Q: I have a brain injury from a car accident in Philadelphia. How do my medical bills get paid?
A: Under Pennsylvania accident law which applies to brain injury cases, you may be able to recover for both economic losses (medical bills and lost wages) as well as non-economic damages, like pain and suffering. The at-fault driver may be ordered to pay fair and reasonable financial compensation for your injuries and damages.
Claims for the Initial Medical Bills
However, it is important to note that in a Pennsylvania car accident case, medical bill claims will first be made with your own car insurance company, up to the amount of coverage purchased. This is known as personal injury protection (PIP) benefits which are required on every auto insurance policy issued in this state; the minimum amount of benefits is $5,000. These claims are made without regard to fault. Injured drivers and passengers make PIP claims with their own car insurance companies.
Therefore, the initial economic losses (i.e., medical bills) will first be paid by your own car insurance company. The company may then seek contribution from the at-fault driver. In other words, after your car insurance company pays for medical bills (up to the amount you purchased on your car insurance policy), it may go back to the at-fault driver’s insurance company and obtain reimbursement.
Medical Bills Incurred After PIP Exhausts
In brain injury cases, the default PIP amount of $5,000 is often exhausted quickly. Thereafter, the innocent, injured driver or passenger will have their medical bills paid by their private health insurance company. The injured individual will have to pay co-pays and other out of pocket medical expenses.
In a subsequent car accident lawsuit against the at-fault driver, the injured individual is allowed to make a claim for both the medical bills that were paid by private health insurance as well as co-pays and other out of pocket expenses. In general, the private health insurance company may be allowed to obtain reimbursement out of the settlement. This is called a right of subrogation and applies in many PA car accident cases. However, it is important to note that subrogation law in auto accident cases is very complex and depends on the facts of the given case. Therefore, only a lawyer can determine whether a health insurance company has a right to subrogation.
Brain & Head Injuries in Auto Accident Cases in PA
Brain and head injury victims, especially in auto accident cases, often suffer life-altering injuries and changes. Brain and head injuries often result in permanent disability. Injured individuals are often unable to resume full-time work duties or are unable to work altogether. This is especially true for individuals with highly specialized jobs, such as accountants, programmers, etc.
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