Frequently Asked Questions - Do I Need Uninsured Motorist Coverage If I Have Health Insurance?
If you are injured in an auto accident with a person that only has the minimum required in the State of Florida and that person is at fault, you will have to make a claim under your Under Insured Motorist (UM) coverage against your own car insurance company. UM coverage is the type of insurance that pays for injuries caused by an Uninsured (someone that has no insurance) or Under insured (someone that does not have enough insurance). Unfortunately, in the State of Florida there are many people that are driving without Bodily Injury (BI) coverage since it is not required by law. Then you can make a claim, under your UM coverage. There is a misconception that if a person carries health insurance then they do not need to carry Uninsured Motorist Coverage. That is completely wrong and misinformed information.
Health insurance does not provide the same coverage as uninsured motorist coverage. For instance, you can have health insurance coverage today and lose your job tomorrow, then most likely you will lose the health insurance benefits paid through that employer. Further, health insurance will not pay for lost wages or pain and suffering. Also, some doctors on health insurance plans will refuse to see patients involved in a car accident claim. It’s mostly because they do not want to ever have to testify at a deposition or trial litigation proceedings. In fact, the doctor is allowed to choose who he/she will or won’t see. If the at-fault party doesn’t have bodily injury insurance and you do not have Uninsured Motorist Coverage, seeing a doctor on a letter of protection (LOP) may not be an option. If you do not have UM or health insurance, your treatment then may be very limited. If you need follow up care, you will have the option of seeing a doctor who takes your health insurance (if one will agree to see you knowing that you were in an auto accident and are bringing a car accident claim) — or you can see a doctor who will see you on an LOP –where the doctor agrees to treat you now with no out-of-pocket co-pays or deductibles, with the understanding that the provider will get paid after the case is settled. Immediately, you may notice that this opens up some options.
Since Florida is a no-fault car accident state, all drivers claim their injuries and losses on their own car's insurance policy. PIP will generally cover up to $10,000 of your medical costs. PIP insurance covers medical bills after a car accident for any person injured in an auto accident, it does not matter if you were the victim or the at fault driver. PIP is no-fault medical bill coverage. The standard minimum for PIP insurance to cover is 80% of the medical bills up to $10,000.00. Therefore, if you are in an auto accident, you will first have to use your own Personal Injury Protection coverage (PIP) benefits before you can use your own health insurance benefits. What is Personal Injury Protection (PIP)? PIP (Personal Injury Protection) is the type of insurance that will pay cover medical bills up to 80% and 60% of wage loss. In Florida, you must carry $10,000.00 in PIP coverage. Florida PIP covers medical costs, lost wages and death benefits. In case of a death, PIP coverage offers compensation of up to $5,000.00. PIP would also pay for funeral and burial expenses. In addition, PIP insurance coverage will cover you as a pedestrian or riding a bicycle. Furthermore, it is extremely important that if you are filing a Personal Injury Protection claim, you start treatment within fourteen (14) days from your auto accident. If you do not, your automobile insurance company can deny your coverage and refuse to pay. These medical expenses must also be “reasonable” and “medically necessary” or a PIP carrier may deny payment for certain services it deems to be unreasonable or not medically necessary.
Personal Injury Protection is primary and health insurance is considered secondary. However, let’s say you have medical payment (Med Pay). Then Personal Injury Protection (PIP) is primary, medical payment (Med Pay) is secondary and your health insurance can be used as last resort. Nonetheless, it is important you know that if you use health insurance to pay for any auto accident related bills, the health insurance can place a lien on your case. This basically means that upon any settlements, the health lien (what the health insurance paid) will need to be paid from the settlement. However, as any other medical bills, this health lien in most cases can be negotiated at the end of settlement. Generally, your health insurance carrier/plan will have final financial responsibility for treatment related to car accident injuries as soon as all other forms of payment are exhausted. In other words, they have paid all the monies under policy. What is covered and what is not will hinge on the policy itself. Injured patients will likely still have to pay: their deductible amount under their health insurance policy; any co-payments that are required under a health insurance policy and for any charges that are not typically covered by the policy. The bills are higher if a prolonged hospital stay is required, with co-pays and deductibles. Some people cannot afford on-going co-pays, especially if they’re not working due to the car accident. Multiple weekly session of physical therapy may be necessary in addition to a couple of MRIs, doctors’ visits and any other procedures needed to treat the injury. These co-pays will start to add up
In short, uninsured motorist coverage protects you and your family in case of a serious car accident and is important to have, even if you also have health insurance. Nonetheless, if you have been injured in an auto accident and your insurance is not providing your coverage as specified under your policy, speak to an experienced Central Florida personal injury and car accident lawyer at Trial Pro. Call us at Trial Pro, P.A. At 1-800-TRIAL PRO.