Getting Medical Bills Paid After a Car Accident in Philadelphia – Pennsylvania PIP Law


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Part 2 – Car Accident Medical Bills After PIP Exhausts

Making a PIP or personal injury protection claim is probably one of the most complex and confusing things about getting into a car accident in Pennsylvania. The insurance process can be incredibly frustrating, and Pennsylvania PIP law certainly doesn’t make things easier.

Part 1 of this article explained how medical bills get paid after a car accident in Philadelphia and discussed the basics of PIP coverage. Part 2, below, will discuss how medical bills get paid after PIP exhausts.

As part 1 of this article discussed, many Philadelphia area residents choose the minimum PIP limit ($5,000) on their car insurance policies. This means that someone injured in a car accident in Philadelphia can make a claim for PIP benefits (i.e., medical benefits) up to $5,000.

When PIP Coverage Exhausts

While $5,000 in medical benefits/PIP coverage might sound like a good amount of coverage, it isn’t. In serious injury cases, a $5,000 minimum PIP limit can exhaust quickly. For instance, after a high speed multiple car accident on Kelly Drive or Roosevelt Boulevard in Philadelphia, an injured driver or passenger may need extensive medical treatment. Hospital bills from the emergency room alone can exhaust the $5,000 limit. If an injured driver or passenger needs surgery after a car accident, the $5,000 will almost certainly exhaust. So what happens after the $5,000 limit is reached?

The Role of Health Insurance After PIP Exhausts

After PIP coverage is exhausted, individuals will use their health insurance to pay for additional medical bills. For example, as a result of serious injuries and extensive medical treatment, an injured driver’s PIP coverage exhausts with the first hospital/ER visit. After being discharged, the individual needs rehabilitation care as well as follow-up care with specialists such as an orthopedic doctor. Since the PIP limit was reached, the medical bills for rehab care and the orthopedic doctor would be submitted to private health insurance. The individual would then have to pay for any co-insurance, co-pays and deductibles as required under the private health insurance plan.

Individuals who do not have private insurance can use publicly funded health insurance such as Medicaid or Medicare to pay for medical bills after PIP exhausts.

Claims for Medical Bills in Car Accident Lawsuits in Philadelphia

An individual injured in a car accident caused by another party may be able to recoup out of pocket costs for medical treatment by filing a car accident lawsuit against the at-fault party. This includes any co-pays and deductibles. In addition, in many instances, the health insurance company (private, Medicaid or Medicare) can assert a right to be paid back, in the event the lawsuit is successful. This is known as a right of subrogation. Visit our PA car accident law library for more info, brought to you by our car accident injury lawyers.

Other Claims for Financial Compensation in Car Accident Lawsuits in Philadelphia

Medical bill claims are not the only types of claims for financial compensation in car accident lawsuits. Claims may be made for lost wages and other out of pocket financial costs. In addition, depending on the facts and circumstances, an injured individual may make a claim for pain and suffering.

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