December 29, 2015
April 7, 2024

Does Health Insurance Cover Car Accident Injuries?

The last thing any motorist wants is to be in a car accident. The resulting physical pain and damage to property means you’re going to have to deal with auto insurance carriers. This includes your own, as well as the company of the other person involved. In Texas, all drivers are required to carry liability insurance to pay for car repairs and medical expenses when found to be at fault. But does health insurance cover car accident injuries?

Your liability insurance will typically not cover all the injuries you’ve sustained. To pay for medical expenses, you have options: if the other person is at fault, their liability insurance should cover you. Or, you may be able to use your health insurance to cover the cost of your injuries.

Always Seek Medical Attention Immediately After an Accident

Typically, health insurance covers medical treatment for injuries, regardless of whether or not they were caused by a car accident. Always seek medical attention right away after a car collision, even if you feel fine.

The negative physical effects of a crash aren’t always immediately apparent, and a hospital has the tools to detect injuries you may not feel due to adrenaline or shock.

An insurance adjuster may suggest you wait for their referral to see a doctor, but this could potentially damage your claim. The more time has passed between the time of your accident and the time of medical care, the easier it will be for the auto insurance company to claim your pain and suffering was not caused by the accident.

Health insurance carriers can recover the cost of your medical expenses through a process called subrogation. If your provider successfully recovers these expenses, they will have to divide the amount received proportionally. In this way, any funds you paid towards a deductible are returned.

Know What Your Insurance Plan Covers

To best know which form of insurance will cover what, carefully review both your auto and your health insurance policies. This can help provide basic background information regarding the question, "Does health insurance cover car accident injuries?" Certain health insurance carriers classify auto accident injuries as secondary coverage. These policies won’t cover your medical expenses until the auto insurance limit has been met.

In Texas, if you are found to be at fault in an auto accident, it is your responsibility to pay for property and bodily damage to the other party.

Texas current minimum liability insurance is known as 30/60/25 coverage. This limits payments to $30,000 for each injured person, totaling $60,000 per accident (if two or more people are injured) and $25,000 to cover property damage to the other party. While this may seem like a good amount of money, it may not be nearly enough depending on the severity of your injuries.

To illustrate, say you suffer the misfortune of a traumatic brain injury or spinal cord injury; $30,000 won’t cover the cost of rehabilitation for one month, let alone a lifetime. It’s a smart idea to include Personal Injury Protection (PIP) or medical payments coverage to your policy. This can help offset potential costs associated with a wreck.

What is Personal Injury Protection (PIP)?

Personal injury protection, or “PIP,” is a type of automobile insurance that provides reimbursement for medical expenses and certain other costs after a car accident. PIP coverage in Texas pays for you and your passengers if an accident results in injuries, no matter which party is at fault.

Depending on the exact terms of the policy, PIP can cover:

  • Reasonable medical costs, such as surgeries and other treatments
  • Ambulance services
  • Rehabilitation therapy
  • Lost income

Texas law requires that insurance companies offer every policyholder at least $2,500 of PIP insurance. This must be offered, though it can be rejected by the policyholder. Additional or greater coverage can be obtained at higher costs for more financial protection (for instance, $5,000 or $10,000 of PIP).

This indicates two things: First, while PIP can provide coverage for costs beyond normal insurance policies, it still has its limitations. It might not cover every single expense, especially for serious crashes involving severe injuries. Second, not everyone may be able to afford PIP insurance, especially the more expensive options.

Even with PIP and/or health coverage in place, it is still possible for a person to have to pay if they get into a car accident. In such cases, filing a lawsuit may be the best avenue for ensuring that the victim is fully compensated for their losses caused by the accident.

Woman meets with doctor and discusses a form on a clipboard

Will I Still Have to Pay Even if I Have Health Insurance?

In most instances, what is covered or not will depend on the actual terms of the health insurance policy itself. Depending on the situation, injured car accident victims may still have to pay:

  • Deductible amounts under their health insurance policy
  • Any required co-payments under the health insurance policy
  • Charges and expenses not typically covered by the policy

Examples of the last point may be when there are alternative or additional treatment methods that are needed to treat severe injuries like paralysis. In such cases, legal action may be needed to help the victim recover expenses through a damage award or settlement.

Car accident victims can often recover these out-of-pocket expenses by filing a lawsuit with the at-fault driver and/or their insurance carrier.

Your Next Steps

When it comes to ensuring your ability to physically and financially recover after an auto accident, the best advice is: be prepared and know what to do after an accident. Consider what you stand to lose if you are gravely injured in an auto accident or if you injure someone else.

Saving a few bucks on your monthly insurance rate might not save you anything at all when you weigh it against the worst-case scenario. Research the kind of coverage that will properly protect you. If you are still wondering, “does health insurance cover car accident injuries?”, you can consult with an attorney for advice on your best options.

You should also contact an attorney if:

  • You have any disputes with an insurance agent or company, whether yours or the other party
  • You suspect that insurance fraud may be occurring
  • You believe you were treated unfairly or unethically by an insurance agent

Remember, insurance agencies often care more about their profits than your recovery. Sometimes the only way to get through their red tape is by having an experienced attorney fight on your behalf. If you were injured in an auto accident, a personal injury attorney will make all the difference in your ability to get the compensation you deserve.

Contact us at (832) 690-7000 for a no-cost, private consultation regarding your car accident claim. We at Pierce Skrabanek PLLC have extensive experience going against insurance companies and their representatives, and are here to help you get the maximum recovery amount for your case.

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