There are 12 states that currently have a No-Fault insurance laws for consumers. Pennsylvania is one of them. No-Fault essentially means that if you own a car that is registered or required to be registered with the Commonwealth, it must be insured with the mandatory minimum coverage, including medical payments. Regardless of fault, each person must use their own car insurance to pay the bills. The problem is that in the very beginning of a Personal Injury claim from a car accident, the car insurance does not get notified when you are injured in an accident. Here is an example:
Operator A is stopped in traffic. He is rear ended by operator B. It is a very severe crash, and operator A is rushed to the hospital where he seeks emergency medical attention. About a week later, operator A seeks a lawyer and hires him.
Then, all of the sudden, operator A begins to receive bills for the treatment at the hospital and for the ambulance company. Operator A is very upset because he has a great insurance plan with Blue Cross or Keystone or Aetna and they are not paying his bills.
The above scenario is very common in Pennsylvania. Section 1713 of the Motor Vehicle Financial Responsibility Law answers this question (who pays my medical bills):
§ 1713. Source of benefits.
- General rule.–Except as provided in section 1714 (relating to ineligible claimants), a person who suffers injury arising out of the maintenance or use of a motor vehicle shall recover first party benefits against applicable insurance coverage in the following order of priority:
- For a named insured, the policy on which he is the named insured.
- For an insured, the policy covering the insured.
- For the occupants of an insured motor vehicle, the policy on that motor vehicle.
- For a person who is not the occupant of a motor vehicle, the policy on any motor vehicle involved in the accident. For the purpose of this paragraph, a parked and unoccupied motor vehicle is not a motor vehicle involved in an accident unless it was parked so as to cause unreasonable risk of injury.
What this means is that when you are in a Car Accident, the first company that pays your bills, regardless of fault (because Pennsylvania is a No-Fault state), is the car insurance that you are required to have. That is what the statute means by “the policy on which he is a named insured.” If you own a car and have a policy of insurance, that company pays first. So in the example above, the first thing when you are able is to report the injuries from the accident to your insurance company and let the hospital know and the ambulance company the details of your auto insurance like the claim number so they can bill the auto insurance. This is why your private health insurance did not pay. If you are an insured on the policy but not a named insured, then that policy pays your medical. If you do not own a car, then the car that you are in pays the medical. If you are a Pedestrian, then any car that was involved in the accident will pay the bills. When the benefits are exhausted from the car insurance, then your private health insurance must be billed. If the provider that you are treating with does not accept the private health insurance, then you can recoup those outstanding bills from the wrongdoer’s automobile policy.
At The Law Offices of Greg Prosmushkin, P.C., our attorneys and staff can assist you with the claim process. If you or a loved one were injured in a car accident and need assistance, call us today. We can help, and the consultation is always free.
This content was written on behalf of Greg Prosmushkin.