What Does It Mean If The Insurance Company Is Offering To Pay Up To A Certain Amount Of My Medical Bills?

We often get calls from car accident victims reporting that the at-fault insurance company is offering to settle with them for “up to” a certain amount of their medical bills.  Depending on the extent of injuries, this may sound reasonable, but in reality, the insurance company’s offer is meaningless.  Worse yet, it is a trick by the insurance company to see if they can get you to settle quickly. 

You Still Must Prove That Your Medical Bills Are Related To The Accident:

The insurance company’s offer will only extend to medical bills which they decide to be caused by the car wreck.  You may not agree with their determination.  For instance, if you went to the chiropractor for 6 months after a wreck and incurred $6,000 in medical bills, you will still have to prove that all 6 months of chiropractic treatment were related to your wreck and necessary.  Under its agreement to pay medical bills, the insurance company may determine that only 4 months were necessary, leaving 2 months unpaid.  Another example may be massage therapy bills, which helped with your recovery but may not be recognized by the insurance company.  In short, if you accept the insurance company’s offer, they (not you) get to decide which medical bills to consider.

Will The Insurance Company Pay The Entire Bill, Or Just Your Deductible/Copay?  What If You Used Health Insurance?

Does the insurance company’s agreement to pay your medical bills mean that they will pay the “sticker price” of the bills (the amounts actually charged)?  Or does it mean that they will pay only the amount you are responsible for, like the deductible or copay amount?  These are questions you should ask before accepting any settlement.

Also, remember that if your health insurer paid for any wreck-related medical bills, they may have a claim for reimbursement from “any settlement.”  Therefore, before agreeing to any settlement, you should make sure you understand your health insurer’s reimbursement rights and interests and how the at-fault insurance company is addressing those.

What About Pain And Suffering, Lost Wages, And Other Damages?

It is important to remember that your car accident insurance claim includes not only your medical expense, but also damages for your pain and suffering, inconvenience, anxiety, lost wages, and other things.  Typically, when an at-fault insurance company offers to pay up to a certain amount for medical bills, they also throw in a small offer (like $1,000) for “everything else.” 

Generally, if you have thousands of dollars in medical bills and the insurance company is offering you a small amount for “everything else,” something is not right! 

Beware!  This Is A Final Settlement!

The insurance company knows that you have medical bills piling up and that’s why the offer to pay up to a certain amount is tempting.  But beware!  This will be a final settlement.  If your medical bills (past or future) end up exceeding the amount the insurance company agrees to pay, you will be stuck holding the bag and will be unable to bring any additional claims.  Agreeing to their offer will also restrict you from pursuing any other claims for general damages, like pain and suffering.         

Have You Been Injured In An Accident And Received An Offer From The Insurance Company?

If you have been injured in an accident and received an offer from the insurance company and have quesions about how it works,  contact us online or call our Covington office directly at 985.590.6182 to schedule your free consultation today. Flattmann Law serves clients on the Northshore, including Covington, Mandeville, Abita Springs, Bogalusa, Franklinton, Folsom, Madisonville, Goodbee, Hammond, Lacombe, Pearl River, and Slidell.

Grady Flattmann
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Local Covington, Louisiana attorney focusing 100% on personal injury matters.