Car accidents can lead to substantial injuries, leaving victims in need of extensive medical care. The question is, who pays medical bills after a car accident in New York? If you’re not used to the state’s no-fault insurance system, the answer might surprise you.
Understanding New York’s No-Fault Insurance System
New York State requires all drivers to carry Personal Injury Protection (PIP) insurance through your auto policy. If injured in an auto accident while driving your car or a passenger in that car, that auto insurance policy will be used to pay for your medical treatment related to the auto accident. PIP coverage, also known as “no-fault” coverage, pays for medical bills, lost wages, and out-of-pocket expenses associated with your medical care up to the coverage limit.
In New York State, drivers must carry at least $50,000 of no fault insurance. The reason it is called no-fault coverage is because regardless of whether a person was entirely or partially at fault for causing an auto accident, this coverage is available to pay for your medical bills, lost wages, and other expenses regardless of who caused the accident. PIP insurance covers drivers, passengers in the vehicle at the time of the crash, and pedestrians hit by the vehicle.
When to File a Claim Against Another Driver?
New York’s no-fault insurance system while providing coverage for medical treatment regardless of fault, has a trade-off and that is precluding a personal injury claim for pain and suffering for minor injuries. A person must have a “serious injury” to seek monetary compensation for a lawsuit in New York State.
New York Insurance Law defines “serious injury” as a personal injury that results in any of the following:
- Death
- Dismemberment
- Significant disfigurement
- A fracture
- Loss of a fetus
- Permanent loss of use of a body organ, member, function, or system
- Permanent consequential limitation of use of a body organ or member
- Significant limitation of use of a body function or system
The bottom three categories are not easy to define, but generally, these categories apply to a person who has objective medical diagnostic tests that show some kind of internal injury, such as a tear of the meniscus, herniated discs in the spine, or shoulder tears. If an auto accident victim is actively treating for these or similar medical conditions with physical therapy, injections, or surgery, it will provide the needed evidence to prove a serious injury to warrant compensation for pain and suffering.
When to Consult a Lawyer Regarding Your Medical Bills?
New York’s no-fault insurance system means that accident victims regardless of fault can obtain coverage for medical treatment and lost earnings from the auto insurance company. However, these insurance companies can deny treatment regardless if you do not timely file a no-fault application within 30 days of the accident.
Many times the insurance companies during the treatment require a person to see one of their doctors to determine if further medical treatment is necessary. This is why it is important to have a New York car accident attorney on your side to help you through the entire process.
Your attorney can help protect your rights and interests throughout this difficult process and negotiate a personal injury settlement for your pain and suffering and lost time out of work. Insurance companies will try to take advantage of accident victims without legal representation with low settlement offers. Hiring a New York Auto accident lawyer to protect your rights is a good way to make sure you are getting the fair compensation you deserve.
Common Mistakes That Can Jeopardize No-Fault Benefits
Claims can be delayed or even denied due to avoidable errors by accident victims. Some of the most common mistakes include:
- Missing the application deadline for no-fault insurance coverage
- Delaying medical treatment for too long after the accident
- Having long gaps in your medical care
- Failing to follow your doctor’s medical advice
- Not giving an accurate history of the car accident to your treating doctors
You can avoid these and other common mistakes by hiring an attorney to help with your claim right away.
Medical Bills in Wrongful Death Cases
A total of 1,105 people died in car accidents in New York State in 2024. In these cases, the decedents’ own PIP insurance policies covered the bulk of the medical bills associated with the care they received prior to passing away. However, in cases where another at-fault driver was liable for the death, and the medical bills exceeded the decedent’s policy limit, family members were able to bring claims against the liable driver for any excess medical bills.
FAQs
Do You Have to Pay Health Insurance Back After a Car Accident?
You may have to pay your health insurance back after a car accident. The no fault insurance is the primary carrier responsible for paying the medical bills from an auto accident. However, once that insurance is fully used, or is denied, then your private health insurance may be used to pay for related medical treatment for the auto accident. If your health insurance paid for accident-related bills and you receive a settlement from your car insurance company or the at-fault driver’s insurance, you may have to use a portion of the settlement to pay back your health insurance company. This process is known as subrogation lien. However, in New York State, only a few instances allow for a lien which includes Medicare, Medicaid, and ERISA health plans.
Can your private doctor have a medical lien for an auto accident?
If the no fault carrier was completely exhausted by using all $50,000, or the carrier denied treatment by claiming no further medical treatment is necessary, then your doctors may continue treating you with your private health insurance. However, if there is no private health insurance available, then a doctor may offer to continue treatment without payment immediately, but on a lien basis. In that case, the doctor would be entitled to reimbursement of monies owed for treatment out of any recovery received in a personal injury settlement or award.
Hire a Car Accident Lawyer Today
If you’re worried about who pays your medical bills after a car accident in New York, you don’t have to go through this process alone. A car accident lawyer can answer your questions, explain your options, and guide you through filing a claim.
The team here at the Law Office of Brett J. Nomberg, PLLC, will assist you with the claim-filing process, including alerting your own no-fault insurance company to your injuries and determining whether you are eligible to pursue a claim against another liable driver.
We’ve been practicing personal injury law for over 30 years, and we are intimately familiar with how the New York car accident laws work. You can trust us to help you secure fair compensation. Contact us to schedule an initial consultation today.
