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Auto Accidents & The Intricacies of Insurance

March 29, 2017

Auto accidents often leave people wondering what will happen next, and it is important to have a basic understanding of the different types of insurance and coverages that come into play during this hectic time.  

Auto Insurance Personal Injury Protection

To begin, Florida is a no-fault state, which means that Personal Injury Protection, commonly referred to as PIP, provides the primary medical coverage for your initial treatment when you are injured in an auto accident.  PIP coverage is afforded by your personal auto insurance policy. This seems counterintuitive to some, as they don't understand why they have to file a claim with their own insurance company when someone else caused the accident.  In Florida, PIP will typically pay 80% of your medical bills up to a maximum amount of $10,000.  However, one must make sure to follow the guidelines of PIP.  For instance, you must treat with a licensed physician within the first 14 days of an accident.  Also, your insurance company can send you to a doctor of their choice for an examination called an Independent Medical Examination, or an IME.  If this doctor doesn't believe that your injuries are plausible and/or related to the accident, the insurance company can suspend paying out your PIP benefits.

Medpay (Medical Payments Coverage)

Medpay, also known as medical payments coverage, is another type of insurance that an individual's personal auto insurance policy affords.  Medpay is not required like PIP, and people might choose not to have it because it can contribute to a higher insurance premium.  However, Medpay coverage is highly beneficial because it typically covers the 20% that PIP doesn't cover.  This means that people usually won't have to worry about the hassle of rounding up their bills and paying the remaining balance, or worry about bills going into collections, because their auto insurance will ideally pay the bill in full.  It also means that people can treat for a longer duration of time, as there is more coverage allocated to them.  For example, if someone quickly exhausts their $10,000 of PIP coverage on bills from a hospital and ambulance company, they could use $10,000 of Medpay for rehabilitation and specialist visits.  If they didn't have the Medpay, they would have to find an alternate form of payment for the physicians.  Also, Medpay coverage often has to be repaid to your insurer in the event of settlement with a third party, which is called their right to subrogation.

Health Insurance

Lastly, health insurance is another type of insurance for people who are injured in an auto accident.  However, health insurance can only be billed once PIP has been exhausted, or used up.  Also, like Medpay, health insurance companies are entitled to get their money back if there is a settlement from a third party.   Health insurance helps to reduce balances owed even further, especially with the write-offs and adjustments that health insurance companies are legally required to make.  Some issues can arise when there are out of network providers or claims aren't submitted timely for payment.  Also, sometimes it is necessary to Coordinate your Benefits with your insurance company to determine what the insurance company is willing to payout.

If you need an auto accident lawyer

The intricacies dealing with the different types of insurances that come into play when one is in an auto accident can at first seem overwhelming.  However, with the help of an experienced, knowledgeable attorney, these intricacies can be both explained and properly managed.  Please call my office today if you have been involved in an auto accident, and we can find out what insurance is available to compensate you for your loss.

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