Medical bills can become a major concern after a car accident, especially when emergency treatment or a hospital stay is involved. Understanding which insurance may pay, what balances remain and when payment is due can help you avoid surprises.
In the video above, Scott Marshall of Marshall Injury Attorneys explains how personal injury protection coverage, health insurance and arrangements with medical providers may help address treatment costs while an injury claim is pending.
Start by understanding your PIP coverage
Florida’s personal injury protection insurance, commonly called PIP, generally pays 80% of reasonable, medically necessary covered expenses, subject to eligibility requirements, deductibles and available benefits.
The $10,000 figure discussed in the video is a benefit limit, not a guarantee that every medical bill will be paid. Qualifying initial care must be received within 14 days after the accident. Medical benefits up to $10,000 require an emergency medical condition determination by an authorized provider. If a qualifying provider determines that no emergency medical condition existed, medical benefits are limited to $2,500.
You can read these requirements in Florida Statutes section 627.736.
What happens to the portion PIP does not pay?
Scott explains that medical expenses not paid by PIP may form part of the claim pursued against the responsible driver. That can include eligible unpaid portions of bills and expenses beyond available PIP benefits.
Including an expense in a claim does not guarantee reimbursement or mean the other driver’s insurer will pay each bill as it arrives. Responsibility for the accident, available coverage and the evidence supporting the expenses all matter.
Health insurance may help with additional treatment costs
Scott recommends using available health insurance when appropriate, including after PIP benefits have been exhausted. Your provider and insurers can help clarify how claims should be submitted and how benefits coordinate.
Health insurance may still leave deductibles, copayments or other patient balances. Scott specifically cautions against assuming that a pending injury claim prevents a provider from seeking payment or referring an unpaid balance to collections.
Review bills and insurance explanations of benefits. If you cannot pay a balance, contact the provider promptly and discuss the situation with your attorney.
Can a provider wait for payment until settlement?
Scott describes arrangements in which a medical provider agrees to continue treatment and defer an agreed balance while a claim is pending. If a settlement is obtained, that balance may then be addressed from the proceeds.
Not every provider accepts this arrangement. Do not assume a bill is on hold simply because you have hired an attorney or opened an insurance claim. Ask for clear written terms explaining payment timing, collection activity and your responsibilities.
Understand what happens if the claim is unsuccessful or the recovery is insufficient. Deferring payment does not make treatment free or guarantee that settlement funds will cover the bill.
What if you do not have health insurance?
Scott acknowledges that finding ongoing care can be more difficult without health insurance. Some providers may agree to treatment under an arrangement involving payment from a future recovery, while others may require a different payment method.
Discuss available options with your attorney and the provider. The provider’s suitability for your medical needs and the financial terms both deserve attention.
Medical bills and repayment claims at settlement
Scott explains that outstanding provider balances and applicable repayment claims need to be reviewed when a case settles. These obligations can affect the amount of money you ultimately receive.
For example, Medicare may make conditional payments for accident-related care and seek repayment after a settlement. Other insurers or benefit plans may also assert reimbursement rights, depending on the applicable rules and plan terms.
Ask your attorney to explain which balances and repayment obligations apply to your case before settlement funds are distributed.
Keep your billing information together
- Keep medical bills and insurance explanations of benefits.
- Track payments you make toward accident-related care.
- Confirm which insurer each provider has billed.
- Get any deferred-payment arrangement in writing.
- Send collection notices and repayment requests to your attorney promptly.
Have questions about medical bills after a crash?
Marshall Injury Attorneys can review your circumstances and explain how medical expenses, available insurance and outstanding balances may fit into your injury claim.
Request a free case review or call 727-772-5900.
This article summarises Scott Marshall’s video and includes additional general information about insurance and medical billing. It is not legal, medical or financial advice and does not create an attorney-client relationship. Coverage, payment arrangements and repayment obligations vary. Every case is different.
