Does Health Insurance Cover Car Accident Injuries?

Every year, hundreds of thousands of Floridians are involved in car accidents throughout the Sunshine State. These drivers depend on their auto and health insurance policies to cover medical bills and other losses they sustain. Preliminary data from the Florida Department of Highway Safety and Motor Vehicles reports that in 2022, there were 381,156 total crashes across the state with 242,622 injuries. 

Your health insurance can cover some of your medical expenses when a car accident happens. But before your insurance policy can kick in, your auto insurance and even the other driver’s auto insurance can go into effect. Knowing how your auto and health insurance kicks in after a car accident is important to recovering the compensation you need to cover your medical bills.

Florida’s car insurance laws

Florida is one of a dozen states that adhere to no-fault auto insurance laws. Under this type of insurance law, it doesn’t matter who caused an auto accident. All drivers in Florida are required to carry an auto insurance policy. In the event of an accident, their insurance policy will kick in to cover any medical bills, property damage, or other losses. 

In states that recognize at-fault auto laws, the driver’s insurance company that caused the accident will typically be responsible for covering the losses of the other motorists involved in the accident. 

Florida’s no-fault insurance system

Under Florida’s no-fault insurance system, Florida drivers are required to carry personal injury protection (PIP) and property damage liability (PDL) automobile insurance. PIP insurance kicks in to cover the expenses of a driver’s medical losses, while PDL covers the damage caused to another person’s property. 

At the time of registering a vehicle, a Florida driver has to show proof of their PIP and PDL insurance. Failing to do so can result in fines and other penalties. 

Florida’s PIP insurance coverage

After an accident, the amount your PIP insurance will cover depends on the extent of your injuries and the expenses involved. Under Florida’s PIP insurance laws, PIP insurance will cover the following: 

• 80% of medical expenses that resulted from the crash, up to the $10,000 PIP limit per insured person. This includes things like ambulance rides, medical services, hospital bills, doctor’s visits, and even dental work.
• 60% of lost wages and services up to the $10,000 PIP limit per insured individual. If you are unable to work or move around because of your injuries, this insurance can also kick in to cover other services like house cleaning or even childcare. 
• $5,000 death benefit for every individual insured by the policy. This death limit does not count toward the $10,000 PIP limit. 

Health insurance role after a car accident

Florida drivers are required to carry auto insurance so that in the event of an accident, their auto coverage policy kicks in to cover medical costs. Your health insurance can help cover any costs of medical bills after a car accident, but it’s not the first go-to because your auto insurance coverage should kick in first. Any injuries not covered by your auto insurance can then be covered under your health insurance. 

Auto insurance vs. health insurance

Your PIP auto insurance covers minor accidents, but the at-fault driver’s insurance coverage can be applied when the damages exceed your policy coverage. 

If the other motorist’s negligence caused your injury, their auto insurance coverage may be able to cover the cost of remaining medical bills before your health insurance ever comes into play. Typically, the at-fault driver’s insurance will kick in if a victim’s injuries rise to the level of a significant or permanent injury. Under Florida law § 627.737(2), this type of injury can result in the following losses: 

• A permanent loss of a critical bodily function
• A permanent injury within a reasonable degree of medical probability
• Significant scarring or disfigurement
• Death

There are also other aspects to consider with auto and health insurance. For example, there is no deductible to reach with PIP insurance before your benefits can kick in, as is the case with health insurance. 

Additionally, health insurance does not offer a death benefit for policyholders, as with PIP coverage.

The nuances of what coverage kicks in and when can be complicated. That’s where the expertise of a car accident injury lawyer can prove invaluable. An experienced car accident attorney will ensure your rights are protected, and the claims process is followed accordingly so you can recover the compensation you deserve.

How to file a health insurance claim

The severity of your car accident will determine the claims process when you seek compensation for your injuries. Here’s what to know and what to do when filing a claim to cover your medical expenses. 

File a claim with your PIP insurance 

After a car accident, you will need to notify your auto insurance company immediately after the accident so you can start the claims process. Under Florida statute § 627.736 (a), claimants have 14 days to bring forward a claim, or they may lose out on their PIP benefits. 

File a health insurance claim 

If you have used all your PIP benefits, you can file a claim with your health insurance. Contact your insurance company to begin the claims process. They will inquire about your PIP insurance and may even communicate with them as they will want you to exhaust your PIP benefits before their benefits kick in. 

Workers’ compensation

If your car accident occurred while you were on the job or engaging in work-related duties, your employer’s workers’ compensation coverage will cover the costs of your medical expenses. Speak with a workers’ compensation attorney to learn more. 

Take legal action 

If the other driver who caused the accident was negligent in their actions, and you suffered a severe or permanent injury, you may be able to seek additional compensation via a personal injury lawsuit. Speak with an experienced car accident attorney at  Bernstein & Maryanoff Injury Attorneys to determine if this is the best avenue for your case. 

Dealing with insurance denials and disputes

Unfortunately, it’s not uncommon for insurance companies to deny a claim even if you suffered injuries. Claim denials often occur because the insurance company wants to shift the blame to another party, especially if a car accident results in severe injuries or a commercial party was involved in the accident. 

Working with an experienced car accident injury attorney ensures your rights are protected even in the denial of a claim. An attorney can help you dispute the denial, so you receive the benefits to which you are entitled. 

How can an experienced car accident injury attorney help?

Working with a car accident injury attorney means you’ll have the legal representation of an attorney well-versed in Florida’s auto laws. You don’t have to feel overwhelmed or intimidated because you’ll have a legal expert to help you navigate all aspects of the claims process.

At Bernstein & Maryanoff Injury Attorneys, our attorneys will help you file a claim when dealing with the insurance companies, navigate disputes, negotiate for higher compensation, and support you in pursuing additional legal action in the event your accident was the result of another driver’s negligence. 

Call Bernstein & Maryanoff Injury Attorneys for a free consultation

Get the legal representation you deserve and recover compensation for your losses when you contact the team at Bernstein & Maryanoff Injury Attorneys. Schedule your free case consultation today to learn more about how our legal team can serve you.  

Sources:

Florida Crash Dashboard. (2022).
§ 627.736 (a).
§ 627.737(2).
§ 627.7407.