and other damages.
Can You Sue the Other Driver?
Florida no-fault legislature requires a driver’s insurance company to pay the drivers and passengers injuries where eligible. However, a driver or passenger can take the other driver to court and sue for damages if their injuries and those costs reach a permanency threshold.
The only way a car or truck’s driver or their passengers can take the other driver to court for economic damages is if their injuries meet certain requirements, known as the no-fault threshold:
- Significant and permanent loss of an important bodily function
- A permanent injury
- Significant permanent scarring or disfigurement
- Death of the driver or passengers in the vehicle
These injuries must be diagnosed by a professional or a doctor.
If someone died in the accident, their family may also have the right to file a wrongful death claim. Or if you have reached the limit of your PIP insurance and you still require compensation for medical bills, lost wages, and pain and suffering, you can speak to a car accident lawyer and sue for damages.
What About Passengers’ Medical Bills?
Passengers have to contact the driver’s insurance company or their own. (as a side note, that passengers should be wearing seatbelts)
If you were a passenger in the car during the accident and you are a member of the household of the driver, then the driver of the car is usually responsible for medical bills which will usually be taken out of the Driver’s PIP.
If you are not a member of the driver’s household and you have your auto insurance, then you will likely be covered under your PIP insurance.
If you are one of the 25% of Florida drivers that are not covered by insurance, then you will have to speak to a Florida car accident injury lawyer. You may have to sue the driver to receive compensation to cover your medical bills.[2]
The key is to talk to a lawyer quickly so you know exactly where you stand.
Why You Need a Florida Car Accident Attorney
Being in a car wreck is a stressful experience. Between car damage, missing work and dealing with the pain of your injuries, the last thing you want to worry about is a stack of medical bills that you can’t possibly overcome.
Whether your accident happened in Miami, West Palm Beach, Tampa, Fort Lauderdale, or anywhere in Florida, the laws are the same — but your experience shouldn’t be. The right attorney will deal with insurance companies, handle your paperwork, manage your bills, and fight to get you every dollar you’re owed.
At Steinger, Greene & Feiner, you don’t pay anything unless we win your case. Call us today at 800-431-6841 or contact us online for a free, no-obligation consultation. We’ll review the details of your case and any settlement offer you’ve received. If we believe the offer is fair and we can’t get you more compensation, we’ll let you know so you can move on with your life. But if we believe we can get you a greater settlement, we’ll let you know that, too.
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