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Sergio Escamilla
Founding member

Should I use my health insurance if the accident wasn't my fault?

Sometimes, when accident victims visit the hospital,Hospital representatives tell you not to use your health insurance. Be careful!  In some states, like Arizona, this can be a big mistake.

First and foremost, you have to understand that hospitals do not wait for their money. If you don’t use health insurance, there is a good chance that they will bill you personally no matter whose fault the accident was. That is reason enough to be sure to use your health insurance. However, and more importantly, having health insurance is a big benefit to an accident victim especially in states like Arizona. Keep in mind, the hospital will not investigate how a crash or accident occurred.  That is not their job, and hospitals really do not care whose fault the crash was. Regardless of fault the hospital will want to get paid. Sometimes, when a motor vehicle accident happens, it takes time to generate a police report. Sometimes that report is not generated for several weeks. And even though the accident was not your fault, the hospital will likely and quickly request payment. They will not wait for a police report to be generated. Therefore, if you have health insurance, the hospital essentially receives payment or hold the account from collections because it is anticipating payment through your health insurance. Therefore, even if the police report has not been generated, your account is in the payment process and avoids collections when you use your health insurance. Later, if a copayment or coinsurance is owed, the hospital will bill you for that but only for that, thereby you are avoiding the entire bill.

There are other important benefits to using your health insurance also.  Most of the time, your health insurance will have a beneficial contracted rate with the hospital and other providers. Just to use a rudimentary example, let’s say the hospital bill was$5,000. Let’s say your health insurance has a contracted rate to pay the hospital $500 for that visit, and your copayment is $100. In a typical case, when a personal injury attorney sends out his or her demand, we send it out for the entire amount of the damages.  In this case, I bill the responsible insurance carrier $5,000. Sometimes the carrier will ask me “does your client have health insurance?”  My standard response is “it is irrelevant if my client has health insurance are not. Your insured caused the damages and is responsible for these damages and if my client happens to have health insurance that is a benefit for my client and not your insured.”  As you know health insurance premiums can be high and typically it is my client or my client’s family that pays for these premiums and not the auto insurance carrier that is responsible for the damages. Therefore, in many states like Arizona, the benefit of health insurance is passed on to the victim of a motor vehicle accident and not the responsible auto insurance carrier.  So in the example above, I bill the responsible carrier $5,000 and typically recover $5,000for my client.  Then, from those $5,000,I’d much rather repay and reimburse the health insurance carrier $500 that they originally paid, than to pay the hospital $5,000. If you subtract the $100co-pay in this hypothetical I netted my client a windfall of $4,400 because they were savvy enough to use their health insurance correctly. Therefore, typically people who use their health insurance receive a much better settlement than those who don’t use their health insurance.

It is also important to note that an attorney may be able to apply this strategy to government issued health insurance. For example, in Arizona we have state issued health insurance through Medicaid called AHCCCS (Arizona Health CareCost Containment System).  Again, this is health insurance that a victim of a car accident had to apply and qualify to receive the benefit. So again, this is a benefit you or your attorney should try to apply for the victim of a car crash, rather than allow it as a benefit for he person that caused the crash.  Many times, our office has been able to do that and have the benefit applied to the victim of the accident, rather than the person who caused the accident as related to government issued health insurance. Moreover, at times, we have had success getting the government issued health insurance to assist with a reduction of their lien (the amount that has to be repaid).  That’s why it is recommended you review your matter with a reputable and qualified personal injury attorney that has experience in this area because it is important to keep this strategy in mind when dealing with a car crash and resulting medical bills in the context of Medicaid, AHCCCS, Medicare, Tricare, or other government sponsored health insurance

One more thing to keep in mind that may be beneficial is hat sometimes there is no need to reimburse private health insurance. Hiring a qualified personal injury attorney is important so that he or she may assist you to make this determination.  An attorney will typically have to go through a comprehensive analysis to determine whether your private health insurance has a right to reimbursement.

The Responsible Driver Admitted Fault—Do I really need a Police Report?

When a car crash is caused by another driver, it is highly recommended you notify 911 and request the police come out to the scene as quickly as possible.  It is also recommended to make sure that you request police come out to the scene of the accident.  This is important so that you can document how the crash happened. Sometimes people that caused the accident will tell you that it was their fault, and everything will be fine because they have auto insurance to cover the accident. However, in the numerous automobile accident cases handled by our firm, we unfortunately see that sometimes the responsible person may try to change their version of how the crash happened.For example, when they call their own insurance carrier they might describe it differently. That may cause a serious issue for a crash victim that did not request a police report. If that happens, the case for liability becomes a word versus word battle if there are no independent witnesses. That may result in the insurance company for the responsible person denying liability because more often than not, they will take the position of their insured absent a police report or appropriate witnesses.  That’s why even if the at fault person says it is their fault in everything will be covered by their insurance it is still highly recommended that you, as an accident victim, call 911, report the crash, and request the police come out quickly.

