Does Health Insurance Cover Car Accident Injuries?

Thousands of car accidents take place every day throughout the United States, including in Colorado. The number of car accidents occurring yearly in the US is estimated to be about six million [1]. Many have negligible effects, causing little or no harm or damage. Unfortunately, some have serious—and at times even life-threatening—consequences. Car accidents can lead to devastating injuries that are often unpredictable and may evolve dramatically over time. Even worse, a considerable percentage of about 6% results in car accident fatalities in our country.

Car accident injuries may require long periods of medical care, including visits or extended stays in hospitals, long-term care, and rehabilitation facilities. Unsurprisingly, victims often struggle to put their lives back together. In addition to the emotional challenges and adjustments necessary, medical care expenses can also escalate rapidly, adding an extra, considerable strain on victims and their families.

If you or a loved one have been injured in the context of a car crash, you must understand who is responsible for paying for your medical care following an accident. The best way to do this is by seeking independent advice from an experienced car accident attorney rather than relying on what insurance companies may tell you. Your attorney can offer you an accurate overview of your legal rights and seek to gain the compensation you deserve.

Compensation for Car Accident Injuries in Colorado

One of the first things that every car driver in Colorado needs to be aware of is that, as of 2003, our state is commonly referred to as an “at-fault state,” which applies modified comparative negligence.

In practical terms, this makes the party responsible for causing an accident accountable for paying the damages suffered by a victim. At the same time, damages will be distributed in proportion to how much each party is at fault. Therefore, you will be responsible for that portion of the crash damages if you are partly to blame for the accident.

In Colorado, victims injured in the context of a car accident may be entitled to economic and non-economic damages [2].

Thus, depending on the circumstances of the accident that led to your injuries, you may receive compensation for the full spectrum of your losses. This may include things like the cost of medical care required for treating your injuries, lost income and other economic losses arising due to the accident, and even damages related to the ensuing pain and suffering you and your loved ones had to undergo. It is even possible to be awarded punitive damages in exceptional cases, mainly when the person responsible for causing the injury acted willfully and wantonly [3].

Are There Any Compensation Limits?

Colorado laws have in place various caps on the amount of compensation car accident victims can recover.

There is no limit to the amount you may recover in economic damages. There is, however, a cap in place for pain and suffering. This limits related compensation to $250,000 but may go up to $500,000 if there is clear and convincing evidence that such an increase is warranted [4].

Who May Cover the Cost of Your Car Accident Injuries

Once you receive a medical bill for your car accident injuries, the person who is responsible for paying them is you—even if the accident wasn’t your fault.

The fact that you may seek compensation to cover such bills from another source is often the ‘second step’ in such cases, as in many cases, you may have to pay those bills out of your pocket until you can collect compensation from a third party.

Such bills can rise to hundreds of dollars and may range from modest to hefty hospital bills, fees for doctor visits, medical equipment costs, and rehabilitation and long-term care costs, among others.

In addition, car accident injuries often involve ongoing and future medical costs. There is also the possibility that you may have to spend more money on mental health and psychological health care, not to mention paying for medications.

Therefore, you must know your options and receive professional advice on claiming the compensation you deserve to cover these bills. You must also have the support to navigate this challenging and often complicated process.

Ross Ziev and his team at Legal Help in Colorado are committed to assisting victims from all walks of life and offer aggressive representation toward securing fair and just compensation for your losses. This lets you focus on what truly matters: your healing.

The At-Fault Party and Their Insurance Company

Since Colorado is an “at-fault state,” the party responsible for any injuries you suffer in the context of a car accident—and, thus, their insurance company—will be liable for paying you related compensation.

Colorado law stipulates that each licensed motorist must have minimal auto insurance coverage, setting out the relevant amounts they should purchase to cover such compensations.

Many drivers purchase the minimum insurance coverage required by law rather than additional insurance. As a consequence, their policy may not be enough to cover the related injuries, especially since car accidents may lead to extensive property damage, severe injuries, and even death.

Besides the possibility of the other party having low policy limits, their insurance company may seek to undervalue your claim or even deny it altogether. In such cases, you can file a personal injury lawsuit and seek to collect the amount you and your lawyers believe you deserve directly from the party responsible for your accident.

Your Own Health Insurance

If you have health insurance coverage, you can cover your medical bills through it.

It may take quite some time before you receive a settlement through an insurance company or be awarded damages in a personal injury lawsuit following an accident. Using your private health insurance is an option you may wish to consider. Indeed, people with health insurance often choose to have at least a portion of their medical expenses paid through this if the party responsible for the accident still needs to spend for it.

Of course, each health insurance plan is different, so you need to be aware of your policy’s particulars—including the small print—. For example, most health insurance plans are subject to specific deductibles, co-payments, and limits.

