After car accidents in Pennsylvania, injured individuals such as drivers, passengers or pedestrians, need medical attention. Injured car crash victims are often transported to a local emergency room to receive treatment. However, victims are often confused as to which insurance policy they should use to cover their medical treatments, i.e., the at-fault driver’s car insurance, their own car insurance or their own private health insurance.
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Pennsylvania is a no-fault state; this means that injured victims’ own auto insurance companies pay for their medical expenses related to the car accidents regardless of fault. In other words, an injured individual’s medical bills are paid via medical or PIP coverage under their own auto insurance policy. Therefore, a driver injured in a Philadelphia rear-end accident must use his own auto insurance to pay for his medical expenses even though the accident was caused by a driver who was texting while driving.
Though emergency rooms at hospitals accept auto insurance or no-fault insurance as payment for the medical expenses, some primary doctors or specialists may not. Some physicians do not take no-fault insurance because they are unfamiliar with the forms and paper work associated with car accidents. Unfortunately, this often creates more confusion and stress for the injured victims.
Let’s use the above example where a driver is rear-ended by a distracted driver in Philadelphia. After the accident, the driver is transported to Temple University Hospital due to neck and back pain. The driver also complains of a severe headache. The emergency room doctor diagnoses the driver with a concussion and orders neck and back x-rays. The diagnostic images do not show any broken bones. The doctor discharges the driver and tells him to follow-up with his primary care physician for his concussion and neck and back pain.
The driver goes home and his neck and back pain do not improve; rather, they get worse. The driver makes an appointment to see his doctor, and he is seen few days later. When he arrives for his appointment, the receptionist tells him that the office does not accept auto insurance and that he must use his private health insurance if he wants to see the doctor. Because the driver was in pain, he gives the receptionist his private insurance card.
The doctor examines the driver and prescribes physical therapy. Because the driver used his health insurance to see his primary doctor, he thinks that he also needs to use his private health insurance for his physical therapy treatments. However, this is not true. Any reasonable medical treatments related to a PA car accident are covered by injured drivers’ PIP benefits.
Therefore, it is important for injured individuals to confirm with their physicians that they accept no-fault insurance. If they do not, injured individuals would have to find another doctor that accepts no-fault insurance. However, injured individuals may decide to see their doctors even though they do not accept no-fault insurance. If that is the case, then injured drivers will be responsible for any co-pays.
It is important to note that health insurance does come into play once the PIP coverage is exhausted. PA car accident law requires insured drivers to carry the minimum amount of $5,000 PIP coverage. Insured drivers may purchase additional PIP benefits beyond the required minimum amount. Once the PIP benefits are exhausted, the injured drivers would then use their health insurance to pay for the medical treatments.
If you were injured in a car accident and want to explore your legal rights, call Daniel J. O’Brien, Esq. to schedule a FREE consultation. Mr. O’Brien has been practicing law for over 30 years and will work tirelessly to get his clients the best results they deserve. 877.944.8396