A pending claim does not make bills disappear
After an accident, do not assume that the other party’s liability insurer will pay each medical bill as treatment occurs. Payment options and responsibility depend on coverage, provider arrangements and the facts. Attorney Norman Gregory Fernandez discusses these issues in the accompanying video. Address billing questions early so an unresolved injury claim does not become a reason to ignore important notices.
Identify available benefits
Health insurance and other applicable benefits may help pay for care, subject to their rules. Some automobile policies include medical payments coverage, commonly called MedPay. The California Department of Insurance explains that this coverage can pay limited medical expenses regardless of fault, within the policy terms. Obtain the relevant policy and benefit information; do not assume every driver purchased the same coverage or limits.
Understand any provider payment arrangement
Some providers may agree to defer payment under a particular arrangement. Ask what you are signing, how charges are determined and what remains owed in different outcomes. Do not assume that deferred payment means free treatment or that every charge will be recovered from another party. Discuss available options with your attorney and healthcare providers, while making treatment decisions based on appropriate medical needs.
Keep bills and payment records together
Retain itemized bills, insurance explanations of benefits, receipts and correspondence. Distinguish the original charge from payments, adjustments and the balance claimed. Tell counsel about Medicare, Medi-Cal, health insurance and any provider agreement that may relate to the injury. Duplicated or incomplete records can complicate settlement review. Promptly forward collection or reimbursement notices instead of assuming the law office has already received them.
Evaluate the net recovery
A settlement amount is not necessarily the amount available to spend. Attorney fees, case costs and valid reimbursement or lien claims may need to be addressed. Whether a particular demand is valid or reducible requires review of the applicable facts and rules. Ask for an explanation of anticipated deductions before deciding on a settlement. Keep copies of the eventual accounting and any documents resolving payment claims.
General information, not legal advice. Viewing this article does not create an attorney-client relationship. Outcomes and applicable requirements depend on the facts.
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