1. Will the at-fault insurance company pay my bills?

Yes – but with a catch. The at-fault insurance company will never pay your bills as you incur them. They will pay one time and one time only, and that will be in exchange for a full release of all claims. The insurance companies know that if they were to pay your expenses as you go, it would increase the value of the claim and ultimately cost them more money. Therefore, they will not help you get the treatment you need. Instead, they will often try to keep you from getting the treatment you need in an effort to suppress the value of your claim.

2. Should I use my health insurance?

I am often asked by clients whether they should use their health insurance to pay for medical expenses after a wreck. The answer is yes!(Though don’t expect the same answer from your insurance company or medical provider.) Although completely false, clients often tell me that certain medical providers told them that they cannot use their health insurance because the injuries are a result of a wreck. This is simply not true. There is no clause in your health insurance policy that says, “We will agree to accept your premiums in exchange for providing health insurance benefits unless the injuries are a result of a wreck.” That clause simply doesn’t exist. If you have health insurance, you should make sure every medical provider you see is aware of it and is instructed to bill your insurance company. Please note that, if you fail to advise them of your health insurance in a timely manner, you may lose the right to bill your health insurance at all.

I have also had clients tell me that the at-fault automobile insurer (e.g., Geico, Progressive, State Farm) have actually told them not to use their health insurance and not to seek treatment from a specialist, because they will not pay for it. This is extremely frustrating, and it is unfair that adjusters are allowed to manipulate people this way. Really, the only exception is Med-Pay. If you have medical payments coverage on your own automobile policy, you must exhaust that prior to using your health insurance benefits. Otherwise, you should absolutely use your health insurance.

3. Do I have to repay my health Insurance company?

Usually, the answer is no. Health insurance companies do not have a right of reimbursement under Georgia law. The only way a health insurer subject to Georgia state law has a valid right of reimbursement is if, and only if, the insurance company can show that the injured person has been “made whole” or “completely compensated.” As you might imagine, this is usually very easy to defeat, as money can never make a person whole.

However, do note that there are some plans, known as self-funded ERISA plans, that are governed by federal law. If you have one of these plans, then the federal law will trump our state law, and the federally governed plans do have a right of reimbursement. This is why it is important to determine which plan you have and to make sure you only reimburse a plan that has a valid right of reimbursement.

4. What if I don’t have health insurance or Med-Pay?

If you don’t have health insurance or Med-Pay, we can make arrangements with medical providers so that you can obtain the treatment you need. The medical providers will agree to treat you and wait to receive payment until your claim has been resolved. At Van Sant Law, we have you covered!