Who Pays Medical Bills for Auto Accident Insurance Claims Under Maryland Law?

By J. Scott Robertson, Esq., Auto Accident Attorney
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One of the most confusing aspects of being injured in a car or truck accident is determining who pays your doctor’s bills and other medical expenses. The answer to this is not logical and is often misunderstood.

The logical answer would be: “The insurance company of the at-fault driver is responsible for the medical expenses and other losses.” And while this is technically true, it is misleading.

The truth is that the insurance company for the at-fault driver will ultimately be responsible for your medical expenses for fair and reasonable medical treatment that is related to the accident. But the problem is one of timing. The liability insurance company is not legally obligated to pay your bills until you make a settlement (including those expenses) or obtain a court judgment against the negligent driver for those expenses. And you never want to make such a settlement prematurely, as you only get one chance to settle – you cannot keep your claim for medical expenses “open” against the liability insurance company.

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So the question becomes: “How do you pay your medical expenses until you are ready to make a settlement?”

Given recent changes in Maryland law, coordinating the available insurance coverages to pay medical expenses should be handled differently depending on the coverages available to each client. Historically, the medical bills were first paid by the Personal Injury Protection (“PIP”) coverage on the car in which the injured party was riding or driving at the time of the accident. This is usually their own car, but might be the car or truck of a family member, friend or co-worker.

Maryland law now allows us to use other options to pay medical expenses to pay medical bills before PIP is used. We evaluate each client’s claim to determine what coverages should be used to the maximum benefit of the client. Such an analysis is subject to a number of factors and too complicated for this article. Perhaps the most important factor we consider is the legal right of repayment of each potential payer (PIP, health insurance, etc), which can vary depending on the law, the state of residence of the client, the language of the policy, and whether the policy is controlled by state or federal law.

In Maryland, the PIP insurance limits are usually low – oftentimes only $2,500. When the PIP is used up – what we call “exhausted” – we investigate any other available PIP policies to see if there is additional coverage. This most often happens when a client is injured in someone else’s car, but also has PIP coverage on his or her own vehicle – even if it was not involved in the crash.

Some policies also contain Medical Payments Coverage – often called Med Pay -which is excess to the PIP coverage. Taking full advantage of this benefit is very important.

We frequently handle accident cases for Delaware and Virginia clients, as well as residents of other states. Delaware PIP typically has much higher limits than Maryland PIP insurance, but their right to repayment is also substantially different, and varies depending upon where the accident occurred. Virginia car insurance policies do not include PIP, but usually do contain Med Pay benefits. We are very familiar with making PIP and Med Pay claims under Delaware and Virginia policies for our clients.

Making a PIP Claim Will Not Cause Your Maryland Insurance Rates to Rise.

I am frequently asked by clients if making a PIP claim against their own policy will cause their insurance premiums to increase. In Maryland, the answer is “NO”. Personal Injury Protection is considered a no-fault coverage. Making a PIP claim will not cause your insurance rates to go up.

PIP insurance was devised so that an injured party would have a mechanism to pay at least some medical expenses incurred without feeling pressured to make a premature and ill-advised settlement. It also pays medical bills for the at-fault driver, who does not have a right to make a liability claim.

Correctly coordinating the various coverages to pay medical expenses is crucial in order to ensure a good end result in an auto accident case. At Robertson & Robertson, Accident & Injury Attorneys, we deal with these issues every day for our clients. Getting us involved in your case early will ensure that these issues will be handled correctly the first time. By doing so, the chance of a successful settlement without a lawsuit is greatly increased.

Robertson & Robertson, Accident & Injury Attorneys is based on the Eastern Shore, but handles car and truck accident cases in the Entire state of Maryland. The firm offers a free consultation for personal injury claims. Call us today at 410-749-9111.

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