How Medical Bills Are Paid After a Pennsylvania Car Accident
Pennsylvania uses a first-party medical-benefits system for many auto-accident medical bills, so the statutory order of insurance coverage, not who caused the crash, determines the first source of payment. At Conlon Tarker, P.C., our car accident lawyers help Butler County clients identify which insurer should receive the bills and what options may remain after first-party benefits are exhausted.
Which Auto Policy Pays Medical Benefits First?
Under 75 Pa.C.S. § 1713, first-party benefits are generally paid in a statutory order of priority. Depending on the person’s insurance status and role in the crash, the applicable source may be:
- Your own auto policy
- A policy held by a relative you live with
- The policy on the car you were riding in
- The policy on any car involved, if you were on foot
The other driver’s insurer does not pay your treatment bills as they come in, even if the driver got the ticket. Provide your own auto insurer’s claim number to Butler Memorial Hospital or UPMC Passavant at check-in so the bills are sent to the correct insurer. Your limited tort vs. full tort PA choice does not change any of this, because it only affects pain and suffering.
What Happens When Your PA PIP Medical Benefits Run Out?
Pennsylvania requires at least $5,000 in medical benefits on many private passenger auto policies under 75 Pa.C.S. § 1711. A serious injury can quickly exhaust that amount, although some drivers purchase higher limits.
After first-party medical benefits are exhausted, health insurance may become another source of payment depending on the policy and coordination rules. Deductibles, copays, liens, and reimbursement rights can affect what is ultimately owed or recovered. A liability claim against the at-fault driver may also address legally recoverable losses that are not paid through first-party benefits.
Other coverage sometimes exists that nobody mentions. In one of our case results, our attorneys found an extra underinsured motorist policy for a woman hurt in a T-bone crash, and she recovered $1,050,000. Results depend on the facts of each claim.
Records to Keep After a Route 19 Car Crash
Three insurers may touch the same bill, so paperwork matters. Keep a folder with the following:
- The letter saying your PIP benefits are used up
- Every explanation of benefits from your health plan
- Itemized hospital and therapy bills
- Receipts for prescriptions and copays
Your health plan may ask to be repaid from any settlement. Those records show what it actually paid.
Let Us Review Your Medical Bills and Insurance Coverage
Hospital statements and insurance letters can arrive at the same time and may not match. Conlon Tarker has worked for injured people in Butler for decades, and we can review the coverage sequence and paperwork with you. To start, call 724-285-7700 or schedule your free online consultation.
