Medical Bills

As an injury lawyer, I always recommend that my clients advise their medical providers to bill their health insurance for all their medical treatment following an accident. However, accident victims may have another source to pay their medical bills, it’s called “medpay,” which is short for medical payments coverage. Read the blog below, “Is medpay worth it – an injury lawyer perspective.”

This topic has been talked about a lot online but recently I watched a video on YouTube where a speaker said that medpay was not that important. I disagree.

When you get in an accident, the insurance for the person who caused the accident will NOT pay for your medical bills until your case settles. In the meantime, your medical providers want to get paid. If the bills don’t get paid, they will send the bills to collections which might damage your credit rating.

Is medpay beneficial from an injury lawyer perspective? Read on to find out.

Who is covered by medpay?

In short, if you’re in a vehicle when it gets in an accident, you may be covered by medpay. So, if the car’s insurance policy has a $5,000 medpay policy and there are three people in the car, all three can utilize up to $5,000 to pay for their medical bills.

Is medpay mandatory in Illinois?

No. Medpay is an optional coverage in the state of Illinois. However, we strongly recommend that you have medpay insurance in your auto policy. Why? Keep reading.

The benefits of using medpay

I can’t tell you how many times I’ve signed up clients who ask me as their injury lawyer what they should do about their medical bills. While more people have health insurance, most of us have higher deductibles than we used to. We also often have co-pays every time we see a provider.

There are a lot of people out there who cannot afford these expenses. Medpay is the answer. First, you should always insist that your medical providers bill your health insurance. However, the co-pays and deductibles are the accident victim’s responsibility. It doesn’t make a lot of sense from an injury lawyer perspective. But we’ve seen a lot of bills sent to collections because of medical bills, even though the accident was not the victim’s fault.

If you have medpay insurance, you can and should submit your co-pays and deductible to your auto insurance carrier for payment. If you do not have health insurance at all, medpay can pay whatever medical bills you incur, up to your policy limits – regardless who was at fault for the accident.

Medpay is cost effective

The cost of medpay is extremely inexpensive! According to Glenview, Illinois, Farmers Insurance agent Erick Weingardt, you can add $5,000 in medpay to your auto insurance policy for approximately $10 every six months and you can increase that to $10,000 in medpay for only a few dollars more (depending on your driving record).

Erick said “Medical coverage is an important coverage for all drivers to include on their
auto insurance policy. It pays for all people in the vehicle, regardless of fault. The medical coverage will pay most, if not all, of your health insurance deductible & co-pays. Many people need to use this coverage even when the accident was caused by the other driver. Auto insurance companies do not want to offer a blank check, so they wait to settle. With medpay, you get your medical bills paid right away. For good drivers, the cost is only $1 to $2 a month for $5,000 or $10,000 of medical coverage.”

What medpay does not cover

There is something called personal injury protection (PIP) that is offered in some states. That is similar but slightly different from medpay. I have yet to have a client with pip coverage in Illinois.

The main difference is that PIP coverage also compensates the injured party for, among other things, their lost wages that were the result of their injuries.

Medpay reimbursement

Finally, medpay is great but if you are involved in a third-party accident, meaning the accident was caused by another (at-fault) party, then your auto insurance policy will seek reimbursement, if and when you settle/resolve your case.

However, pursuant to a legal theory, your auto insurance company will likely reduce the amount you owe by 1/3.

In sum, your injury lawyer has had so many cases where medpay has been an effective tool to help pay an accident victim’s medical bills, that we strongly recommend getting at least $5,000 in medpay on your auto policy.

For a free quote on auto insurance, contact Erick Weingardt at (847) 729-4620.

For a free legal consultation, feel free to call our office at 847-305-4105.

People are often surprised when we tell them that their personal injury case may take twelve to twenty-four months to resolve. They always

ask why personal injury cases take so long. For the answer to this and other personal injury related questions, see part one of the blog article, or contact our office for a free consultation at 312-848-9783.

Why personal injury cases take so long – Part Two

In part one of this blog article, we explained that obtaining insurance from the defendant who caused your accident, confirming that the defendant’s insurance company has accepted liability or responsibility for the accident, and the severity of your injury, can all affect how long it takes to resolve your case.

In part two of this blog, we will address additional factors that explain why personal injury cases take so long.

