After a car accident, an individual may discover that they require care beyond the immediate medical services employed to keep them from immediate harm or save their life. Long-term care is a broad term to encompass any care required by an individual to execute tasks of daily living after an accident. Catastrophic injuries resulting from a car accident often require long-term care.
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The American Medical Association defines catastrophic injury as severe injury to the spine, spinal cord, or brain, which may also include skull and spinal fractures. The most dangerous type of car accident, which leads to catastrophic injuries and even death, is head-on collisions. Although they make up only 2% of all car accidents, they result in 10% of driving fatalities according to HG.org.
The Florida Department of Safety and Motor Vehicles reports that out of the 400,431 crashes in 2021, over half resulted in injuries. Therefore, the likelihood of needing care and possibly long-term care is fairly common.
How are medical bills paid after a car accident in Florida?
Generally, the initial medical bills are paid by auto insurance companies. According to Florida Statute 627.736, an insurance policy must provide coverage for the injured, their immediate relatives, any person in the vehicle, and any persons stuck by the vehicle at the time of the accident. Medical benefits paid by your automobile insurance company are limited to eighty percent of the reasonable and necessary medical expenses as described in the Statute. The remaining twenty percent of those medical bills is the patient’s responsibility. Moreover, if a doctor does not determine that the accident resulted in an “emergency medical condition,” the automobile insurance company benefits are further limited to only $2,500.
Once an individual has exhausted their personal injury protection (PIP) and MedPay auto insurance benefits, they should begin to employ their health insurance coverage. A driver’s automobile insurance is primary, meaning it is the first to pay. Health insurance companies may refuse to provide benefits for a car accident until the PIP benefits are exhausted. Most PIP policies carry a deductible that can result in an out-of-pocket expense for those injured. Florida requires all drivers to carry PIP as part of their auto insurance coverage while MedPay is an elective program.
What is considered a long-term effect of a car accident?
Injuries resulting from a car accident often result in long-term effects. According to My Family Chiro, injuries may include herniated discs, whiplash, cervical injuries, meniscus tears, and soft tissue damage. Catastrophic injuries such as spinal cord injuries, severe spine injuries, traumatic brain injuries (TBI), severe head injuries, loss of limb(s), severe burns, disfigurement and significant scarring, and any injury that results in long-term or permanent disability all require long-term care.
Does Medicare cover auto accident injuries in Florida?
According to MedicareAdvantage.com, Medicare does cover some accident injuries, but it depends on the kind of treatment required. The types of treatments covered depend on whether an individual has Medicare Part A or Part B. Part A covers inpatient care in a hospital or skilled nursing facility, and hospice care. Medicare Part B helps cover medically necessary services, which may include ambulance services and doctor’s services or supplies that are needed to diagnose or treat a medical condition, as well as preventive services, which may include clinical research and routine check-ups. Medicare coverage should be available to covered persons for bills that are incurred after the exhaustion of PIP benefits. However, Medicare will only pay the charges of providers who participate in the Medicare program and will not reimburse a patient for their PIP deductible or patient responsibility.
Health Insurance and Medicare Liens
Because health insurers and benefit providers are secondary payors, any amounts paid by a health insurer or Medicare will be claimed by the insurer as a lien against the ultimate recovery from the at-fault parties. If there is no recovery, no settlement, or judgment entered, from the at-fault parties, patients are not required to reimburse their medical benefit providers. However, a significant part of any settlement or litigation resolution is the negotiation of those medical benefit liens. An experienced personal injury lawyer will negotiate with a patient’s medical benefit providers in an effort to reduce the lien and increase the ultimate net recovery to the client.
How long does it take to settle a car accident case in Florida?
A car accident settlement typically begins when the injured person sends a demand letter. In a demand letter, the injured party states why the insurance company’s insured is at fault and therefore responsible for damages. Once the demand letter is received, there are three possible outcomes, and each adheres to its own timetable. If the settlement amount is immediately accepted, which is unusual, the claimant can expect payment for damages typically between two weeks to two months. However, if the insurance company does not accept an injured person’s original demand, then a back-and-forth negotiation is triggered. On average, negotiations can take anywhere from fifteen to ninety days but can last longer.
Speak To An Experienced Car Accident Attorney
At Panter, Panter & Sampedro, our Florida car accident attorneys work with a wide range of experts to thoroughly investigate accidents. Through accident reconstructions, crashworthiness testing, medical reviews, and eyewitness testimony, we are able to seek maximum compensation for our clients.
For over 30 years, our experienced trial attorneys have worked one-on-one with clients to successfully get the justice, recovery, and compensation they deserve. To speak to a dedicated attorney, call 305-662-6178.
Sources:
https://en.wikipedia.org/wiki/Catastrophic_injury
https://www.hg.org/legal-articles/head-on-collisions-the-most-dangerous-type-of-car-accident-29016
https://www.flhsmv.gov/traffic-crash-reports/crash-dashboard/
https://www.valuepenguin.com/can-you-use-health-insurance-in-car-accident
https://www.my-family-chiro.com/long-term-effects-of-auto-accident-injuries/
https://www.medicareadvantage.com/coverage/does-medicare-cover-auto-accident-injuries
https://panterlaw.com/2021/07/07/how-is-a-car-accident-settlement-negotiated/
