Visitor Question

How to request compensation when I only paid a copay?

Submitted By: Gayle (Southern California)

I was involved in an auto accident when I was stopped at light and rear-ended by the other party. The other party’s insurance has already paid out the maximum property damage and totaled the vehicle. I was also injured in the crash. I have been in physical therapy for 3 months with soft tissue damage to my neck and back.

I am now ready to request compensation, but I’ve only been going to my own insurance that has a minimal $20 co-pay per visit. How should I proceed with my demand? Can I request payment based on the actual cost of treatment? How do I show the actual cost if it’s not what I actually paid? Any tips you can give would be great. Thanks.

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.


Dear Gayle,

California does not require no-fault insurance. Instead, it is a third party “fault” state. This means you have a legal right to pursue the negligent driver personally, or through his insurance company, for property damage and for your personal injuries and required costs of treatment.

In California the legally required minimum limits for car insurance are:

-$15,000 for injuries to one person

-$30,000 for injuries to two or more persons

-$5,000 for property damage

Because the other driver appears to have been 100% at fault, all of your damages should be covered. For purposes of your personal injury claim, damages should include payment for your medical and/or therapy treatment, out-of-pocket expenses (for medications, bandages, cost of travel to and from treatment, etc.), your lost wages, and for pain and suffering.

In your case, it appears your insurance company has already paid for a substantial amount of your medical and/or therapy bills. If so, your insurance company may have a right to be reimbursed for the amount they paid on your behalf, once you settle your claim with the other driver’s insurance company.

Contact both insurance companies. Find out if your insurance company has a lien on your settlement proceeds. If so, the driver’s insurance company may hold back that amount and thereafter transfer it directly to your insurance company.

In the event there is not a lien, and you receive the entire amount of the settlement, there is a good chance when your insurance company finds out they will seek reimbursement from you.

In the event your insurance company requires reimbursement, you can negotiate with them to “compromise” the amount they require back. If your damages are so high as to leave you with little or nothing for your pain and suffering, you may be able to convince your insurance company to reduce the amount they require as reimbursement.

Learn more here: Personal Injury Compensation Guide

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 888-972-0892.

We wish you the best with your claim,


One comment on “How to request compensation when I only paid a copay?

  1. Anonymous says:

    I think that in your case, if you are injured, try to talk to your insurers first. It won’t hurt to talk to an Attorney that deals with physical injuries.

    Do you have any info on the Third party that hit your car? Police report.

    Try to read and understand your insurance coverage if you have one. Contact the other insurance would also help. Most importantly is understanding what your auto insurance policy covers.

    Good luck!

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