Visitor Question

Why do I have to use my own medical auto insurance policy?

Submitted By: Yolanda (Chapel Hill, NC)

On April 29, 2016 I was rear ended. The lady wasn’t paying attention as traffic was at a complete stop. Her insurance company handled my car repairs by paying me for the damage done to my 2002 Toyota Camry.

Here is their breakdown of my medical bills:

We have your medical bills totaling $2,695.64 after the adjustments. We have your lost wages noted at $1,862.26. We can extend a settlement offer to you for $5,500. Please be advised that you will be responsible for paying any outstanding medical bills from the settlement amount. Please get back to me so that we can get this resolved. (Email sent on 11-26-16)

Do you have medical payments coverage under your own automobile policy? If so, you can file a claim with them for up to the amount of your limit. This is something that you can check into. We extended a settlement offer of $5,500. What amount are you looking for to get this resolved? (Email sent March 13, 2017)

I don’t agree with this settlement amount which hasn’t changed. Why do I have to pay for an accident I didn’t cause by using my own medical automobile policy?

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Yolanda,

Reimbursement of medical bills is the primary objective of most people who have been the victim of a car accident. Outstanding medical bills must to be paid. As the patient, you are responsible for making sure they are.

The at-fault driver’s insurance company has no legal or or moral duty to make sure your medical bills are paid. They are an independent third party, and as such, have nothing to do with your legal duty to pay those doctors who treated you.

The settlement offer includes reimbursement for your medical bills. You do not have to use your medical insurance. However. if you choose not to, you must use part of the settlement amount to pay your outstanding medical bills, or pay those bills from another source.

Your medical bills and lost wages amount to $4,557.90. The settlement offer is 5,500. The difference between your medical bills and lost wages, and the settlement offer is $942.10. This amount reflects compensation for your pain and suffering. It appears your position is that you think the entire amount of $5,500.00 should be paid to you exclusively for your your pain and suffering. It just doesn’t work that way.

If you think your pain and suffering is worth more, you can of course negotiate for a higher amount with the insurance adjuster. There’s no guarantee they will increase their offer, but it’s worth a shot.

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

Best of luck,

Published: October 19, 2017

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