Aren't my medical bills the business's responsibility?

by Aurthur
(Deerly, TX)

I was injured while at a local business when an employee backed a piece of equipment into another and pinned me up against a wooden post. I was sent to the ER by ambulance where I received treatment and was admitted. I am being told by the business's Insurance that the medical bills are my responsibility and will be included in the settlement.

Why would I have to pay these out of pocket and wait to be reimbursed through a settlement? Why would these bills not go directly to the Insurance company? It is with out a doubt the liability of the business. Thanks for the help.

Visitor Question:
Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter. Our response does NOT create an attorney-client relationship. Always get a formal case review from a licensed attorney in your area.

ANSWER for "Aren't my medical bills the business's responsibility?":

This is a very common scenario, and unfortunately there may be little you can do. Unless the insurance company has a "direct pay" billing scenario set up, you would need to pay your out-of-pocket medical expenses yourself and simply get reimbursed from your settlement.

The other option is to work with your medical providers to take your case on a lien. What this means is that they "lien" your settlement for the dollar amount attributed to your medical bills in the case. This enables you to receive treatment without gaps and also not have to pay for what can be very costly care.

Consult your doctor first about whether they will work with you on a lien. From there, discuss the direct pay option whereby the insurance company pays the medical bills directly or reimburses you immediately.

As a third option, you may need to use your own insurance and provide the bills to the insurance company at the time of settlement. If those fail, you may be faced with coming out-of-pocket then recovering your expenses from the final settlement your receive.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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