When you're involved in a truck accident in Pennsylvania and the truck driver is at fault, determining who pays for your medical bills can be complex. The Urban Law Offices can help you understand the interplay of your insurance coverage as well as the at-fault driver’s policy.
Insurance Coverage in Truck Accidents and Other Collisions on the Roadways
One would naturally think the at-fault truck driver or the trucking company’s insurance carrier should immediately start paying for your medical expenses. However, while the at-fault truck driver may ultimately be responsible for all of your damages and losses, the first level of coverage of medical expenses in any vehicle crash, including truck accidents, does not come from the truck company’s insurance policy. Instead, in Pennsylvania, the Personal Injury Protection (PIP) coverage under your auto insurance policy is the first layer of coverage for medical expenses, regardless of who is at fault in any type of auto accident, including truck accidents.
PIP covers medical bills and, in Pennsylvania, reimburses healthcare providers including doctors and hospitals for medical care at a reduced rate unless it is for emergency trauma care. The minimum PIP coverage required by law is $5,000, but it's advisable to have higher limits for better protection. Lost wages, rental vehicles, and other benefits may also be added to your policy.
Not to be confused with full tort (which refers to how you can recover damages against the responsible third party), the term "full coverage" does not refer to PIP or first-party coverage (your own coverage) or third-party coverage from the at-fault driver’s policy. Instead, full coverage usually refers to property damage protection on your own car.
There is separate property damage coverage if you were responsible for the crash and third-party coverage for bodily injuries. Unlike medical benefits, if you have “full” comprehensive coverage on your vehicle, you can choose to go through your own carrier for repairs or seek a property damage claim against the at-fault driver. However, with medical benefits, you do not get the option to choose.
PIP Coverage: Understanding Your First Layer of Protection
Always check your policy coverages on your declaration (“dec”) sheet to see how you are protected. If you don’t own a vehicle and, therefore, don’t have your own auto insurance coverage, other auto policies may pay for the first level of medical benefits. For example, if you don’t own a vehicle, but there is another “household” policy for a family member who lives with you (a “resident relative”), that household policy should pay PIP benefits for your care.
Likewise, if you are struck by a car or truck while riding a bicycle or as a pedestrian walking across the street, you can seek medical benefits from the striking vehicle, regardless of fault, if you don’t own a vehicle.
What Happens When Your PIP Coverage Is Exhausted?
Once your PIP coverage is exhausted, your health insurance will cover the remaining medical expenses, subject to co-pays and deductibles. These excess medical expenses above what PIP paid can be disclosed in a court case, especially when the health care plan seeks to subrogate to recover the benefits paid on your behalf for your treatment.
These reimbursement rights asserted by health care plans against a recovery are referred to as liens. Medical charges are paid based on the contractual reimbursement rate between the health care plan and the healthcare provider, which is agreed upon by the healthcare system. If necessary, these rates can be factored into a lawsuit when seeking compensation.
Filing a Claim or Lawsuit Against the Other Driver or Insurance Company
If the truck driver is at fault, you have the option to file a claim against the truck driver's insurance company or pursue a personal injury lawsuit to seek compensation for your medical bills and other damages. It's important to consult with a personal injury attorney to determine the best course of action based on your specific situation.
You have two years from the date of the accident to file a lawsuit in court under Pennsylvania’s statute of limitations against the at-fault driver. It’s crucial to seek the medical expenses paid or accrued for your care. You have four years to bring a breach of contract claim against your own carrier for UM or UIM benefits under your own policy, household policy, or host vehicle policy, but only two years to bring a claim for bad faith insurance practices if the insurer mishandles your claim.
Likewise, you have four years from the last billing date or last payment date to file a claim against your auto carrier for failing to pay available PIP benefits for reasonable and necessary treatment related to the accident. Sometimes, auto carriers may deny medical bills they believe are unrelated, so you must file a “PIP suit” against your auto carrier to compel payment.
Handling Medical Bills and Unpaid Billing Statements for Accident-Related Treatment
Health care providers in Pennsylvania must accept the PIP medical benefits (and the amount paid) by your auto policy; doctors and hospitals may not bill for the amount not covered when you have PIP benefits available. Likewise, they cannot bill both your PIP and your health care plan at the same time for the same treatment unless PIP is exhausted.
When you receive medical bills and unpaid billing statements related to your accident, it’s crucial to keep detailed records of all expenses. Here are some steps to follow:
Organize Your Documents
Keep all medical bills, receipts, and correspondence with healthcare providers in one place. Make sure you keep records as proof of payment and to provide copies to your attorneys. Medical bills may also be submitted as evidence in a personal injury case.
Notify Your Insurance Company
Inform your auto insurance company about the accident and provide them with all necessary documentation. You should receive a PIP or medical claim number to use for billing purposes. It’s important to provide that information to the billing departments of the health care providers that treated you.
When your auto carrier pays for your medical treatment with your PIP benefits, you should receive a statement (EOB or EOR) from your carrier showing what was paid or why medical benefits were denied. Once the PIP benefits are exhausted, you should receive an exhaustion letter to advise you and any health care provider to bill your health care plan instead.
You should also obtain a payment ledger from your insurer, which will show all the payments made to health care providers.
Seek Legal Advice
Consult with a personal injury attorney to understand your rights and options for seeking compensation. The auto accident attorneys at Urban Law Offices have the experience and knowledge to navigate the complex insurance system and ensure that your medical bills are paid.
Negotiate Payment Plans
If you’re struggling to pay medical bills, discuss payment plans with healthcare providers. If you have a lawyer, many times a healthcare billing office will enter into a “letter of protection” (LOP), which is essentially an agreement to pay the doctor’s office out of your settlement or verdict if successful. Additionally, sometimes it’s possible to obtain a short-term litigation funding loan to help pay for outstanding medical bills.
Consider Legal Action
If you’re unable to resolve the billing issues, consider filing a claim or lawsuit against the at-fault party. The car accident lawyers at Urban Law Offices possess the legal skills necessary to navigate through the litigation process and obtain a favorable settlement or verdict to compensate you for your losses, including outstanding medical bills that have yet to be paid.
Differences for Out-of-State Accidents: How Medical Benefits Are Paid by Insurance
If you're involved in a truck accident out of state, the laws and procedures may differ. Each state has its own insurance requirements and statutes of limitations, so it's important to consult with injury lawyers like those at Anthony Urban Law Offices to help guide you. If necessary, we can refer you to a trusted colleague in another state where the accident occurred.
In addition to Pennsylvania, Brian Urban is licensed to practice law in New Jersey and has been admitted pro hac vice to handle cases in many other jurisdictions over the past 30 years.
When seeking treatment outside of Pennsylvania, some state’s motor vehicle laws for reimbursing healthcare providers may not apply. For example, your PIP benefits may be paid to out-of-state doctors or hospitals at the full amount of medical bills charged, as opposed to the Act 6 reduction (which applies to in-state medical services).
Why You Need Legal Help for Your Truck Accident Medical Bills
It’s important to obtain solid legal advice on how to handle medical bills when involved in a truck accident. The truck accident lawyers at Urban Law Offices can help you get your medical bills paid and recover compensation for future medical expenses, as well as other losses attributable to the fault of the truck driver that caused the crash.
If you have questions about medical bills for a truck accident in which you were injured, contact Urban Law today.