Bike Accident Compensation If Your Health Insurance Paid for Your Medical Treatment
One of the biggest concerns the cyclists who have been hit by cars have is if they will receive bike accident compensation and how they will pay for their medical care.
It’s no surprise why. The kinds of injuries cyclists can sustain in a crash — like broken bones and brain injuries — are expensive to treat. Many cyclists will undergo emergency care immediately after their crash, but many also continue to receive expensive, long-term medical treatment for weeks, months, or even years after the crash.
Luckily, more and more cyclists today have health insurance coverage that helps take care of their medical costs so they aren’t burdened with thousands of dollars in bills that they may or may not be able to afford to pay.
But if your health insurance pays for part of your injuries, can you make a case for bike accident compensation and for those costs to be covered, even though you didn’t pay them yourself?
You can get bike accident compensation for injuries your health insurance covered
You are entitled to compensation for the entire value of both your paid and your outstanding medical expenses for your crash-related injuries.
That means that even if you aren’t the one who paid for a specific treatment, you are entitled to be reimbursed for those expenses. For example, if you have $50,000 worth of medical bills, you are entitled to be reimbursed for the full $50,000, even if your health insurance company covered part or even all of that $50,000 bill.
Your case is about the value of your injuries, not just the out-of-pocket expenses that you suffered.
Your health insurance will receive compensation for the coverage they provided
Although you are entitled to claim the full amount of your medical costs, your health insurance provider is (most likely) also entitled to be reimbursed for the amount they spent to cover your injuries — and those funds will come out of any bike accident settlement that you receive.
Why does your insurance company get to be paid back out of your settlement? It’s because most insurance policies include a “subrogation clause” or “right to reimbursement clause”, which means, essentially, that they are entitled to be repaid for what they paid to cover you in the event that you receive a settlement.
You are, of course, not expected to reimburse your health insurance company for their costs if you don’t get a settlement. You are not personally responsible for paying them back unless you have received a settlement as part of a case.
However, in the event that you do get a settlement, the insurance company may be entitled to take the full amount of their payment for your medical expenses from that settlement amount. Depending on the extent of the coverage, this can significantly impact the amount of your take-home bike accident compensation.
Your reimbursement only covers the amount that a third-party was responsible for your injuries
The amount of your settlement and the amount that your health insurance company will take also depends on the amount to which you were at fault for the crash.
That is, if you were 50% responsible for the crash, then you will not get as large a settlement as if you had been 0% at fault. The law takes this into account, and so if you are 50% responsible for the crash, then your insurance company is only entitled to 50% reimbursement of their costs.
Unfortunately some insurance providers don’t agree with this, or have included fine print to try and get around this. Be sure to ask your attorney about this.
Do you have a question about paying for your medical bills after a bicycle crash?
Call Bay Area Bicycle Law today for a free, no obligation consultation to talk about your case: 415-466-8717.