Typically, your health insurance may cover your injuries if coverage exists. The insurance company will still have a right to subrogate any funds awarded through trial, an out-of-court settlement, or a lien on any settlement or judgment. These are rights held by most insurance carriers, enabling them to legally pursue a third party that caused an insurance loss to the insured.

In practical terms, if you are subsequently successful in obtaining an award for damages, your health insurance company may be reimbursed for the money they paid, essentially “preventing” you from being compensated twice for the same expense. In addition to this, insurance companies may also have a lien on any settlement or judgment, always depending on your particular insurance policy.

A word of caution: failure to pay back your health insurer out of any settlement or judgment will put you at risk of losing your health insurance benefits and increasing your premiums. You may even end up facing legal action. Therefore, you must be very careful about how you use your health insurance company to pay for your car accident injuries and what happens after you receive a settlement.

To ensure maximum financial recovery, we highly recommend you consult a skilled attorney specializing in car accident injuries. Our Legal Help in Colorado team can go through your options with you, advise you on a wide range of related matters, and take on negotiations on your behalf.

Your Own Insurance Company: MedPay and UM/UIM Coverage

As mentioned earlier, Colorado became an “at-fault” state in 2003, enabling car accident victims to seek compensation for their injuries from the at-fault party’s insurance company.

Before that, it was a “no-fault” auto insurance state. Persons involved in car accidents had to turn to their insurance company and personal injury protection (PIP) coverage to receive compensation for their medical expenses and crash-related losses.

As of 2023, victims of car accidents can seek compensation for accident-related injury expenses directly from their insurance company if they have opted to purchase additional insurance.

MedPay

Even though it is not mandatory to acquire this in Colorado, car insurers are under obligation to automatically add $5,000 of MedPay coverage to all auto insurance policies sold in the state. Policyholders are only allowed to opt out of it in writing. This additional protection pays for the insured driver and passengers’ medical expenses, including copayments or deductibles. You may also choose to purchase more than the standard $5,000.

The main benefit of purchasing MedPay is that it lets you have your medical care paid after a car accident up to your applicable policy limits. This is irrespective of whether you were—partly or wholly—responsible for it. Also, you won’t have to pay an often costly deductible to access its benefits.

All this makes MedPay an optional, relatively inexpensive auto insurance policy that will provide you with a certain amount of health coverage in addition to your health insurance and personal injury protection coverage. Opting in favor of it is certainly recommended, as it can be a beneficial means of immediate funding shortly after your accident and, in any event, before a claim or court case decision.

UM/UIM Coverage

Likewise, motorists in Colorado may elect to purchase additional uninsured/underinsured motorist insurance (UM/UIM) coverage on top of the minimal amounts required by law. This coverage will pay for bodily injury losses caused by a hit‑and‑run driver, a driver with no automobile insurance, or a driver of an underinsured vehicle. This policy takes the place of the insurance the at-fault driver should have purchased.

Having UM/UIM insurance lets you claim the cost of medical bills, repairs, fees, and other expenses if you get into an accident with an uninsured driver, provided you are not at fault. Even if the driver responsible for the accident doesn’t have sufficient—or any—insurance coverage to pay for your damage, you will have the opportunity to receive a payment from your own insurance company.

Like MedPay, UM/UIM is optional under Colorado law. Nevertheless, all insurers in the state must provide UM/UIM coverage equal to the policyholder’s current liability coverage for bodily injury. Policyholders may only refuse such coverage and opt to carry a lower level of coverage if they do so in writing.

Health Insurance and Car Accidents: a Complicated Story

Like any other business, insurance companies seek to maximize profits. As such, they are more inclined to avoid paying out claims. Even though you purchase insurance to protect yourself from the unpredictable, victims who file personal injury claims often realize that insurance companies may employ various tactics to avoid liability.

Dealing with the aftermath of a car accident that has left you or a loved one with injuries is a very stressful and demanding task. Adding further complications to this is wholly unnecessary and unwelcome. If you believe that an insurance company is not dealing with your case as it should, the best course of action is to seek the advice of a seasoned legal professional.

Ross Ziev and his team at Legal Help in Colorado have extensive experience representing personal injury victims and negotiating claims with insurance companies. We are familiar with insurance company tactics and are not intimidated by them. Also, you won’t have to pay us any fees until you recover your compensation.

Contact us today at (303) 351-2567, book a time for your free consultation, or visit our offices at 6795 E. Tennessee Ave. #210, Denver, CO, 80224. During our consultation, we can discuss your case and see how we can help you pursue your claim aggressively and successfully.

References

[1] https://www.driverknowledge.com/car-accident-statistics/

[2] https://leg.colorado.gov/sites/default/files/images/olls/2003a_sl_271.pdf

[3] https://law.justia.com/codes/colorado/2016/title-13/damages-and-limitations-on-actions/article-21/part-1/section-13-21-102

[4] https://codes.findlaw.com/co/title-13-courts-and-court-procedure/co-rev-st-sect-13-21-203/. All numbers, as of 2023, adjusted for inflation