Injuries and damage to the vehicle naturally take priority after a crash, and the insurance puzzle comes later. Which insurance policy covers the medical bills? Does health insurance chip in? What happens to the situation when both insurance policies come into play?
There’s more to Utah auto insurance laws than most people realize. Here’s a breakdown of how the payment order works and why it is important to understand it correctly, especially for your recovery.
How Utah’s No-Fault Statutes Work?
Utah is one of the many states with a “no-fault” system. Regardless of which driver is at fault, you are required to file a claim for your medical bills with your own auto insurance first, and not the other driver’s. All auto insurance policies in Utah are required to provide coverage for Personal Injury Protection (PIP) per Utah Code Ann. 31A-22-302(1).
PIP kicks in after an accident and covers the first $3000 in medical costs, regardless of fault. Beyond medical bills, PIP also provides reimbursement for lost wages (up to a maximum weekly benefit of $250, or 85% of gross income for up to 52 weeks), household services, and funeral expenses in accidental death cases.
How Costs are Covered After a Utah Car Accident?
After a crash in Utah, the payment order for medical bills is typically as follows:
- Workers’ Compensation — If you were at work at the time of the accident, your employer’s workers’ compensation pays for the medical bills first.
- PIP (Personal Injury Protection) — This option covers medical costs up to $3,000 from your personal auto policy.
- Private Health Insurance — After the exhaustion of PIP benefits, your private health insurance pays. You’ll have to send your health insurance a letter from your auto insurance showing that PIP benefits have been exhausted and pay medical bills.
- Lien-Based Care — If costs exceed PIP and health insurance benefits, some medical care providers will provide care on a lien basis. In this situation, the provider provides treatment and waits for payment of the claim until your personal injury case is resolved.
It is important to know this sequence. If you go directly to health insurance before PIP benefits are exhausted, not only will that delay your medical care, but it will create unnecessary complications in the future.
What Role Does the At-Fault Driver’s Insurance Play?
PIP and health insurance cover some of your needs, but they do not cover all of your needs. PIP and health insurance do not cover suffering or damage that is over your policy coverage. For that, the liability insurance of the at-fault driver deals with the rest.
In Utah’s no-fault insurance system, you can go beyond the no-fault system once you have medical costs totaling over $3,000, or if you have serious injuries such as broken bones, permanent disfigurement, or impairment. An attorney experienced with car accidents will guide you if your injuries match these descriptions and if it is worth the trouble to pursue the at-fault driver.
How Health Insurance Subrogation Affects Your Settlement?
Just because you used your health insurance after your auto accident does not mean that those costs go away. Your health insurance carrier can assert a right of subrogation against the at-fault driver’s settlement. Subrogation allows the health insurance carrier to recover the funds it paid.
This is where many clients lose money without even knowing it. A Utah car accident attorney can assist with negotiating a settlement with your health insurer for a much smaller reimbursement amount, allowing you to retain more of your settlement. Without this attorney, you could be looking at having to reimburse the full amount, resulting in a significantly smaller settlement.
Tips to Help Protect Your Claim
There are a few things that you can do to help protect your rights after the accident.
- File a PIP claim right away and provide the claim number to all your doctors and healthcare providers so they will bill your PIP claim, not you.
- Monitor your PIP claim to see how much time remains before the funds are depleted and you are on your own to cover your medical bills.
- Save and copy all your medical bills and Explanation of Benefits because your Utah accident attorney will use these documents to prove your injuries and build your case.
- Do not sign a quick release. This can leave you owing the insurance company more money than you received.
Adjusters for insurance companies, including your own, will minimize your claim to withhold money that rightfully belongs to you. A Utah car accident attorney will help determine the value of your claim and help you avoid losing money to avoidable pitfalls.
Get Advice from a Utah Car Accident Attorney
The insurance process after an accident can be complex and difficult to navigate, with many moving parts. Knowing which coverages apply and in what order is just one piece of the puzzle. Utah car accident attorneys can help you determine the best moves to make to protect your financial recovery and help you with guidance to mount a recovery in the form of settling your bills and payments for PIP, health insurance, and claims against the other driver.