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Pain Resources
Pain Resources

Medical Benefits FAQ

FAQS for Claiming Medical Benefits

If you were recently hurt in an auto accident, you are likely facing thousands in medical bills. In 2013, the average liability claim for bodily injury was more than $15,000 after a car crash. From the ambulance ride to hours of rehabilitation, the costs of an injury after an accident are exorbitant.

In Florida, you are required to have at least $10,000 in personal injury protection (PIP), which means anyone injured has a right to at least $10,000 in medical benefits should they be injured in a crash. Still, even with insurance, there are many questions about how medical benefits work and how they can help you.

The following are some frequently asked questions about claiming medical benefits after an accident.

How do I claim my benefits?

You should report an accident to your insurance company as soon as possible. If you went to the hospital, you’ll need to provide documentation of the visit to your insurer. You might also need to submit to an independent medical examination by a doctor of the insurer’s choosing.

Based on your medical bills and the company’s investigation, they will issue a settlement check to cover your medical expenses. Keep in mind, this process may be long, especially if the injuries require a long recovery time and you continue to amass medical bills.

How long do I have to claim these benefits?

Florida law requires that you seek medical treatment after an accident within 14 days of the crash. However, it is suggested that medical care is sought out as soon as possible.

I was a passenger in an accident, am I entitled to benefits?

The most basic car insurance policies do not cover passengers. However, PIP insurance should cover you if you’re injured as a passenger in another car or as a pedestrian. Read through your insurance policy or ask your insurer if you are covered as a passenger and if your own passengers are covered by your policy.

What if the accident was my fault?

PIP insurance coverage is available no matter if the accident was or was not your fault. It can also cover lost wages and transportation to medical appointments.

I have a pre-existing medical condition, will this be a problem?

If you have a pre-existing condition that you believe was made worse by the accident, your insurer should cover the medical expenses. However, it can be difficult to differentiate the injuries, which can make the claims process challenging. If your insurer is not covering the new injuries and accompanying medical expenses, you may need to consult with an attorney.

Can I use my own health insurance to cover medical bills?

Yes, you can use your own insurance to cover your medical bills. If you were not at-fault for the crash, you may actually want to use your insurance rather than wait on the auto insurance to pay. You may also experience issues when attempting to get the other auto insurer to pay your claim, which is when your own health insurance will be beneficial.

My insurer is denying my claim, what can I do?

Whether it’s your insurer or the other driver’s insurer denying your claim or not providing the amount needed to cover medical treatment, you may want to consult with an attorney about your legal rights.

What doctors or medical professionals am I allowed to see?

You do not need to wait for the insurer to approve your doctor and should get medical care as soon as possible. Be sure you thoroughly understand your insurance policy in order to determine if you will be required to complete an independent medical examination by a doctor of the insurer’s choosing.

Furthermore, if you have health insurance, you can use that coverage to see a medical professional immediately. You should be able to see any doctors or medical professionals you need to get proper treatment and heal from your injuries.

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