Car Accidents and Medical Bills

New York State, many, many years ago, adopted a plan to provide for mandatory medical insurance for people who are occupants of a motor vehicle or pedestrians struck by a motor vehicle.  It is called "No-Fault" Insurance.

The reason it is called "No-Fault" insurance is because, we are told, the fault of the person in causing the accident does not, in most cases, prevent the driver, occupant or pedestrian from having his medical bills paid by the insurance company that insured the vehicle that everyone is riding in.  You don't have to chase down the person who caused the accident and find him and sue him and win a judgement against him.  No-Fault insurance was designed to simplify the process.  If I am in an accident, the car that I was driving or in which I was a passenger, (or if a pedestrian, the car that hit me), must be insured.  Part of the insurance MINIMALLY must provide up to $50,000 coverage to pay, among other things, my medical bills, lost wages, and other necessary and reasonable out of pocket expenses.

However, insurance companies are in business to make money.  It is hard to convey this to a lot of people that insurance companies are in a business to make money because usually you are dealing with a kind person called an insurance agent or an insurance broker.  And the insurance agents and brokers are for the most part very fine and friendly people who are accesible and answer questions the best they can.  But, at the end of the day, they are agents FOR THE INSURANCE COMPANY and they are NOT AGENTS FOR YOU.

So, because Insurance Companies, including your own insurance company, is out to make money they have stacked the rules against you -- they really, really have -- so that you have to work and do things in order to get coverage after an accident in order to cover your medical bills and lost wages.  THERE ARE FOUR THINGS THAT YOU MUST, MUST DO WHEN YOU ARE INVOLVED IN AN ACCIDENT IN ORDER TO SECURE THIS "NO-FAULT" COVERAGE.  IF YOU DO NOT DO THESE FOUR THINGS - AND YOU NEED THE COOPERATION OF YOUR MEDICAL CARE PROVIDER -- YOU WILL NOT GET COVERAGE.

Here are the Four Things that you have to do to get insurance coverage.

1.  You must provide written notice of the accident to the insurer within 30 days after the accident.  This form must be asked for from the insurance company or agent for the company that insured the car that you were driving, or in which you were a passenger, or the car that hit you if you are a pedestrian.  If you donot provide this "No-Fault Claim Form" within the 30 days you may be out of luck.

2.  Your doctor, or the hospital, the radiologists -- anyone who bills you for services related to the car accident -- must submit the bill for medical services to the insurer within 45 days after the services are rendered to you.  This is important.  This rule means that you must tell your doctor or medical care provider or the hospital the name and address and claim number, when you get it, for the No Fault Insurance Company.  Even if you have personal insurance, it is better for you, particularly if you are contemplating suing the wrong-doer that caused the accident, to demand that they bill the No-Fault carrier and not your personal insurance company.

3.  From time to time, depending upon the nature of the injury, the No-Fault insurance company can demand that you see a doctor to be examined so that the insurance company can determine if you really are hurt and the extent of the injury.  This is where the insurance companies really screw the injured person.  The insurance companies that we have dealt with for our clients use "stable" doctors who, with the rare exception, know that they will continue to get business from the insurance company for these "insurance company examinations" if they minimize the injured persons injuries.

4.  The injured person AND the medical provider, if requested, must submit to a question and answer session, where your testimony is taken under oath, as the insurer may "reasonably require." 

If you fail to do 1 or 2, above, on a timely basis, the medical care claim will not be paid by the No-Fault Insurance Company.

If you refuse to do 3 or 4, if and when asked, the medical care claim will not be paid by the No-Fault Insurance Company.

If you have any questions, make sure you call us at 1800-924-3529