Conceptually, ideally, and legally, the at-fault party is responsible for your personal injury medical bills and should pay them if they were at fault. Sounds simple, right? Here’s how it becomes not simple:
Start with the concept of you are now dealing with an auto insurer who has no interest in your well being, whose only interest is turning a profit, and is using the adjuster that is assigned to your case to accomplish that goal. How do they create profits when it comes to paying personal injury medical bills? By not paying them. At least not in full. Day in and day out I get offers on cases where personal injury medical bills have been presented to the insurance company and that company reduces that bill to an amount they claim it should be. They have no agreement with the provider of course, they just unilaterally decide the bill is too high, it should be lower, so they lower it themselves and offer that amount. It does not change the amount of the medical bill that is sitting in my client’s mailbox, about to go to collections, but it’s what the insurance company does in auto accident personal injury cases.
An example of this is as follows: client is injured in an auto accident and has to go to the emergency room. While at the emergency room a CT scan is performed that the hospital bills at $4,000. Client does not have health insurance to cover these services, or has health insurance that covers only a portion of these services, leaving a deductible to be paid. The bill is submitted to the auto insurer and instead of accepting responsibility for the bill, they claim the CT charges are too high, that they should only be $1,500, and they reduce the amount of the bill by $2,500 in making an offer. They do this on almost every service, to include chiropractic, physical therapy, radiology, etc. They hire companies that prepare reports exclusively for insurance companies that claim the medical bill should be lower. These companies are essentially on the payroll of the insurance company, but since they have a different name it is supposed to add legitimacy. It does not.
Of course all this is done to the harm of the injured party. They are put in a very difficult situation of having medical bills overdue, have paid bills using money that was allocated for other purposes, and are not in a good bargaining position to deal with the auto insurer. This is where the insurance company wins, yet again. For every 10 non-attorney represented injured people, let’s just assume half of them cannot or just will not engage in the fight to get what’s right. Rather, they just accept the unfair offer made by the insurance company. Insurance company wins, injured person loses. Please don’t do this. Please just go retain a personal injury lawyer that will cost you nothing up front and get you a full recovery on your bill to make sure all your obligations are met.