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Won’t My Health Insurance Cover My Car Accident Injuries?

stethoscope and medical bills in background

In Michigan, we must purchase insurance for ourselves if we are going to be operating our vehicles on public roadways. Up until mid-2020, when the changes to the Michigan auto no-fault system largely went into effect, auto insurance policies included lifetime unlimited medical coverage for ourselves and our resident family members. This unlimited no-fault PIP medical coverage paid for medical expenses incurred as the result of injuries sustained in a motor vehicle collision, regardless of who caused the accident. However, as a result of the recent auto no-fault reforms, Michigan residents can now purchase varying levels of no-fault insurance protection from their auto insurance carrier. In addition, and depending on specific situations, some Michigan residents can choose to opt-out of medical coverage through their auto policy altogether – and many are! Those with private or state-sponsored health insurance are now lulled into a sense of false security and opting out of no-fault PIP benefits. If you’re in this situation and asking “will my health insurance cover my car accident injuries?” below are two real-world instances of when these insurances failed to do just that. Unfortunately, there will be many more of these situations that occur in the years to come for people who did not purchase unlimited n0-fault medical coverage.

As a lawyer who handles car accidents and claims for auto no-fault benefits on a daily basis, I am now witnessing the effects many people are experiencing due to their “choice” when deciding the level of medical coverage on their auto insurance policy. Let me provide two real-world scenarios I’ve already personally encountered due to a person choosing less than unlimited medical coverage.

Private Health Insurance Denying Auto Accident Medical Bills

In the first scenario, a drunk driver struck a young man on his way home from work. The victim suffered an injury that required surgery and a hospital stay. Before the accident, the victim had a health insurance plan that allowed him to opt-out of buying medical coverage on his auto policy. However, when the accident occurred, he found nothing but red tape and denials from his health insurance provider and a ridiculously high deductible he had to meet.

To date, his health insurance still has not paid a dime toward his medical bills. The insurer also continually gives one excuse after another for denying payment of his claims. Since his insurance isn’t paying his doctors, he cannot get the therapy he needs for his post-surgery recovery. In addition, now his credit score is taking a hit as his bills continue to pile up. If he had purchased medical coverage through his auto insurance plan, these expenses would be paid for, he would receive the appropriate treatment, and his credit would be unaffected.

As a result, this man now has to chase the drunk driver through the Michigan court system and hope they had sufficient auto coverage to pay his medical bills. The unfortunate reality is, oftentimes, other drivers don’t purchase enough in liability coverage to compensate adequately to cover an injured victim’s medical bills. Furthermore, the process of pursuing a liability claim against the at-fault driver is one that could take several years to resolve. To make matters worse, this man is now unable to work or replace his vehicle with such a damaged credit score. To add further insult to injury, the drunk driver never served any jail time for their actions.

State-Sponsored Health Insurance and Complex Auto Accident Injuries

In scenario number two, a victim of a distracted driving accident severely fractured her hand and vertebrae. Before the crash, this victim opted to purchase $50,000 worth of medical coverage rather than unlimited medical on her auto policy. She is covered under a state-sponsored Medicaid plan, so she figured she was okay for coverage in the event of a car accident.

However, unfortunately, the victim soon learned that $50,000 does not go very far toward covering a 5-day hospital stay, numerous medical tests, and ultimately surgery. Additionally, she will require two more surgeries and therapy despite already exhausting all of her $50,000 in medical coverage. While she does have her Medicaid policy, she was devastated to learn that the hand surgeon who is the best in the state at performing the very complex hand surgery she needs is part of a practice that doesn’t accept her health insurance.

Unfortunately, the distracted driver who caused the accident did not have any auto coverage, so this woman has nowhere else to turn for medical coverage.

Opting Out of Unlimited Medical Creates Great Risk

The bottom line, for those wondering if your health insurance covers car accident injuries and considering opting out of auto no-fault benefits, this is a very risky situation to put yourself in as a Michigan driver. Health insurance carriers are not all created equal. The medical coverage for auto accident victims through a private or state-sponsored health insurance policy pales in comparison to the comprehensive, unlimited array of benefits available under Michigan’s auto no-fault system. As more and more people opt-out of medical coverage in order to save a few dollars in their auto insurance premium, the situation will continually get worse. Victims of auto accidents won’t have access to the care they need, bills will continue to mount, and credit scores will be destroyed, leading to more lawsuits. The purpose of the no-fault act was to provide speedy coverage for those injured in auto accidents. We now find ourselves in unprecedented times and greater complexities than ever before. As a Michigan car crash law firm, we strongly encourage everyone to keep their unlimited medical coverage and budget to save their money elsewhere.

 

Authored by Lansing car crash lawyer, Kevin Komar

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