Unfortunately, car accidents are a fact of life and the effects can be extremely inconvenient and often devastating.  All too often, people consider handling their case on their own without hiring an attorney.   Sadly, this allows insurance companies to take advantage of accident victims, often paying them significantly less than they deserve.

     The truth is, the law regarding car accidents and various insurance coverages is very complicated, and insurance companies will do their best to pay out as little as possible.  A skilled lawyer can advise you on how your health insurance, your auto insurance, and the other driver’s auto insurance all work together to maximize your recovery.

     Consider the following hypothetical example:  John has health insurance with a $5,000.00 deductible.  Dave rear-ends John and John goes to the hospital and incurs a $10,000.00 hospital bill.

     Here are three potential outcomes:

Scenario 1:

The hospital tells John that they will simply “bill” Dave’s insurance rather than John’s health insurance so that John doesn’t have to pay any copays or deductibles.  John thinks this sounds great.   Dave’s insurance covers the $10,000.00 bill and John feels happy that he didn’t have to come out of pocket.

     The result:

Dave’s insurance pays the hospital $10,000.00
John gets $ 0.00

Scenario 2:

John asks the hospital to bill his health insurance.  The $10,000.00 bill gets “adjusted” or “discounted” through the health insurance down to $2,900.00 which John owes as it falls under his deductible.  Dave’s insurance offers to pay the $2,900.00 and John feels grateful that he didn’t have to come out of pocket.

The result:

 Dave’s insurance pays the deductible of $2,900.00
John gets $ 0.00

Scenario 3:

John asks the hospital to bill his health insurance.  The $10,000.00 bill gets “adjusted” or “discounted” through the health insurance down to $2,900.00.  John knows that legally Dave’s auto insurance does NOT get to benefit from the fact that John has health insurance.  Dave’s insurance pays the full $10,000.00 bill directly to John.

The result:

Dave’s insurance pays John $10,000.00
John pays his $2,900.00 deductible and nets $7,100.00 in his pocket.

     Which scenario do you think the hospital prefers?  Obviously under the first scenario, the hospital gets paid the full $10,000.00 rather than being forced to take any discounts that it might be required to take under a health insurance contract.  (i.e. contractual adjustments)

     Which scenario do you think Dave’s auto insurance prefers?  Under the second scenario, Dave’s auto insurance gets away with paying only $2,900.00, rather than the full $10,000.00 that they are legally responsible for.  Notice that under this scenario, John’s decision actually saves Dave’s insurance company $6,100.00.

     Which scenario do you think John prefers?  Under the third scenario, John actually walks away with money in his pocket.  Additionally, John may be entitled to lost wages, pain and suffering, etc.

     This is one small example of how insurance companies can short-change someone.  Sadly, the person in the first two scenarios probably thinks that the insurance company is doing him a favor by paying the out-of-pocket expenses.  (i.e. copays or deductibles) In reality, that person got short-changed.  This scenario happens very frequently.

     There are numerous laws and nuances that insurance companies can exploit to their advantage.  They want to settle with you before you get an attorney.  I even had a client who was offered money at the scene of the accident to settle.  Fortunately, he declined the offer and retained our law firm and we got him significantly more money – even after paying us our fee.

     Each case is different and should be assessed by a skilled attorney to make sure you don’t get taken to the cleaners.  If it is just you vs. the insurance company – who do you think is going to win?  You are already the victim of a car accident – Don’t let yourself become the victim of an insurance company as well.

     Always get a free consultation from one of our accident injury attorneys before you make any decisions. A good lawyer can make all of the difference!

Tyler Hammond, Esq.