Who Will Pay My Medical Bills If I Am in an Accident?

If you are involved in an auto accident and you are worried about the medical bills you run-up, I have some very good news for you.

The good news is that if you have auto insurance your bills will be paid through what is called your first party benefits file.

In plain English that means your own insurance company will pay your medical bills up to at least the first $5000 of treatment.

It gets better.


First of all your insurance company will not pay your medical bill dollar for dollar.
They do something called an Act 6 reduction for any bills they receive.
So for example if you were taken to the emergency room and were treated there for several hours you will get a bill for say $1000.

Maybe they did x-rays maybe they did a CAT scan maybe they ordered an MRI.

So what happens?

Your insurance company gets your 1000 dollar bill for the emergency room treatment and they use a formula for how much of that thousand dollar bill has to be paid.

Maybe it’s $600 for example.

The good news about this is twofold.

First the hospital is bound to accept as payment in full the $600 that your insurance company pays for your medical treatment.

The 2nd bit of good news is that you personally will NOT be responsible for repayment of the $5000 in med pay from your first party insurance company.

Why is this?

Because Pennsylvania is in what is called a no-fault state.
That means any bills that are incurred medically by anyone involved in an accident are paid through their own insurance company without a requirement of reimbursing the insurance company for the money they paid out.

Even the person who caused the accident has an absolute right to have their bills paid by their insurance company.

Without raising your insurance rates and without requiring you to reimburse your insurance company for the money they paid out in your behalf.

So what happens if you do not own an automobile?

Well if you are in someone else’s car as a passenger for example and you do not have auto insurance on your own, then you look to the car that you are in for their insurance company to pay your medical bills.

Again in Pennsylvania the minimum amount that must be purchased is $5000.

So in that situation you’re covered also because your bills will be paid by the cars insurance company that you were in.

This is all separate and distinct from the pain-and-suffering aspect of your case.

Who you look to for your pain-and-suffering reimbursement is the other side that is the wrongdoer’s insurance company.
They are the ones on the hook for the injuries they caused you as a result of the auto accident and the pain-and-suffering and inconvenience you go through as a result of their negligence.

Can you see the difference between the two aspects of the case?

Your own insurance company basically pays your medical bills up until at least the first $5000.

The wrongdoers insurance company then is responsible to you for your pain-and-suffering and related expenses.

So what happens if your medical bills exceed the first $5000?

This often happens and it can actually be to your advantage to be in this situation.

Why is that?

Because that means your treatment is lengthier and the insurance company will have to set a higher reserve for payment of your case than if you just went to the emergency room for limited treatment.

Pittsburgh car accident. wrongful death and first party medical bills attorney Bernie Tully want you to understand that getting your bills paid is often a pretty straightforward proposition.

At least for the first $5000.

Anything after that will have to be worked out with the medical provider in guaranteeing that their bills get paid.

Let Pittsburgh first party benefits car accident and slip and fall attorney Bernie Tully help you get your medical bills paid.
We stand ready to help you.

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Thanks for reading.

Bernie the attorney.