Hello, everyone. This is Robert Mansour. I wanted to make a brief video today about how to pay for your medical care when you're involved in an automobile accident. This is a very important issue and you cannot enter into it lightly.
The firs thing that I do when I contact a client or when they talk to me is I say, "Okay. If I take this case, we have to decide how are we going to pay for your medical care." There are several options. If you have health insurance, that might be one way to do it. Have your health insurance pay for the medical care. Keep in mind that in most cases, your healthcare insurance company will have a right to be reimbursed if you recover money from the responsible party.
If your health insurance company pays out $2,000 for your care and you recover $5,000 from the responsible party, you may have to repay your health insurance company if that is the case. That hold true for Medicare and Medi-Cal and most of the major health insurance companies out there.
If you have medical payments coverage under your automobile policy, you might also be able to use that. Medical payments coverage is like having health insurance attached to your auto insurance policy. Usual policy amounts are $2,000, $5,000. I have seen some that are $25,000. It all depends on what you have if you have it available. The nice thing is that you can use that money to pay for your healthcare in many cases.
Now, here's the thing. If your auto insurance company pays based on that provision, they have a right to reimbursement as well, and you have to make sure you take care of them at the end of your case.
Another thing you can do is proceed on a lien basis, lien. What does that mean? That means that if you don't have health insurance and you don't have medical payments coverage, you might be able to get care from certain doctors who specialize in personal injury matters, or they don't specialize but they know how to do a personal injury case, they know how to handle one, and they accept them.
Here's the thing. A lien means you're going to sign a form that promises to pay the doctor regardless of the outcome of your matter. You can't just tell the doctor, "Well, I didn't win and I lost the case," or "I decided not to pursue and so I don't want to pay you anymore." The doctor is not going to be very happy with that, nor is the physical therapist or the chiropractor or anybody that you hire on a lien basis.
When you proceed on a lien, the doctor is basically fronting his or her services to you with the expectation that you're going to pay them out of the recovery of your case. What you may not realize is that you in most cases, owe the doctor regardless of the outcome of your case.
Contrast that with your health insurance company and your medical payments coverage on your auto policy. In those cases, yes, you have to pay them back, but only if you recover money from the other party. If you lose or you don't recover any money from the other party, you don't have to pay them back versus going on a lien which is essentially a tab at the doctor's office, and having everything done that way in which case, you have to pay those healthcare providers regardless of the outcome of your matter.
So you have to be very careful with how you proceed and how you choose to have those things paid for. Every case is different. In some cases, it makes sense to go one path, in some cases, it might make sense to go a different path. That's one of the issues that I talk about with my clients. Which is the least financially dangerous path for them to go down?
I hope you found this video helpful. I appreciate it very much that you took the time to watch it. Feel free to visit my website, valencialawyer.com for lots more educational information about personal injury cases. Thank you.
VIDEO TRANSCRIPT: Hello, everybody. This is Robert Mansour, and I wanted to make a brief video today about the issue of medical payments coverage. Medical payments coverage is something that a lot of people have under their insurance policy, and they're not even aware of it. Your auto insurance policy may have some coverage for you called "medical payments coverage," or MPC. What that means is, they basically serve as a health insurance company for you.
So, let's say you don't have health insurance. If you have medical payments coverage under your auto insurance policy, they might be able to pay for your health care coverage, or your health care needs after an auto accident. Now, it's important to know what the limits are of your Medical payments coverage.
So for example, you might have $2,000 available to you, or $5,000 available to you. You need to make sure number one that you have it available; and number two, you need to know what the limits are. In some cases, I have seen clients with $25,000 of medical payments coverage available to them. And the nice thing about this is that you can get your health care providers paid more quickly. Some of the health care providers don't understand personal injury cases, and they don't want to work on a lien, for example.
They don't want to defer their payment for later on in a case. They want to get paid now. And if you don't have health care insurance, it might be good to use your medical payments coverage. In some cases, the medical payments coverage will only pay after you've exhausted your health care coverage. So, if you use your health care coverage first and then you have some money left over that you have to get paid, some bills, you can use your medical payments coverage at that point. The other thing is that they may want you to exhaust your health care coverage first, your health care coverage options; or at least demonstrate that you don't have health care, before the medical payments coverage kicks in.
In many cases, and I would say in most cases, the insurance company has a right to reimbursement of their medical payments. So, let's say you recover money from the party at fault. You probably have to repay your insurance company for the medical payments they advanced on your behalf. So, it's not necessarily a freebie. So, let's say your insurance company pays $5,000 to the doctors on your behalf, under your Medical payments coverage. If you recover money from the other party, let's say you recover $10,000, you have to repay your insurance company for the Medical payments coverage that they extended for you.
Now, that is, in most cases, a contractual obligation that many clients aren't even aware of. So, make sure you talk to your lawyer about your medical payments coverage, whether or not it's even going to be available for you. And also make sure you discuss the right of reimbursement that most insurance companies have, when it comes to the medical payments coverage provision. If you don't have medical payments coverage, talk to your insurance professional and see if it will be appropriate for you. In most cases, it's not very expensive and it can be very helpful if you have a personal injury case. Thank you very much for watching this video. I hope you found it helpful.
If you need help with your accident matter, please call my office to learn more and see if we can help you with your personal injury auto accident case. Call (661) 414-7100. Also, visit our Videos page for more educational videos you may find helpful.
by Robert Mansour
Robert Mansour is a personal injury lawyer serving Santa Clarita, Valencia,