Who Will Pay My Medical Bills After a Car Accident in New York?

New York is a “no-fault” car accident state. Most of the time, your insurance will cover the cost of your injuries. If people were hurt in the other vehicle, their insurance would pay their medical bills. It might seem unfair if you had nothing to do with causing the accident. Still, the idea behind the law is to expedite compensation. This law, in theory, eliminates the need to finger-point, investigate, or get New York City personal injury lawyers involved. Of course, the system doesn’t always work as planned, particularly when your injuries are serious and expensive.

Does Car Insurance or Health Insurance Pay for Car Accident Medical Bills?

Typical auto insurance policies cover at least $50,000 in “no-fault insurance” to pay medical bills and lost wages. This insurance is considered primary, meaning that it kicks in before any other policies you may have.

Insurance policies generally cover all “necessary expenses” for medical treatment, such as:

  • Ambulance or helicopter airlift
  • Diagnostic imaging
  • Emergency medical treatment
  • Nursing services
  • Surgery and medical procedures
  • Hospital stays
  • Prosthetics devices
  • Assistive technology
  • Prescription medication
  • Physical Therapy and rehabilitation
  • Vocational rehabilitation
  • Mental health counseling
  • Doctor’s follow-up visits

Sometimes your medical expenses exceed the $50,000 coverage provided by your provider. If you purchased additional supplemental insurance, that would kick in once you’ve met your basic coverage threshold. If you do not have additional coverage or any coverage at all, it will be up to your healthcare provider, whether private or public (like Medicaid / Medicare), to contribute toward your claim.

Who Pays for a Car Accident When Medical Bills Exceed Insurance Policy Limits?

Medical expenses can add up after a car accident, particularly if you’ve suffered multiple fractures, a traumatic brain injury, or spinal cord damage. New York is one of 12 states that allows victims to step outside the no-fault system when injuries meet the “serious injury threshold.”

State law defines a serious injury as death, dismemberment, significant disfigurement, loss of a fetus, fracture, permanent loss of a body part or organ, or significant limitation of a bodily system or function. It also includes any non-permanent injury that prevents the individual from performing daily duties for 90 out of 180 days immediately following the accident.

In these cases, you can contact a personal injury lawyer to file a civil lawsuit against the at-fault driver. Though it may take a while to resolve, you could end up getting fully reimbursed for anything you’ve paid toward your medical bills– and then some.

Do I Have To Pay Medical Bills From My Car Accident?

Sometimes you may receive bills from the ambulance, doctor’s office, or hospital asking for details on your insurance policies; you can enter the necessary information and mail the bills back without paying them.

However, there are several circumstances where you will have to pay your own medical bills from the accident:

  • You are under contractual obligation. Even with a generous insurance policy, you may be responsible for copays and deductibles that are part of your auto and health insurance contracts. You must pay these minimums before your policy coverage applies.
  • You failed to follow protocol. You must submit a claim to your insurance provider within 30 days of the accident. If you fail to do so, you could have your no-fault coverage denied and be forced to pay everything out-of-pocket from your own bank account.
  • You were breaking the law at the time. Sometimes the insurance company sees that you have been convicted of drunk driving, illegal street racing, or driving without a license at the time of your accident. Even though New York is a “no-fault” state, there are exceptions.
  • Your treatments are controversial. Insurers agree to pay for any “necessary” medical care, but they may not cover alternative medicine, new “experimental” therapies, or specialist bills. It can be an uphill battle to get the coverage you deserve.
  • You received money from the other party. Sometimes health insurers attempt to recover money paid on your behalf if you receive a settlement or jury award. This action is called subrogation. While it is within their legal right to collect reimbursement, you may need an experienced attorney to mitigate these losses. It is also worth noting that balance billing– a practice where hospitals seek payment from the patient after they agree to a discounted payment from the insurance company– is illegal.

What If I Was A Pedestrian or Riding a Bike?

If you were on a skateboard, scooter, bicycle, or rollerblades at the time of the accident, coverage might involve:

  • The Driver: New Yorkers hit by a car while walking or riding a bicycle should be covered by the motorist involved in the accident. The maximum payout from an insured driver in New York is $50,000.   
  • Uninsured Motorist Coverage: If the vehicle that hit you drove away from the scene or involved an uninsured/underinsured motorist, you can access the underinsured/uninsured motorist coverage in your policy or the policy of a member in your immediate household.
  • MVAIC – The Motor Vehicle Accident Indemnification Corporation (MVAIC) was created to cover the medical bills of pedestrians, cyclists, or motorists injured by uninsured drivers, allowing no-fault benefits up to $50,000. It can be challenging to obtain, though, so hiring a lawyer is always recommended.  

How we can help

The New York City car accident lawyers at Douglas and London can assist with your claim. It’s never too early to have a qualified legal representative look into your case to see where support may be needed. We’ll ensure that your no-fault claim is filed promptly, resolve disputes with your insurer through arbitration, investigate third party liability, negotiate for a full and fair settlement, take your case to trial if necessary, and ensure that any outstanding medical bills are resolved. If you have been seriously injured in a motor vehicle collision, call now for a free consultation. We ask for no money upfront to pursue a legal claim.