Why Should My Insurance Company Pay My Medical Bills in a Car Accident?

Monday, June 06, 2011
One of the most asked questions when I am meeting with a new client who has been injured in an Orlando or Florida car accident is "Why should my insurance company pay for my medical bills when the accident was not my fault"? In the early 1970s, Florida decided to enact what is known as the Floria No-Fault law. In its simplest form, Florida's No-Fault law says that no matter who caused a car accident, if a person sustains personal injury in that car accident, the injured person must look to their own insurance company to pay a percentage of their medical bills (80%) and lost wages (60%). The reason this law was passed is fairly basic.
 
In other states that do not have a No-Fault law, medical bills and lost wages are only paid by the insurance company who insures the person who caused the accident. While that sounds easy enough, there were problems with this type of law. First, what if the drivers involved in the accident dispute who is at fault? We call this a red light, green light case where each driver says they had the green light and there are no witnesses to prove conclusively who had the red light. If no one admits fault, then no medical bills will get paid until the case settles or maybe not until after a trial is conducted. Second, even if there is no dispute as to which driver caused the car accident, the medical bills and lost wages would likely not be paid until the case settles. Getting a case to the point of settlement could take months, if not years. Third, if the person injured in a car accident did not have health insurance, the medical treatment options available to him or her could be very limited as they would essentially be asking a doctor or other medical provider to treat them without getting paid right away. Many doctors and other health professionals, understandably, did not want to treat persons injured in accidents who did not have insurance that could pay for treatment right away.
 
So, in order to avoid the disputes and to afford the citizens of Florida who were injured in a car accident, the Florida No-Fault law was enacted in Florida, the purpose of which is to “provide for medical, surgical, funeral, and disability insurance benefits without regard to fault " and to provide "swift and virtually automatic payment [of medical bills and lost wages] so that the injured insured may get on with his life without undue financial interruption". The No-Fault law provides "a minimum level of insurance benefits without regard to fault". As you can see, this law even applies to the person who causes the accident and is injured in the accident. These persons may also have their medical bills and lost wages covered by the No-Fault law.
 
The No-Fault law does not pay 100% of medical bills and does not pay 100% of lost wages. And the limit of the basic No-Fault insurance amount is $10,000 (that covers both medical bills and lost wages). For a detailed review of what exactly the No-Fault law does cover, please see our newsletter titled Florida's Automobile Insurance Law. You can find that newsletter by clicking HERE.
 
Thus, Florida sought to provide a degree of protection to people who were injured in car accidents to enable them to receive medical treatment and protection for lost wages. There are problems with the No-Fault law, but I will save that discussion for another blog entry.
 
So, please make sure you have adequate automobile insurance protection. Having the minimum coverage the No-Fault law requires is a start, but in many instances is not enough. Again, please see our newsletter on Florida's Automobile Insurance Law.
 
If you have been injured in an accident that was caused by someone else, please contact our Orlando personal injury and car accident attorneys for answers to your questions. You may call us at 1-800-I-AM-HURT or fill out our CASE EVALUATION FORM. All consultations are free and without obligation. And remember, there are no fees or costs unless we make a recovery for you.
Mark A. Risi 6/6/2011

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