If someone’s carelessness caused a Florida car or truck accident which required hospital treatment, then you probably want to get your hospital bills paid so you are left owing nothing.
For purposes of this article the word “hospital” also means “urgent care center.” For purposes of this article the word “car” also means “truck.”
Warning! Different states have different auto accident laws in regards to who is responsible for paying your hospital bill after an accident. This article will focus on Florida car accidents caused by someone else’s carelessness. If you are injured in a Florida car crash, do not rely on article that does not specifically apply to Florida car accidents.
Tip: If you get medical treatment at the hospital or urgent care center, then there will also be an emergency room doctor bill which is separate from the hospital bill.
In order to determine who pays your hospital bills after an accident caused by someone else in Florida, first we look at PIP coverage.
1. PIP Insurance Pays Hospital Bills
Florida has No Fault (PIP) laws when it comes to getting your hospital bills paid after a Florida car crash. If you were an occupant of a car in a Florida car accident, and you are covered under PIP, then PIP will may pay your hospital bills up to $10,000.
Note: PIP may pay for medical bills other than hospital bills, but I am limiting this article to discussing hospital bills.
But don’t get too excited. There are several scenarios where you might not be entitled to PIP insurance.
Let’s say that you are an Uber driver, and you’re engaged in a ride. Perhaps you’ve read my article about whether Ubers have PIP insurance in Florida. There, I explain that Uber’s insurance policy (when the Uber is engaged in a ride) doesn’t have PIP. On the other hand, Lyft’s insurance policy has PIP even if the Lyft isn’t engaged in a ride.
OK. Let’s get back to talking about how PIP applies to hospital bills.
You need to be diagnosed with an emergency medical condition by a medical provider within 14 days of the car accident for PIP to pay the full $10,000. If you are not diagnosed with an emergency medical condition and you treated within 14 days of the car accident, then PIP (if available) will only pay up to $2,500 of hospital bills.
If you do not treat within 14 days following the car crash, then PIP will not pay any of your hospital bills.
2. Medpay Coverage Pays Hospital Bills
If you are an insured under “Medical Payments coverage” (Medpay) in an auto policy, then you should make a claim with the Medpay insurer to pay the 20% of your hospital bills that PIP does not pay. You should request and review all of your hospital bills and send them to the Medpay insurer.
If you are an insured under Medpay coverage, then Medpay will pay the 20% of your hospital bills that PIP does not pay, up to a certain limit.
You should send, via certified mail return receipt requested, the proper letter to the Medpay insurer which requires them to let you know if they are seeking subrogation (to be repaid) from the injury settlement. If the Medpay insurer does not respond within the applicable time required by Florida law, you should argue that they have waived their right to get paid from the settlement. This can result in a big savings to you.
If the Medpay insurer has subrogation rights, then you should attempt to negotiate the amount that they are claiming from the personal injury settlement against the party who caused your crash.
Tip: If you have an attorney, the Medpay insurer is required to reduce its lien by a minimum of the pro-rata share of your attorney’s fees and costs. The fact that an attorney can get your Medpay lien reduced is one of the 11 reasons to hire a Florida injury lawyer if someone caused your injuries.
3. Health Insurance, Medicare, Medicaid (and Other 1st party coverage)
Even if you are covered by PIP and Medpay, your health insurance may pay hospital bills that PIP or Medpay does not pay including, but not limited to, the deductible, co-pay, bills that are above the PIP or Medpay limits, or bills that are not paid because PIP denied coverage.
Tip: Even if you are covered under Florida auto insurance, always give your health insurance, Medicare or Medicaid information to the hospital. Even if they tell you that they do not need it.
I recently settled a case for $25,000, where a drunk driver hit my client in Miami and she went to the hospital with complaints of neck, back and knee pain. All settlements on this page are before deduction for attorney’s fees and expenses. Most cases result in a lower recovery. It should not be assumed that your case will have as beneficial a result.
The hospital submitted a $27,000 or so bill to the PIP that covered my client. After the auto insurance paid $10,000 to the hospital, the hospital submitted the bill Medicaid. Medicaid denied payment and the hospital wrote off the huge balance of about $15,000 or so. This put a lot more money in my client’s pocket.
Be sure to send your health insurance company a letter from PIP or Medpay showing that benefits are exhausted. Without this letter, your health insurer may deny paying the hospital bills.
4. Workers Compensation
If you are an occupant of a car and you were injured while working in Florida, then workers compensation is the primary coverage that will pay for your hospital bills. Workers compensation should pay 100% of your hospital bills so that you should be left owing the hospital nothing.
Even if workers compensation pays 100% of your hospital bills, you can use any PIP, to which you are an insured, to pay off the workers compensation lien. This may result in putting more money in your pocket from your personal injury claim for bills, lost wages, pain, suffering from the careless driver’s BI insurance.
Example in a case I handled
I settled a case for $125,000 when a car crashed into my client’s car, and my client treated at the hospital and had surgery on his hand shortly thereafter. Although workers compensation paid all of the hospital bills, I sent the PIP carrier, State Farm, the workers compensation lien and demanded that they pay the lien with the $10,000 in my client’s PIP benefits.
At first the PIP carrier refused but after I insisted that they pay the lien they changed their position shortly thereafter and paid. This put and extra $10,000 in my client’s pocket.
You still have a claim against the careless driver for your future medical bills and other damages that workers compensation does not pay.
5. Bodily Injury (BI) Coverage
You should send a letter to the parties who are liable for the crash which puts them on notice of your injury claim. You should request, review and immediately send the following documents to any of the parties who are liable for the crash:
- Your hospital bills
- The PIP payout log and Medpay payment log
- Any of the following liens and itemized breakdown of payments made by health insurance, a health plan, Medicare, Medicaid, Tricare or other first party coverage lien.
If the BI liability coverage is not limited, then you should submit a demand package to the insurer with a demand that gives you enough negotiating room so that you can settle for the fair value of the case, which hopefully includes full payment of the hospital bills.
6. Uninsured Motorist (UM) Coverage
If another driver’s carelessness caused you to get hospital treatment, and PIP, health insurance and the BI coverage do not cover your hospital bills, then you should make a claim under any policies of UM coverage to which you are an insured.
Does Your Attorney Have to Pay the Hospital from Your Settlement?
It depends on the county where the hospital is located. Certain counties have valid hospital liens by County Ordinance. If a hospital has a valid lien, your attorney needs to pay them from the personal injury settlement.
The Florida Counties with valid hospital liens by County Ordinance are:
- Alachua County (Shands Hospital and others)
Broward County (hospitals include Memorial Regional and many others)
Miami Dade County (Baptist Health, Jackson Memorial and many others)
Orange County (many hospitals near Walt Disney World)
Therefore, for people who are treated at the above hospitals, your attorney is required to pay the hospital from the settlement. However, the attorney is only required to pay the reasonable value of services provided.
Unless and until County Ordinances are passed in other counties in Florida, or a statewide lien statute is passed, injury-related hospitals bills in all other Florida counties are not secured by liens.
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