Are You Without Insurance Or Are You Covered by an ERISA Plan?

If you get hurt in an automobile accident, your first priority should be to seek treatment for your injuries and get better as soon as possible. However, if you are a driver in the state of Arizona without health insurance or are covered by your employer’s ERISA health insurance, the steps of your claims process may differ dramatically from others who hold private health insurance. The following is an explanation of the two scenarios as they relate to the injured party in an automobile accident.

Personal Injury: If you Lack Health Insurance and Pay out of Pocket for All Treatment

If you are hurt in a automobile accident, need medical attention, and are paying for all of your medical expenses out-of-pocket, then the claims process is rather straightforward. The first step is always to seek treatment and recover from your injuries. Due to the fact that you will be paying for all of your expenses without help of any insurance, you will not need to reimburse other parties if or when you receive Med Pay coverage from your own auto insurance of from the at-fault driver’s auto insurance. There are no liens placed on your medical treatment and you will only need to communicate with your own car insurance and the defendant’s insurance in terms of your claim. Each accident and situation is still different, and an attorney could be the most valuable resource in helping you through the personal injury process.

Personal Injury: If you Have ERISA Privately Funded Health Insurance

When you are the victim in a car accident and your primary care provider is an ERISA plan provided by your employer (generally a large corporation) , there is a likelihood that you will have to reimburse the health care plan for a portion of your medical expenses from over payouts you stand to receive due to your injury. Of course, your first course of action is to get better and receive necessary treatment after your accident. While all injury cases vary, a claim cannot be submitted on your behalf if you do not obtain treatment for your injuries. Therefore, upon seeking the treatment you need – it is in your best interest to contact an attorney.

Your insurance will know that the treatment you are receiving is due to an accident that was not your fault – and thus want to be reimbursed for your treatment because they know you will generally receive compensation from other parties involved in the accident. An experienced ERISA lawyer in San Francisco is the best ally to have in this process, as dealing with your health insurance plan may prove difficult. This is because the ERISA plan that your employer had must be both qualified an approved before placing a lien on your treatment and demanding repayment from the at-fault driver’s insurance company or your own auto insurance. The lien is not automatic and its presence might affect the amount of financial compensation you stand to net from the at-fault driver and/or the Med Pay coverage on your auto insurance. This process may play out over many months and can be enriched by the presence of an experienced attorney. Contact a local attorney to discuss your situation, and see if they can help you navigate the waters of insurance companies and medical bills.

(Please note: while informative, these posts are not intended to be formal legal advice and should not be solely relied on as a primary basis for legal action.)