“After an Accident, Should I Bill My Health Insurance?”

August 18, 2015

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We get asked this question a lot, “After an accident, should I bill my health insurance?”

To answer this question, we’re posting Chapter 7 of Doug Zanes’ best-selling personal injury book titled “Winning Your Personal Injury Case”.   >Click here to download a free copy!<

Chapter 7 – “Don’t bill my health insurance,” said the misguided patient!

            Over the years I have had clients who honestly believed that their health insurance should not have to pay any for any of the medical treatment that they needed after being injured in an accident.  Personally, I have never understood this perspective because this is why you have health insurance.  You pay your health insurance premium every month so that if you ever become sick or are hurt you are able to get the medical care that you need and also have it paid for.  So why then when you are hurt in an accident would you not want to use your health insurance?  I understand that you want the at-fault driver who hurt you and his auto insurance company to be responsible, and eventually they will be.  But it’s a process, and it can be a lengthy process.  So make sure that when you go to the hospital or a doctor, you provide them with your insurance information and also make sure that you insist that they bill your health insurance for the treatment.

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I have actually had clients tell me that while they were at the hospital in the emergency room, when the hospital realized the client had been in a car accident the hospital staff actually told the client that they didn’t need their health insurance information.  The client was told that the hospital bill would get paid by the car insurance for the at-fault driver.  This is a bad scenario for you the patient for a number of reasons.  First, as the patient you are personally responsible for this bill no matter what happens in your future car accident claim.  So if it turns out months later that no car insurance exists that will pay this bill, you will then be personally responsible for it.  Second, if, when this happens, it is now too late for the hospital to send this bill to your health insurance company for payment you will truly be personally responsible for your hospital bill.  This can be extremely bad because a single outpatient emergency room visit can cost tens of thousands of dollars, and you would be responsible for the entire amount.

Here is an example of how, in my opinion, you need to handle this situation.  If, for example, you are in a car accident and are taken to the emergency room.  When you get to the emergency room and you fill out all of their paper work, you must make sure that you give them your complete health insurance information and that you give them your health insurance card to copy.  Specifically tell them that you want them to bill your health insurance for the treatment that you are receiving.  Then, after you are treated and sent home, you need to call the hospital billing department and make sure that they have all of your correct insurance information and you also need to make sure that they are billing your health insurance.  Keep in mind, that if your hospital bill is $10,000 your health insurance probably is not paying the hospital nearly that much money.  Your health insurance will pay the hospital what they contractually have to pay the hospital per their agreement with the hospital.  So wouldn’t you rather have this bill paid and taken care of by your health insurance?  The alternative is that you personally are responsible for the full amount (not the lower amount that your health insurance would pay), and this is simply setting yourself up to be victimized once again.  Please do not make this

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