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Florida Car Wrecks and Health Insurance

What legal role does your health insurance have in your Florida car wreck and/or personal injury case?

So, you are the victim of a careless driver or other negligent actor and as a result, you have medical bills, and lots of them.  Fortunately many victims already have a health insurance policy that covers them for all of their healthcare needs.  Once an accident happens and medical treatment is needed, what happens if your health insurance company pays any of the bills?   The short answer is that the health insurer is entitled to be reimbursed at the conclusion of your legal case.  

When you enter into the health insurance agreement one of the terms of every policy is the insurance company’s right of subrogation.  This is a fancy legal term that means you can’t be compensated twice for the same item of expense.  In terms of medical expenses this means that if the insurance company pays your medical bills related to your accidental injury then it is entitled to be reimbursed out of your settlement.  Otherwise, you would be recovering twice of the same injury, once by the payment of the bill and second by the recovery from the careless driver/party.  

A good personal injury law firm handling a Florida car wreck case, will have years of experience in dealing with these reimbursement or subrogation issues.  Most times the health insurers will permit discounts to be negotiated by the law firm which maximizes the recovery for the client.  So, even after a long fight with the insurance company for the at-fault party, the lawyers and staff at Zarzaur Law continue the fight until even the health insurance companies reduce their subrogation interest to the lowest possible amount.  

To add a bit of complexity to this discussion is the function of personal injury protection (PIP) coverage in Florida car wreck cases.  Florida’s car wreck law provides that each insured driver in Florida must purchase at least $10,000.00 in PIP benefits.  These PIP benefits must by law pay for 80% YOUR car wreck related medical bills up to $10,000.00.  Even if you have the best of health insurance policies, being involved in a wreck immediately makes your own car insurance the primary payor of your medical bills.  To say it another way, your health insurance will not honor any car wreck related claims until your car insurance has used the entire PIP benefit.  This is important for several reasons.  First, using PIP benefits instead of health insurance benefits means that the right of subrogation held by the health carrier is not permitted by the car policy.  So, this means that once your Florida car wreck case is concluded, you will not be required to reimburse the PIP (auto) carrier.  Unlike health policies, car insurance policies in Florida do not have rights of the insurance company to subrogate.  In essence, this permits the Florida car wreck victim to achieve double recovery for at least the first $10,000.00 in medical expenses.  In practice however, the value of the case will likely not be increased by this $10,000.00 since the at fault insurer will be negotiating settlement terms knowing that this $10,000.00 in bills has already been paid by the auto carrier.  

In some cases, Florida car wreck victims end up not using all of their PIP benefits and their health insurer overlooks this and starts paying expenses.  The case is concluded and the health insurance wants their reimbursement.  Florida car wreck lawyers who know their business will recognize this issue and make sure that the PIP carrier reimburses the health carrier so as to maximize the total recovery.

Zarzaur Law prides itself in making certain that all of these medical/insurance issues are handled in the most professional way.  For more information about Florida car wreck cases, feel free to contact us at zarzaurlaw.com or by phone at 855-Hire-Joe.