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Who Pays For Medical Bills After a Personal Injury in PA?

Posted on May 10, 2022

After a personal injury accident, you may be stressed about how you will pay for all of the related expenses. How your medical bills get paid will depend on the circumstances of the accident, and the types of insurance available. 

Getting Medical Bills Covered after a Personal Injury

After a car accident, for example, your no-fault insurance coverage will pay for your medical bills regardless of who caused the collision. However, your auto insurance policy may only cover $5,000 in expenses unless you purchased additional coverage. After no-fault insurance is exhausted, you can use your personal health insurance. You will be responsible for your deductible and any co-pays up front, but you can file a claim against the at-fault party’s insurance company for reimbursement. If your injury qualifies as severe under state law, you may be able to sue the at-fault party for compensation beyond what no-fault insurance pays for. Still, it will depend on whether you have “limited tort” coverage or “full tort” coverage. 

If your injuries were sustained in another type of personal injury accident, such as a slip and fall, medical malpractice, etc., the party responsible for causing your injury might be liable for your medical bills. For instance, if you slipped and fell in a grocery store, you may have to file a personal injury claim against the property owner’s insurance company to cover your medical bills and any other losses up to policy limits. Your settlement should include payment for medical expenses you have already paid and any future treatment you will require due to your injury. 

Limited Coverage vs. Full Tort Coverage – What’s The Difference?

When it comes to auto insurance, Pennsylvania is a “choice” no-fault state, meaning drivers turn to their insurance companies to cover medical expenses regardless of who caused the crash. When purchasing auto insurance, drivers must also choose between “limited tort” coverage or “full tort” coverage. 

  • Limited Tort Coverage: With limited tort coverage, drivers forfeit their right to recover compensation for pain and suffering after a car accident and can only sue the at-fault party in limited circumstances. Typically, their injuries must qualify as “serious” under state law. There are a few exceptions; for example, the court may allow you to sue for pain and suffering even if you have limited tort coverage if the at-fault driver was intoxicated and convicted of DUI. 
  • Full Tort Coverage: Allows drivers to sue the at-fault party under any circumstances. That means there is no injury threshold. Full tort insurance costs more than limited tor insurance but provides better coverage. 

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What Can I Do If The At Fault Insurance Company Does Not Offer Fair Compensation for My Bills, Pain & Suffering?

Although you may be entitled to fair compensation for your losses caused by another party, it does not mean their insurance company will offer it freely. Proving the amount of compensation you are entitled to requires thorough investigation and substantial evidence to support your claim that another party was responsible. As a result, it is critical to speak to a lawyer. Our Philadelphia Personal Injury Lawyer at Rosenbaum Injury Law will go over your legal options, help you navigate the claims process, and ensure you recover maximum compensation.