A frequent discussion we have with a new client:
Question: Do you have health insurance?
Answer: I do, but the hospital told me to just bill the other driver’s insurance. The accident was his fault.
In a world where everything is ‘fair’ that might be the correct answer. But that is not how it works. In fact, you may have created a problem for yourself.
The law in Georgia is that when you go to the hospital or doctor’s office, you are responsible for paying your own way. That is regardless of who caused the collision. And that is really the way it has to be. Imagine having to argue about every visit to the doctor? What if the other carrier wants you to go to their doctors, as if it were a workers’ compensation claim? What if they took months to respond, resulting in you getting no treatment? In our experience, insurance companies will always try to take advantage of you if they have any control over your medical treatment.
Medical bills and lost wages are a legitimate item of recovery in an accident claim. But an insurance company paying you for those losses happens at the end when you reach a settlement
How this works to your advantage
For most people, paying your medical bills out of your pocket now in the hope that an insurance company reimburses you later is not a good option. But this can work to your advantage.
When we represent a client, we are able to claim the full amount of the medical bill. For example, let’s say you go to the hospital. The bill you receive in the mail is $10,000, but between your deductible and the payments made by your insurance company, you satisfy the bill for $2,500. We are able to claim the full $10,000 on your behalf from the insurance company. That is because the discounted rate is considered a “collateral source” under Georgia law and is not admissible as evidence.
Hospitals sometimes try to game the system
Lately, we have experienced several large hospitals in the Atlanta area trying to game the system. If you have health insurance, the hospital is required under their contract with the insurance company to bill your health insurance policy for the bill after an accident. But when there is a car accident, some hospitals believe that they can get more by circumventing their responsibilities and filing a lien against your claim instead. While this is allowed for a Medicare/Medicaid beneficiary or someone without health insurance, it is not appropriate for patients with private health insurance.
We always go through our client’s medical bills with a fine tooth comb to make sure that their medical providers have not pulled this stunt. Unfortunately, we are seeing this more and more recently.
If you have any questions about your options after being injured by the negligence of someone else, please reach out to Lloyd or Alex Hoffspiegel by calling us at (404) 760-8600 or e-mailing us at firstname.lastname@example.org.