Hello, Ty Wilson here, Georgia Personal Injury Attorney, I practice law in the state of Georgia. And our video question for today is, “How come I keep getting a bill from the hospital after my car wreck?” Now, this question came from an individual that I know has health insurance. And so their big question is, “Why is the health insurance company not paying for my medical care? As I have health insurance so that they can pay for that.”
Well, the hospital has the option to bill the hospital or to bill you directly. If they bill you directly, they want to get paid 100% of their charges. If they agree to bill the health insurance, they’ll have to take a discount. And some health insurance policies have you pay the balance. Some health insurance policies have what’s called a “Capitated Plan” where there is no additional payment that need to be made. These are agreements that allow the insurance carrier to make a flat payment for each person that it covers.
Unfortunately, that is up to the hospital. And so we’re seeing a lot more hospitals that are relying on their lien through the state of Georgia that says that they should be paid back for their services. Often they will wait for the conclusion of the personal injury case so that they can get paid back dollar for dollar.
Now, as far as the At-Fault Insurance company, they’re not required to pay for medical care as you go. This is a common myth that’s out there. And a lot of people are surprised when they find out, “Well, I need to go to the doctor and I can’t afford it. How do I get to the doctor?” Well, the At Fault insurance company is not going to pay as you go. If they pay you, they’re going to try to settle the case for one time and be done with it.
What to do if the insurance company is not paying medical bills? It’s critical that if you are injured in a personal injury claim that you complete all your care. You want to get the best care you can for your injuries and be comfortable with where you’re at, because there is no going back to the insurance company later.
If you find that you need legal advice or even a case review, contact Ty here.