How Personal Injury Victims End Up In Collections & Medical Bankruptcy.
The at-fault driver's insurance company will pay my medical bills
At-fault insurance companies do not pay for medical bills. Period. Only when your case settles or you win a jury verdict, will the at-fault insurance company distribute money for your injuries.
My health insurance company is required to pay my medical bills
Illinois law does not require health insurance companies to pay medical bills that result from an accident.
Hurdle #1: Providers don't bill your health insurance.
Illinois courts have yet to decide whether medical providers are required to bill your health insurance company for treatment related to a car accident (even when they are in-network). Medical providers generally prefer billing injured victims directly as they stand to make more once the case settles (health insurance pay lower negotiated rates). You will have to pay for bills out of your own pocket.
Hurdle #2: Your health insurance refuses to pay.
Illinois law does not require your health insurance company to pay medical bills that result from an accident when there is car insurance coverage. Here, the emergency room sends your bill to BCBS or Humana, but they deny coverage because you have not utilized 100% of your Med Pay Coverage (health insurance companies claim they are secondary insurance under these circumstances, your car insurance being primary). You may have to pay for bills out of your own pocket.
Hospitals and other medical providers will wait until my case is over to accept payment
Hospitals are most guilty of this, but all medical providers will eventually send your bills to collections. Any outstanding medical bills will be sent to collections in as few as 90 days. Rarely will a personal injury settlement conclude sooner than 6 months to a year (or more).
Scenario #1: Your provider refuses to bill your health insurance or your health insurance refuses to pay. Your bills gets sent to collections.
Scenario #2: Your health insurance pays their portion of your medical bills, but you cannot afford your coinsurance or co-pay. Depending on your health insurance plan, your deductible might be $3,500 - 7,500. Ask yourself, do I have access to $7,500 right now? Those outstanding balances get sent to collections.
Your bills end up in collections. If you are fortunate enough to win a settlement and pay your outstanding bills, the negative marks for non-payment will continue to affect your credit score for up to 7 years.
Plaintiff's (victims) lose half of all personal injury cases that go to trial in Cook County. The number is even higher in the surrounding counties. Juries are not plaintiff friendly. By then, it is too late for providers to bill insurance because of timely filing rules. Victims are responsible for paying 100% of their bills. Even relatively minor accidents can result in $20,000 or more in medical charges. At that point, the best option for some Americans involves filing for bankruptcy.
How I Help My Clients
Step 1: Client Education
If you read everything up to this point, congratulations! You now know the basics of medical billing practices in Illinois as they relate to personal injury. Most people I talk with are not aware of the information in this article.
Step 2: Keeping Bills Out Of Collections
Depending on the extent of your injury, your current outstanding bill situation, and your insurance providers (not to mention the strength of your case), I will determine the best course of action for keeping your bills out of collections.
This could involve:
Threatening to sue medical providers if they do not bill your health insurance
Negotiating with your health and car insurance companies to use available Med Pay coverage for copays and coinsurance (using health insurance for medical bills and Med Pay for copays and coinsurance is usually and ideal situation, involving a lot of behind the scenes negotiating)
Setting up low monthly payment plans with medical providers
Getting providers to hold bills in abeyance until the resolution of acase.
Step 3: Silencing Debt Collectors
Unfortunately, your medical bills may already be in collections if you waited to contact an attorney. The bad news, those bills are likely staying in collections. The good news, by hiring an attorney I can put a stop to the harassing phone calls and annoying letters.
Under some circumstances I can talk providers into recalling their bills from collection agencies.
When the case resolves, I spend most of my time getting collection agencies to accept reduced amounts to settle outstanding bills.
Your Next Steps
Now you know some of the pitfalls to avoid after a car accident or other personal injuries. Check back regularly for more information on how to protect yourself in the event you do get injured as the result of someone else's negligence.
If you were injured in an accident, use the contact information below to talk with me or fill out a Contact Form.