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The Doctor Says I Can’t File Bills For My Accident Injury With My Health Insurer. What Should I Do?

If you are injured in a car, motorcycle, or tractor-trailer accident in North Carolina, it’s important to seek medical treatment as soon as possible.  But if the wreck is not your fault, do you still file your medical bills with your own insurance company?  The answer is yes.  It is very important that you tell the health care providers to file your claims through your own health insurer for any treatment you receive that is related to the collision.

In North Carolina, you are responsible for mitigating or lessening your damages.  Some health care providers are eitherstockfresh_5997305_exploded-airbag_sizeS-300x200 unaware of this or hope to receive more money for providing your care by filing it through the at-fault party’s car insurer.  They may insist that you cannot file your treatment with your health insurance and are instead required to file it with the at-fault party’s insurance.  Unless your health insurance refuses to cover the treatment, the medical providers are wrong and should file through your health insurance policy.

Why are they doing this?  It’s very likely that your health care provider is required to charge less for your care if processed through your health insurer versus what they could charge through the at-fault insurer.    Because the total paid or total due is likely to be lower through your health insurer, at-fault insurers in North Carolina can later argue that they are not required to reimburse you for a higher amount than the health care provider likely charged them because it is your duty to mitigate your damages.  In other words, they may argue that you could have received cheaper care and chose more expensive care, so they are not responsible for reimbursing you for the more expensive care. This leaves you holding the bag for the difference and responsible for paying the higher charge for the cost of care you have received out of your settlement or judgment.

If the doctor’s office refuses to file with the insurer, insist that they provide you with something in writing that explains their reasoning.  This will make it easier for an attorney to analyze the justification for their refusal and to determine what steps are available to remedy the problem.

Be sure to keep notes as to the date and name of office personnel who refuse to file with your health insurer.  This will make it easier to keep the facts straight when it comes time to contest their position.

After an accident, you need time to get well, recover from your injuries, and not worry about navigating bills owed, medical liens, and phone calls from the insurance company.  It’s all complicated and time-consuming.  At Grimes Teich Anderson LLP, we have decades of experience with all kinds of accidents and will ensure you understand every aspect of your situation, allowing you to spend less time on the phone with insurers and others and more time focusing on recovering from your injuries.

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