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Should I Have My Health Insurance – Like Anthem – Or My Med Pay Pay My Medical Bills?

There’s no clear answer. Here’s what you need to think about.

When you’re hurt in an auto accident, you can usually get your medical bills paid one of three ways:

1) Directly by the insurance company for the other driver. But they will probably stop paying as soon as they learn you have a lawyer. Or they may make you sign a release promising not to sue if they agree to pay one more bill. So forget them unless you have no insurance of your own. Even then, try to get some other way to pay the doctor.

2) By your own health insurance company, such as Anthem – or Medicare or Medicaid. But this insurance may not pay deductibles or copays. Every policy is different.

3) By your auto policy under a medical payments – or medpay – coverage. A lot of auto insurance policies carry this; some don’t. If you have it, this coverage will pay up to a certain amount to cover your medical bills arising from any auto accident – anywhere from $1,000 to $25,000, depending on your policy.

The trick with your own health insurance and with your auto policy medpay is, they always want the money back. It’s called subrogation.

So how do you pay for your medical treatment after an accident?
Attorneys feel differently about this. Here are two considerations:

1) Some lawyers feel that the other driver’s insurance company will settle their personal injury claims by taking the total medical bills, and multiplying them by two, or three, or four. (This is called the “multiple” theory. They all used to do this.) If this is how the other driver’s insurance is going to settle your lawsuit, you’re better off filing the claim with the automobile medpay policy. Why? Because the adjuster for the other policy will settle the case for a “multiple” of the total medical bills paid, and the medpay will almost always pay more money for your doctor bills than the health insurance company.

2) Other lawyers feel that auto insurance companies have gotten away from the “multiple” theory of lawsuits, and concentrate on what really happened. Let’s say that while you’re in the emergency room, they give you a couple extra tests that cost another $1,000.00. Under the “multiple” theory, the case is worth at least $2,000 (2 x $1,000 = $2,000). But most insurance adjusters and most jurors – and most people who think – won’t value the lawsuit that much more because some tests were done that took another 20 minutes. These lawyers would say to submit the bills to Blue Cross or Anthem, let the insurance company pay 40% of the bill to the hospital, and then pay the insurance company accordingly when you recover.

There is no right or wrong answer. My preference is to send the bills to health insurance, like Anthem, partly because I think they don’t ask for as much money back. Also, I think most auto insurance companies are getting away from valuing a lawsuit based on multiples of medical bills.

But you may not have a choice. A lot of health insurers insist that the first dollars used to pay bills come from automobile medical payment coverage – or that they be reimbursed directly by the automobile medpay insurer.

I have been a lawyer over 30 years. I deal with this issue in every injury lawsuit I file. If you’ve been injured in an accident, talk with an experienced Cincinnati Personal Injury Attorney about the case. Call me, William Strubbe, at 513-621-4775.

Because all situations are different, and because there may be other facts pertaining to your case that I don’t know about, you should not rely on this answer for legal advice. I am not your attorney, and no lawyer client relationship has been formed.

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