Medical Bills After a Car Accident
May 20, 2019
BY: Christina Galarza, Esq.
Car accidents can be traumatic and cause serious bodily injury. Although medical bills are often the last thing on your mind, if you were injured you likely had medical care such as an emergency room visit, x-rays, MRI scans, and other costly care. It is important to know what to do with your medical expenses after a car accident.
New Jersey is a “No Fault” state. Which means that in New Jersey, drivers must purchase Personal Injury Protection (PIP) as part of their insurance policy. PIP is also known as “No-Fault” coverage. This coverage will pay some or all of your medical bills regardless of who was at fault for the accident. Even if you are a passenger in another person’s vehicle, your own insurance company will be responsible for your medical bills up to your limits.
Depending on the level of coverage that you purchased, New Jersey Personal Injury Protection can cover medical care, lost income, and/or death benefits.
The options available for PIP coverage are at $15,000, $50,000, $75,000 and $250,000. If a policyholder chooses the “basic” policy, the coverage is only $15,000 and does not include income continuation, essential services, or death benefits. For protection and ability to receive the medical benefits you or your family may need in a serious car accident, it is recommended that you purchase the $250,000 PIP coverage. New Jersey additionally gives you the option of choosing between your health insurance policy and auto insurance to pay for treatment. It’s recommended that you choose your auto insurance. This is because some health insurance policies exclude coverage for car accidents or offer lower coverage. Similarly, Medicare and Medicaid do not cover as a primary health insurer for auto accidents.
For medical care, PIP coverage provides reimbursements for all medically necessary expenses for the diagnosis and treatment of injuries caused by auto accidents up to policy limits. Medical care can include:
- Ambulance Service
- Emergency Room Visit
- Doctors Visit
- Diagnostic Test
To be payable by PIP, medical expenses and procedures must be reasonable and “medically necessary.” According to N.J.S.A. 39:6A-2(m), medically necessary means that “the treatment is consistent with the symptoms or diagnosis, and treatment of the injury (1) is not primarily for the convenience of the injured person or provider, (2) is the most appropriate standard or level of service which is in accordance with standards of good practice and standard professional treatment protocols… and (3) does not involve unnecessary diagnostic testing.” Often, it is a fight to get the treatment you need. The car insurance industry will often look for ways to cut off treatment. For this reason, you may consider treating with medical facilities who have experience treating victims of car accidents.
At Lesnevich, Marzano-Lesnevich, O’Cathain & O’Cathain, our law firm is made up of skilled and dedicated New Jersey personal injury attorneys.