Does Health Insurance Cover Car Accidents?

    If you were recently injured in a car accident, one of your first concerns may include whether you will be responsible for your own medical bills and other related expenses. Following a car accident, it is paramount to promptly determine which party is responsible for the accident and whether or not that party has the appropriate insurance coverage to compensate for your injuries. This is important because if the responsible party does not have the appropriate insurance coverage, you may need to rely on your own health insurance company to pay for your medical bills. This article will provide a detailed discussion and answer the question: does health insurance cover car accidents?

    What are the most common types of injuries resulting from car accidents?

    The following types of injuries commonly result from car accidents and require medical treatment:

    • Head Injuries: Getting into an auto accident can result in head injuries, such as a concussion. A concussion is the result of a person’s head being thrown back and forth (for example, in a head-on collision). If a person suffers a concussion, he might experience severe head pressure, headache, or a loss of consciousness. Concussions and other head injuries can be serious and have long-lasting effects, so if you get into an accident and experience any of these symptoms, you should seek medical attention immediately.
    • Whiplash: Whiplash is a common injury that can result from a car accident. It is the result of a car making a sudden and unexpected maneuver which causes the neck to be “whipped” rapidly back and forth. This motion can cause major pain to the neck muscles and may manifest as neck pain, neck stiffness, or loss of range of motion. If you experience neck pain after an accident, seek medical attention.
    • Broken Ribs: The impact of a crash can result in broken bones. Broken ribs are specifically common because of the way the ribs are positioned in front of the steering wheel. Ribs are very fragile, and broken ribs can be extremely painful and require a lengthy recovery process. If you feel pain in your ribs after an accident, seek medical attention immediately, because they could also be bruised.
    • Scrapes and Cuts: Scrapes are probably one of the most common injuries a person might get from a car accident. The impact of your car hitting another car or other object can easily result in scratches and cuts. These may not seem like serious injuries, but it is still important to have them checked out by a medical professional because they could get infected.
    • Arm, Leg, and Chest Injuries: Car accidents can also result in arm, leg, and chest injuries. If you crash or are suddenly hit by another vehicle, you typically do not have time to protect your body from the impact. As such, your body may collide with the steering wheel, the windshield, or the car door, causing various injuries to your arms, legs, or chest. Similar to leg injuries, because of the way the knee is positioned under the dashboard, a sudden crash may result in a knee injury. Leg and knee injuries may require crutches or even the use of a wheelchair. If you are feeling pain in any of these areas after an accident, you should have them examined by a medical professional to ensure that the pain does not get worse and that you have not suffered any major internal damage.

    Is Illinois a “no-fault” car insurance state?

    In “no-fault” car insurance states, a driver injured in a car accident will be required to use his own car insurance coverage in order to pay for medical bills and other out-of-pocket losses, regardless of who actually caused the accident. These states typically require drivers to obtain personal injury protection (PIP) insurance, which is a minimum level of car insurance used to pay for medical bills and other related expenses after a driver gets into a car accident. In these no-fault states, a driver typically cannot make a claim against the driver who actually caused the accident unless the claim reaches certain statutory thresholds.

    Illinois is not a “no-fault” car insurance state; instead, the state follows a “fault” system when it comes to financial responsibility for injuries and other damages resulting from car accidents. This means that the driver who caused the accident alone will be responsible for compensating anyone who suffered harm as a result of the crash (i.e. via the responsible driver’s insurance policy).

    Furthermore, because Illinois adheres to a “fault” car insurance system, any person who is either injured or suffers damages as a result of a car accident can typically choose one of the following options to receive compensation from the responsible party:

    • The injured driver can file a claim with his own insurance company (assuming that the particular damages are covered under that policy)
    • The injured driver can file a third-party claim directly with the at-fault driver’s insurance carrier
    • The injured driver can file a personal injury lawsuit in civil court against the at-fault driver

    What types of car insurance coverage are required in Illinois?

    Pursuant to 625 ILCS § 5/7-203, all motor vehicle owners in the state of Illinois are required to obtain (at minimum) each of the following types of coverage:

    • $25,000 for the injury or death of one person in an accident caused by the at-fault driver
    • $50,000 total for all injuries or deaths in an accident caused by the at-fault driver
    • $20,000 for damage to the property of another person in an accident caused by the at-fault driver

    This minimum liability coverage covers medical bills, property damage bills, and other related costs resulting from other drivers, passengers, and/or pedestrians who are injured in a car accident or have suffered damages from this accident. However, it is recommended that drivers obtain additional insurance coverage just in case they are involved in more serious car accidents that result in more substantial injuries or damages. It is important to keep in mind that once policy limits have been reached, an at-fault driver will be required to pay out-of-pocket for any expenses stemming from the injuries and/or property damages suffered in a car accident.

    When would I need to rely on my own healthcare insurance to pay for my medical bills?

    Ideally, you would not necessarily need to use your own healthcare insurance to pay for any medical bills that you incur resulting from an accident because the at-fault driver’s insurance should cover your expenses. Furthermore, even if the at-fault driver’s insurance coverage is insufficient to cover your expenses, he might still be held liable for the entire amount. For example, if the at-fault driver has a car insurance coverage amount of $25,000 for injuries and the expenses associated with your injuries total $100,000, you may be able to obtain the full amount (via court order or judgement) in a personal injury civil suit. It is important to consult with a personal injury attorney before you accept a settlement from the insurance company or before you commence a personal injury lawsuit.

    In most cases, the at-fault driver’s insurance will compensate for your injuries and you will never even have to concern yourself as to whether you need to use your own health insurance. However, there are some instances where you may need to do just that, which include the following:

    • Where you are unable to determine which party caused the accident and therefore cannot obtain payment from that party’s insurance company
    • Where you are unsuccessful at getting the at-fault driver’s insurance company to pay you
    • Where the insurance company reimburses you for some, but not all, of your medical expenses  

    What does health insurance typically cover?

     If you are required to use your own health insurance to pay for your medical expenses, you will first need to understand what is and is not covered under your specific plan. There are various health insurance plans that one can choose from, all with different types of coverage. However, most health insurance plans provide some of the following types of coverage:

    • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
    • Emergency services
    • Hospitalization (like surgery and overnight stays)
    • Prescription drugs
    • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
    • Laboratory services

    What does health insurance typically not cover?

    As previously mentioned, what is not covered under health insurance depends on the specific plan. However, in general, most health insurance plans do not cover the following:

    • Alternative medicine: This includes treatments such as massage, acupuncture, and herbal healing. If you typically use alternative medicine, be aware that the at-fault driver’s insurance company may not provide compensation for these types of medical costs and your insurance may also refuse to cover these expenses.
    • Cosmetic surgery: If you are severely injured in a car accident and need plastic surgery, most health insurance plans will not cover these expenses.
    • Unapproved medical care: Most often, injured parties are required to receive “pre-approval” from their health insurer before receiving certain types of procedures or treatments. As such, if the injured party obtains a procedure or treatment that has not already been approved, the insurance may not cover the associated costs.
    • Experimental treatments or procedures: Similar to alternative medicine, if you are interested in utilizing experimental treatments or undergoing an experimental procedure, your insurance may refuse to cover these expenses. Likewise, it is unlikely that the at-fault driver’s insurance company will reimburse you for these costs.

    Were You Recently Injured in a Car Accident? Contact Our Firm

    If you were recently injured in a car accident, the Palermo Law Group can help. Our Oak Brook personal injury law firm consists of knowledgeable attorneys with over 25 years of experience handling personal injury cases resulting from car accidents. We will do our best to ensure that you receive fair compensation for your injuries. Please contact us today to schedule a free consultation appointment.

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