When you are severely injured in a motor vehicle crash, one of the last things you want to be thinking about is how you will pay for the medical treatment. Fortunately, a dedicated lawyer like David E. Gordon can help you with your insurance coverage. His years of experience can guide you through the nuances of insurance recovery after a Memphis motorcycle accident.
How the Insurer Affects Financial Recovery
If an injured biker uses his or her health insurance coverage to pay for medical treatment, the health insurance company has the right to make a claim upon the settlement to be reimbursed whatever amounts they paid on behalf of the injured biker. In other words, if an insurer paid $5,000 for the medical expenses incurred by the biker, then they can make a claim for that $5,000 against the ultimate settlement paid to the biker.
One benefit of health insurance coverage is that the insurer gets a discount on all medical charges. If the emergency room charged the biker $3,500 for the ER visit, then the insurer might pay just $1,000 to the hospital. The rest of the $2,500 charge remaining is adjusted, meaning that the patient will not have to pay the remaining $2,500 to the insurer or to the hospital. However, at the time of settlement negotiations on the injury claim against the at-fault driver, the motorcyclist can still make a claim for the entire $3,500.
In this way, the at-fault driver will be responsible for the full charge despite the fact that the biker and health insurance company paid only a fraction of the bill. Thus, even when the biker pays back the $1,000 to their insurance company that covered the treatment, they get to keep the extra $2,500 on the medical bill. This is compensation that is separate from the claim for pain and suffering, loss of enjoyment of life, and other non-economic damages.
Vacation and Sick Time
When an injured biker uses vacation time or sick time from their job in order to be compensated while they recover, these funds are not repaid to the employer. These are benefits that belong to the injured person. In fact, the motorcyclist could charge the at-fault driver for the lost earnings during that time, even if they were compensated with vacation days or sick leave. David can explain to a client the intricacies of insurance recovery after they have suffered injury in a Memphis motorcycle crash.
If a motorcyclist makes a claim against a disability insurance policy, then the insurance company is permitted to make a claim for reimbursement against the ultimate recovery against the at-fault driver. There are legal arguments against the disability insurance company’s claim for reimbursement but these arguments are made on a case-by-case basis.
Denial of Benefits by an Insurance Company
It is rare that an injured motorcyclist would be denied health insurance recovery in Memphis. The only reason that a health insurance company will deny benefits to an injured biker is if they claimed that the biker was working in the course and scope of their employment at the time of the crash. In that instance, the insurer would expect workers’ compensation insurance to be responsible for the bills.
There are some physicians and medical providers who do not like to treat people injured in motor vehicle accidents because they do not want to provide medical records and billing to auto insurance companies, nor do they want the possibility that they will ever have to talk to a lawyer. But their charges will be covered if the physician bills the health insurance company in the ordinary course of business.
Learn About Insurance Recovery from an Attorney After a Motorcycle Crash in Memphis
There are a few limitations to health insurance recovery after a Memphis motorcycle accident that you should be aware of. But there are also ways that you can use the coverage to your advantage. Reach out to the Law Office of David E. Gordon to learn how you can maximize your financial recovery.