When someone is injured in a car accident, or a pedestrian/motor vehicle accident, they often wonder, “Who is going to pay the bills?”
The ambulance bill, alone, may cost a thousand dollars out-of-pocket. A third party insurance claim, and/or lawsuit, will often not resolve before the injured person’s pain and injuries subside.
When victims are injured in a motor vehicle accident, they should use their automobile insurance policy’s first party medical benefits (also known as “PIP coverage”) to pay for the required medical treatment in connection with their injuries. Even the at-fault driver, and/or pedestrian, is entitled to claim first party medical benefits under their own automobile insurance policy to cover their medical care and treatment.
Whose Automobile Insurance Policy Provides Me With First Party Medical Benefits?
You are probably wondering whether you have these benefits under your policy of automobile insurance coverage; the answer is yes. Pennsylvania law requires all drivers to have first party medical coverage in their automobile insurance policies.
Vehicle passengers, and pedestrians, may also obtain these benefits when they are injured. They can claim these benefits from their own insurance policy, the insurance policy of a relative with whom they are living at the time of the accident, or else they can claim first party medical benefits from the insurance policy that covers the car that they were occupying and/or injured them. In other words, even people who do not have their own policy of automobile insurance may apply for benefits to pay for medical treatment. (e.g., if a teenager who does not have automobile insurance is injured in a car accident while sitting in the back-seat of a friend’s car, the backseat passenger can claim medical benefits from the insurance policy that covers the friend’s car or truck).
How Do I Make a Claim for First Party Medical Benefits?
Once the insurance company has been contacted, and an application for first party benefits has been submitted, an insurance adjuster will be assigned to handle your claim. The insurance adjuster’s job is to ensure that only relevant medical claims are paid; the insurance adjuster does not work for you, s/he works for the insurance company, and the insurance company will simply not pay money for medical bills unrelated to the motor vehicle accident. Insurance is a profit-driven business.
A law firm can handle the first party claims process so that you do not have to haggle with the adjuster. McLaughlin & Lauricella does not take any fee on clients’ first party benefits (medical, wage loss, funeral/death benefits). Insurance adjusters have years of experience, and have handled thousands of claims. You should contact an attorney who has experience handling car accident claims before initiating a claim on your own. Your attorney’s office will send a Letter of Representation to the appropriate insurance company, and begin the application for first party medical benefits immediately.
Are All of My Medical Bills Covered?
The minimum required first party coverage in Pennsylvania is $5,000. That means you will have at least $5,000 of insurance to go towards medical bills, before you recover from a third party claim and/or a potential lawsuit. Remember, $5,000 is only the minimum amount of coverage required under the law. There may be more money available to you.
For people who are seriously injured, first party medical benefits will not cover all of their medical bills. The costs for necessary medical procedures, therapy, and rehabilitation, add-up quickly. Often, an injured car accident victim will need to pay out-of-pocket, or else submit medical bills to their private health insurance provider. Even health insurance will often not cover all of the costs.