When Your Health Insurance Company Won’t Pay Your Bills, What You Should Do?

A health insurance company must pay medical bills, right? No, not always.

We are often hired by people justifiably angry after their Blue Cross-Blue Shield plan declined to pay for their amulance, hospital, and doctor bills. You have to pay expensive premiums and high deductibles and co-pays. So it is natural to assume that after you are in a car or truck collision in North Texas, that your health insurance company will pay for your medical bills. But unfortunately, it often won’t. But you won’t know this for months.

So the best thing for you to do after being in a wreck is to hire a good personal injury lawyer immediately. He will fight to get your medical bills paid or lowered by your health insurance company and your damages paid by the other driver’s liability insurance company. And if you don’t have health insurance, he can get you treated by qualified doctors and pay for some of them up front or guarantee payment so they are repaid from your insurance settlement or jury verdict. It’s a win-win for you.

How the system works — or doesn’t work

The process after the crash happens is extremely complicated. For starters, there are two and often more liability insurance companies to contend with. Then add in your health insurance company,  government agencies like Medicare, Medicaid and the Veteran’s Administration/Tricare, or workers compensation or disability plans, and thereare a lot of bees buzzing  around the hive. None of the insurance representatives or claims adjusters are in a hurry to process the claim, let alone pay it, unless they are pushed.

Example: in a typical car wreck, the at-fault driver has liability insurance with say, State Farm. You may have additional benefits on your auto policy with GEICO in addition to your BCBS plan. You were rushed by ambulance to the expensive hospital where you had X-Rays and CT scans performed. Then you went to your PCP who said you should see a chiropractor. After your neck or back pain persisited, he orders a Magnetic Resonance Image. These bills pile up in a hurry.

But there is no law that makes State Farm pay your medical bills before a settlement demand or jury verdict, so of course it doesn’t. Otherwise, the company would be in effect financing the war you are waging against it. Instead, it hopes that you do not go to a doctor and it will go out of its way to prevent that from happening. The fewer your medical bills, the lesser your payout.

But your pain can persist. It may not be time for you to settle or file a lawsuit and the law in Texas allows an injured person a two year period to treat with medical professionals and negotiate a claim or file a lawsuit. But the bills keep coming in. Bill collectors start to call and harass you. They threaten to sue you. Maybe their lawyers do. Your credit is being hurt. It’s a financial nightmare.

Problems your injury lawyer will help you tackle

You may call up your BCBS claims office and ask why your medical bills haven’t been paid you. You may be told that one or even all of these things has happened:

1. BCBS writes you later that its payment is secondary to State Farm and GEICO so it doesn’t have to pay until those limits are exhausted;

2. BCBS says that you have not met the annual deductible or copays which are usually high;

3. The hospital and doctor are not in-network, but you didn’t know that;

4. The in-network hospital or doctor wants to get paid more from the injury case than from BCBS so they refuses to file the bill with State Farm;

5. The hospital and some ERs file a lien so they get paid in full, not a lesser amount by BCBS;

6. BCBS pays bills and asserts its right to subrogation; or

7. Many hospitals and doctors won’t see you because they have a non-litigation policy.

New way health insurance companies cheat car wreck victims

You don’t have the insurance plans or know how to read their arcane legal verbiagergh. You aren’t a lawyer. You have your pain, your job, and life to contend with.

What you should do

You need a good car wreck lawyer to guide you through this complicated process. We at Berenson Injury Law have done this every day for the past nearly 40 years.

We will fight the various insurance companies involved, handle all of the documents and negotiations, make them pay your medical bills in full or, depending on the facts, get your bills lowered, and file a lawsuit if it is in your best interest. We know the latest laws and techniques to use against these companies. And we know that if the doctors and health insurance company take all of your money, you are not going to be happy.

We get calls from people who have been in car wrecks every day. But sometimes they have waited months to hire an injury lawyer. Their cases are often damaged because they tried to do it themselves.

Mr. Berenson, our Fort Worth car accident attorney, offers a free meeting or consultation by email or on the telephone to explain what your best options are. The consultation is free and we don’t get paid anything for our time or expenses until you get paid.

Please call us toll-free at 1-888-801-8585 or fill out this form so we can help get your medical bills paid and get you the compensation you deserve.

For more on this topic please read:

Best ways to reduce huge medical bills

What to do when your health insurance company demands repayment – subrogation

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