Can someone explain how medical bills are paid in a situation like this?

[Hyacinth]

A family member was in a terrible car accident. Clearly the other driver's fault (per the police report). The bills are coming in--the initial helicopter ride (she was life-flighted), several surgeries, a lengthy hospital stay, a subsequent rehab facility stay, and now ongoing PT/OT appointments. Current totals are something like $400,000 and climbing. She's starting to get phone calls on these bills and she's referring everyone to her lawyer.

 

My questions: Is this person going to be held responsible for some or all of these charges? Are there limits as to what her or the other driver's insurance will cover? And then what? Who does the lawyer try to get the money from? The other driver (who has nothing)? Do hospitals and surgeons and the other providers settle or write off the rest?

 

I'm overwhelmed for her at the numbers. This is a family of four with an income of likely less than $30k/year. This all happened in Arkansas, by the way.

 

Thanks, Hive!

[Annie G]

Sadly, JFSinIL knows too much about this type of scenario.  If the person at fault has no insurance or inadequate insurance and has no assets, there not really a way to get payment from that side.   I hope she sees this and jumps in.  

 

I'm so sorry for your friend. Being hurt is bad enough but worrying about medical bills just makes it overwhelmingly stressful. Does she have her own health insurance and car insurance?

[Hyacinth]

Yes, she has both auto and medical insurance.

[marbel]

Does she have uninsured driver coverage as part of her auto insurance?    That should help.   :grouphug:

[SparklyUnicorn]

Lot of variables.  They will first try to get payment from the auto insurance companies (both).  What they get depends on what coverage each person has.  Then they will seek payment from medical insurance.  In terms of things like deductibles, she'd have to go after the person who caused the accident, but if they have nothing then she will probably get nothing.  Or they'll settle on some extremely small regular amount.

 

It'll take time to sort it all out either way.

[Guest]

Or maybe the jerk that hit her will sue her. Ask Joanne about that bit of injustice.

[kiana]

Lot of variables.  They will first try to get payment from the auto insurance companies (both).  What they get depends on what coverage each person has.  Then they will seek payment from medical insurance.  In terms of things like deductibles, she'd have to go after the person who caused the accident, but if they have nothing then she will probably get nothing.  Or they'll settle on some extremely small regular amount.

 

It'll take time to sort it all out either way.

 

Yep.

 

But if, after that, the bills aren't paid, the hospital will settle. One of my relatives fell off a roof and hit his head while working minimum wage and uninsured. He had to be hauled off in an ambulance and the bill was not as high as hers, but at least triple his annual salary. He ended up paying $50/mo for a year and then the hospital wrote off the rest of the bill. 

[4kidlets4me]

Hmm maybe our case was different some how. But we were hit by an uninsured driver and I hired a lawyer right away. We carried uninsured motorist on our policy. In the end we sued our insurance company, the woman who hit us, then she was driving someone else's car so we also sued him and his insurance. I think our insurance paid the bulk of it and way over what our limit was. But it took 3 years to settle it. We didn't pay one penny towards any of my daughters medical bills and she ended up with a nice settlement. 

[zoobie]

Has her lawyer not explained it to her? She needs a new lawyer!

[gardenmom5]

I was in a recent accident where it was *clearly* the othe person's fault. their insurance would't pay until I was done with medical treatment, and ready to sign off.  their insurance refused to pay any finance charges caused by their delay in payment. because it was relatively minor, we didn't use our lawyer. (we have other times.)

[Hyacinth]

Thanks, everyone.

 

I don't know how much the lawyer has or has not explained to them. To be honest, her focus is (understandably) on minimizing pain and just healing. She was able to sort of ignore the bills that come in the mail with an "I can't and shouldn't have to deal with this right now; that's what I have a lawyer for" attitude. But now that the providers are calling her at home...it's just more pressure.

 

My husband has offered to call the lawyer on her behalf and get some answers.

[plansrme]

You are right that she needs to remember that the medical bills are ultimately HER responsibility. She can recover from any number of third parties--her medical insurance, her car insurance, his car insurance--but SHE is on the hook for her treatment and is the first place every provider is going to go to get paid.

[Anne in CA]

She does need to take the reimbursement seriously, but I would not answer the phone in her case.

[Tsuga]

She needs to call those parties and inform them of the situation.

 

If they aren't getting their half a million from her due to the fact that she simply does not and will never have it even with home equity, tell them.

 

She needs to set up a payment plan and save every receipt while the insurance companies work it out.

 

Has she called the insurance companies? Has the lawyer? What are they waiting for (ins. Companies)?

[fairfarmhand]

Set up a payment plan (even if it's piddly nothing) to keep the bill collectors at bay. Save EVERY receipt. IT will probably take YEARS to sort it all out.

 

My nephew was in an accident with his mom and sisters 18 months ago and they are still wrestling through the payoff.

 

In the end, it'll be reimbursement for all the stuff that they've paid out.

[zoobie]

Thanks, everyone.

 

I don't know how much the lawyer has or has not explained to them. To be honest, her focus is (understandably) on minimizing pain and just healing. She was able to sort of ignore the bills that come in the mail with an "I can't and shouldn't have to deal with this right now; that's what I have a lawyer for" attitude. But now that the providers are calling her at home...it's just more pressure.

 

My husband has offered to call the lawyer on her behalf and get some answers.

The lawyer will not be able to answer any questions with specificity unless your husband holds PoA for her. If the lawyer does, that's a huge red flag. Even if this person is his mother or his (over 18) child, the lawyer cannot discuss privileged information with him. He could discuss with a spouse who holds spousal privilege IF the client consents.

[QueenCat]

She really needs to talk to her lawyer about this stuff. She could end up harming herself by talking to other parties on her own.