Also, keep in mind that just because the police come outdoes not guarantee that they will make a police report.  That’s why it is also important that when the police do come out to the crash scene, you insist the investigating officers create a police report and cite the at fault party with an infraction.  That way it is clear as to who caused the accident and it is more likely that the other person’s auto insurance carrier will accept liability over the crash. Once the police report is created and the at fault party is identified, you have much more solid documentation of how the accident happened and who is at fault for the crash.  

Lastly, be careful when an officer tells you that the situation looks like minor property damage to the vehicles and no police report is required. Again, it is highly recommended you insist on requesting a police report be made because even if there is relatively low property damage, and you may not immediately experience the effects of any injuries, sometimes injuries are felt a day or two later. If that is the case and you did not create a police report, again your case may become more challenging when it comes to proving liability for the car crash.  Also, keep in mind that not having a police report will also make it more challenging to have your vehicle repaired or have repairs, rental car expenses, and storage fees, or loss of us e claims paid or reimbursed by the responsible auto insurance carrier.  

Therefore, even though it may take a little longer to wait for the police to show up, to sum up, it is typically recommended to report the crash to the authorities and always insist on a police report documenting your accident.

What should I do after a car crash and the accident was not my fault?

1. First, check that you and everyone in your vehicle is OK.

2. Call 911 for injuries and to request a police report.

3. If safely possible, take pictures and video with your cell phone. Remember to take photos of all the vehicles involved and from several different angles including close-ups and wide-angle pictures. Review any videos or photos you took to make sure you captured all the damage.

4. Seek the medical attention you need immediately.  Although you might feel fine after the car crash or you think your injuries are not too serious, injury symptoms sometimes appear hours or even days after the car crash. Getting medical attention quickly isn’t just the best thing for your body and personal health, but it will also strengthen any personal injury claim you may file later.  If you wait too long to see a doctor or medical professional, even though you were in pain or felt discomfort immediately after the crash, if you wait too long, you may not have that injury timely documented and it will be much harder to relate the injuries and pain to your crash.  Therefore, sooner is always better when dealing with injuries following a car crash.

5. Follow the advice of your doctor.

6.  We recommend you schedule an appointment quickly with a personal injury attorney. There are many pitfalls and strategies that the attorney can identify to protect or strengthen your claims after a car crash.  It is very important to make sure the appointment is with an attorney and not a secretary, a paralegal, or in intake specialist.  We have seen many injury law firms try to pawn off and set initial consult appointments with anon-attorney staff member because the attorney is busy or not available for the complete intake.  Be wary of that issue, and insist your appointment is scheduled with a state bar licensed attorney.  If the law firm’s attorney is not available for your appointment, be flexible and offer a different time, or you may want to consider calling another attorney that will take the time to meet with you.  At Escamilla Law Group, all our new consults are only handled by state bar licensed attorneys.

7. Hire a lawyer that you’re comfortable with to help you. It is preferable that an attorney assist you to open all relevant claims, including contacting your own insurance company.

It is important to note that this is not an exhaustive list by any means. Car crashes are complicated, and every case is different.  Also, every state has different laws and strategies that may apply.  That’s why we encourage you to contact and meet with a personal injury attorney that has a focus on personal injury claims and injury cases.  He or she should be able to guide you carefully depending on the specific nuisances of your claims.  At Escamilla Law Group, we have handled thousands of injury claims, and although we sometimes see similar fact patterns, no two cases are identical, and each requires personal input and case management.

I’ve Been Hit by Someone with no Auto Insurance and I am injured—What do I do?

Unfortunately, we all know every time our car tires touch a roadway, we expose ourselves to the risk of automobile accidents.  Some difficult scenarios play out when the person who causes the accident does not have valid automobile insurance.  This mainly comes up in three scenarios—(1) when the person that crashes into you stops at the accident scene, but admits they have no insurance; (2) when the person that causes the crash remains at the scene and gives you and/or the police an auto insurance card, but you later determine the insurance is lapsed or invalid, and; (3)  when the person that causes the accident by crashing into you immediately flees the scene of the accident never to be found, otherwise commonly known as a hit and run.

Any one of these scenarios can be scary, frustrating, and let's admit it, infuriating.  How could someone be so irresponsible and not obey current laws that require drivers to carry valid auto insurance when driving?  Unfortunately, this happens all the time.  Think about it, sometimes people lose their employment, are financially distraught, have an arrest warrant, or worse, are under the influence of drugs or alcohol while driving.  Although we can agree that driving without required insurance is an irresponsible scenario regardless of circumstance, working on personal injury matters, I see these situations arise regularly.  Remember earlier, I mentioned that when your auto tires touch the road, you run this risk?  That is why I always recommend to family, friends, neighbors, clients, and people that discuss these issues with me to always carry uninsured motorist insurance coverage, commonly known as “UM” coverage.  Since I can’t rely on irresponsible drivers to protect my family, friends, and people in my vehicles, I protect myself at all times by carrying uninsured motorist coverage.

Therefore, if you have been hit by someone and identified that they have no insurance, you need to look at your auto insurance declarations page (commonly called a “dec”page) to see if you carry uninsured motorist coverage.

UM should not be confused with collision coverage.  Some people I meet tell me, “don’t worry, I have that coverage” when I reference uninsured motorist.  Sometimes, what they mean to tell me is they have collision coverage on their vehicle.  This is different.  Collision coverage applies when anyone hits their car, regardless of fault, collision will get their car repaired or paid at fair market value if a total loss (minus any applicable deductible).  It is true, if someone carries collision coverage and they get hit by an uninsured motorist or suffer a hit and run, their car will be repaired or paid at fair market value as noted earlier, however, collision coverage does not address bodily injuries.  Therefore, the car damage will be addressed, but if the driver or the driver’s passengers requires medical care, such as an ambulance, hospital, therapy, or chiropractic care, collision coverage will not address it. However, UM will address the injuries and subsequent bodily injury claims.  Therefore, it is important to carry collision coverage to protect your car in a crash, but it is also tremendously important to make sure you carry an automobile policy with meaningful uninsured motorist coverage.  

If you do have uninsured motorist coverage, uninsured motorist will cover your bodily injury claims caused by a third-party crash where the responsible driver that caused the crash(tortfeasor) has no insurance or fled the accident scene and was not found.  The wonderful component of uninsured motorist coverage is that it not only covers you as the driver, but also covers family members, friends, and all passengers in your vehicle up to the policy limits you purchased on the policy.

The other benefit afforded by uninsured motorist (UM) that sometimes gets overlooked is that it covers more than just your medical bills.  Although it does cover medical bills such as ambulance, hospital, doctor, therapy, and chiropractic bills related to your auto accident, as well as those of your passengers, it covers more!  Uninsured motorist also affords coverage for other common auto accident bodily injury claims, such as pain, suffering, discomfort, and inconvenience as a result of injuries, lost earnings caused by the accident (wage loss), loss of love, care, and companionship of our clients familial and/or marital relationship (loss of consortium), loss of enjoyment of life, and any other damages deemed fair and reasonable resulting from the accident.

In addition, uninsured motorist (UM) is portable in Arizona, meaning, once purchased and added to your policy, it follows you no matter what vehicle you are traveling or using.  Even if you are in a bus, on a bicycle, in a friend’s car and that friend does not carry UM and you get hit, it will not cover your friend, but if you purchased uninsured motorist, it follows you and you get the benefit of having it.  And, there is more…in fact, people are often very surprised to learn this when I educate themas to accident law, uninsured motorist follows your resident relative family members and spouse, even if they are not named on your policy or with you when an accident occurs.  For example, if you have a child who is traveling in someone else’s vehicle (we call that the“host” vehicle), and that host vehicle gets hit by an uninsured motorist even if the host vehicle does not have uninsured motorist, your policy at home will follow your child and apply to him or her! This is even if your child is a minor child or adult child, and whether your child is listed or not listed on your policy.  It does not matter so long that child, or qualified resident relative, lives with you.

These are all great reasons to carry uninsured motorist coverage, but everyone is shocked and sometimes even excited to hear this next part.  Uninsured motorist is relatively cheap in price compared to liability insurance!  Yes, liability insurance is typically substantially more expensive than uninsured motorist coverage.  In fact, sometimes uninsured motorist coverage for a month can be as cheap as the cost of a Starbuck’s cup of coffee or two!  In fact, when I sometimes encounter people that don’t have UM and we discuss it, I explain it this way, “you pay a lot of money to carry liability insurance to protect others you don’t know, right?  Think about it, you pay a few more bucks and you protect you and the most important people in your life!”  Once we cover it that way, I often see my clients add it shortly after that.  I am not trying to sell anyone insurance—in fact, I am not licensed to sell these products, but as an attorney practicing exclusively in personal injury law, I am licensed to explain the coverages you have and explain what may be beneficial to my customers and their family.  Obviously, every auto insurance carrier sets their own pricing and you would need to shop around for it, but typically, you will be pleasantly surprised to find that regardless of carrier, it is typically much cheaper than the liability coverage required by law in Arizona.  It is recommended you consult with your insurance carrier or insurance agent directly to discuss adding uninsured motorist to your auto policy, as well as pricing.  Suffice it to say, I am a personal injury attorney that works in this area daily, and I would not drive without appropriate uninsured motorist coverage.

Every time my tires hit that road, I feel more comfortable knowing I am relying on my insurance carrier to protect my family and me rather than drivers that I do not know and may be driving without insurance.