Factors that affect how long it takes to resolve your case

Obtaining medical bills and records

The medical bill and record aspect of your cases is a primary reason why personal injury cases take so long.

Once you are through treating, your law office will have to order all your medical bills and records from your medical providers – and there can be a lot of them. This is a slow process that requires dealing with medical bureaucracy. We are constantly required to order and re-order bills and records. And there are often significant fees for ordering the bills and records that have to be processed and paid.

Often our clients send us copies of the bills they receive and wonder why those won’t work. When we order bills from medical providers, they come with ICD Codes which are the codes insurance companies require before they compensate an accident victim for his or her damages. Our clients do not receive bills with ICD codes, we have to order them ourselves.

Medical bill and record review

Once we finally obtain the bills and records, they are reviewed in detail. This is a time intensive process and must be performed by an attorney or paralegal. Often there are hundreds and hundreds of pages of bills and records that have to be reviewed.

In addition, often when records are first reviewed, we learn that there was additional medical treatment that we did not know about, that there are records we have not ordered or received as yet, or that there were dates of service that were not provided to us. As such, we have to order those bills and records and that starts the process over again.

Once all the documents have been reviewed, your attorney will get on the phone with you to review your case before taking the next step in the process described below.

Demand Letter

Writing the demand letter to the insurance company is also a time intensive process. The demand letter will document:

The facts of the accident
Your theory of liability
Analysis of the medical bills and records
Description of your pain and suffering and loss of enjoyment, among other things
A demand for compensation

Once the letter is written, it must be reviewed and sent to the client for corrections, suggestions and approval. Then we will mail the demand to the insurance company. We will give them 30 days to respond to the letter – though it often takes much longer.

Negotiation

The negotiation process can take several weeks or months. Our demand letters often include very high demands and the insurance companies often begin with a very low offer. Then the process of negotiation begins. Your attorney will argue to the insurance adjuster about the value of your case and where the insurance company has exposure.

The insurance company will attempt to reduce your claim by disputing the severity of your injury and the amount of your medical treatment. They may point out you have pre-existing conditions and allege that the injuries you suffered were not actually suffered in the accident at all.

In many cases, the two sides are able to come to a mutually agreeable resolution of claims. However, that does not happen in all cases, discussed below.

As an aside, it may be that your injuries are so severe that they are more than worth the value of the insurance policy. In that situation, the insurance adjuster may just “tender” or offer the entire amount of their insured’s insurance policy.

Underinsured Motorist Protection

If the defendant offers you the full value of their insurance policy, you may be able to seek to recover additional compensation from your own underinsured motorist policy. We have handled several cases where we were able to quickly obtain the $25,000 or $50,000 policy limits from the defendant and then went after our client’s own insurance policy to compensate our clients for the rest of their damages.

Medical Bill/Lien Negotiation

Once your case settles, your attorney will attempt to resolve all outstanding medical bills you have as a result of injuries suffered in the accident. There are often deductibles, co-pays and in some cases entire medical bills outstanding.

Health insurance companies like Blue Cross Blue Shield of Illinois also intend to be reimbursed for the medical bills they paid on your behalf. Your attorney will attempt to negotiate a reduced amount with your insurance company as well. Do you have to pay your health insurance company back? Yes, often you do.

If you used your auto insurance medical payments (or “medpay”) benefits to pay your medical bills, you will have to pay your auto insurance company back as well. Your attorney will attempt to negotiate this amount down for you as well.

Be aware that some health insurance companies just simply take forever to settle with, mainly Medicare and Medicaid. They are huge governmental bureaucracies and just move much slower than a private health insurer.

Lawsuit/Litigation

The last reason why personal injury cases take so long, is that if you are unable to reach a settlement with the insurance company, your attorney may be forced to file a lawsuit against the defendant on your behalf. If you are in Cook County, you might not get to trial for eighteen months to two years. That’s on top of all the time you already spent on your case.

Despite this, it’s still optimal to try and resolve your claim amicably first as litigation costs a lot of money. Every dollar you spend on costs and expenses for your case comes out of your settlement/your pocket. Pre-litigation expenses cost a few hundred dollars while litigation can cost in the tens of thousands of dollars.

Conclusion

All the above are many of the reasons why personal injury cases take so long. These are just the tip of the iceberg. There are countless other tasks that your law firm must to do prep your case and they all take time. If you want a free consultation to discuss why personal injury cases take so long, contact our office at 312-848-9783.