Wednesday, October 04, 2006

What is the relationship between auto insurance and health insurance?

Because the billing will be generated by the medical provider, they are going to bill the most likely source of reimbursement. That will be your health insurance. They (health insurance carriers) are bound by a contract with the insured (usually via an employer) to provide coverage for a wide variety of treatment in a wide variety of venues. The providers don't care much what coverage you have beyond this health insurance and it is NOT their problem or responsibility. They will simply bill the most obvious source. They are in the business of providing medical treatment and not collections. If you don't provide or have health insurance, they will simply bill you. If you DO have coverage somewhere, they still will not bill coverages/policies OTHER THAN HEALTH INSURERS. The health insurance will likely send you a questionairre about this accident (if the information isn't readily available in what the provider submits to them.) The questions will include where and HOW the accident happened and which law enforcement agency, if any, responded and made a report. IT WILL SPECIFICALLY ASK YOU ABOUT YOUR OWN AUTOMOBILE INSURANCE AND WILL ASK IF YOU CARRY PIP OR MEDPAY ON YOUR POLICY. If you do, they will immediately send a Notice of Subrogation rights to the carrier.
      • note that in true no-fault states, this process is quite different; the majority of states are NOT no-fault states and I am responding for those states.****
If you do NOT have Medpay or PIP coverage, then the Health Insurance carrier will send a notice of subrogation rights to the carrier of the at-fault party or the at fault party themselves if they are uninsured. Your questionairre will also ask if you are represented by an attorney for your injuries. If you are, the health ins carrier will also send a Notice of Subrogation rights to your attorney.

No comments: