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Do I still have a case if health insurance pays my medical bills?

If you were involved in an accident that caused you to experience a personal injury, you are likely wondering if you can seek compensation even though your health insurance will cover your bills. The answer to this question is complex and depends on several factors you should keep in mind.

The state in which you live, the type of insurance you have and the type of accident you had will all play a role in the outcome you can expect. This guide breaks down each factor that impacts your case to give you an idea of how to proceed. As always, seek the advice of an experienced personal injury lawyer to understand the laws that apply to your situation.

No-Fault States

A lot of people live in no-fault states. Those who live in those states must buy no-fault insurance that offers coverage no matter who is at fault for the accident. If you are in an accident and have no-fault insurance, your insurance provider will pay your medical bills. You should keep in mind, though, that many no-fault policies have a limit of around $10,000.

Some states allow you to seek compensation from the other party if your medical bills are higher than your coverage limit. Do an online search to determine whether or not you live in a no-fault state to get an idea of what you should expect as your case unfolds. Reviewing your policy is another excellent way to discover the type and limits of your coverage, but do not forget to discuss everything with a lawyer so that you don’t overlook vital facts.

Tort States

If you do not live in a no-fault state, you live in a tort state. Texas is a tort state. These states require the injured person to prove the other driver was at fault for the accident to cover the medical bills and other losses. If you have been involved in an accident, contacting the police is important.

If the police give the other driver a citation but do not give one to you, proving the other driver was at fault will be much easier. Keep in mind that the insurance companies can disagree with the police officer’s decision about fault. However, if your case goes to trial, having police reports on your side can turn the tides in your favor. When the other driver is at fault and their coverage limits do not pay for all of your damages, then you may be able to make a claim against your own insurance policy if you have underinsured motorist coverage.

Property Liability

If you were injured on someone else’s property, you are likely wondering if their insurance will pay the related medical bills. Most businesses have property liability insurance that covers injuries that occur on their property. If you are at a store and have a slip-and-fall accident, the property owner’s insurance will cover the incident if you can prove that the property owner or its agents were negligent.

Some property insurance policies also contain medpay which will cover medical bills regardless of who was at fault for the accident. However, this coverage often has low policy limits of $500, $2,500, $5,000, or $10,000 if the property owner carried it. If you need extensive medical coverage, your health insurance policy will likely activate. You can file a claim against the property owner if you can prove the property owner knew or should have known about a safety hazard and failed to warn you or make it safe before the accident.

Boat Accidents

Boats may also be covered by liability insurance. If you are a passenger in a boat accident involving more than one boat, you could file a claim against your driver and the driver of the other boat. Boat drivers can only recover against the other party when they are 50 percent or less at fault for the collision. You can make a claim for medical bills, lost wages, pain and suffering, mental anguish, and/or physical impairment if you are injured in a boating accident.

Final Thoughts

Determining who will pay your medical bills and if you can still sue if you have insurance is not always easy. To keep things simple, your insurance will cover your medical bills no matter who caused the accident if you live in a no-fault state. Tort states require the person at fault for the accident to pay for the losses.

If you need more advice or would like to get guidance unique to your situation, reach out to a caring personal injury lawyer.

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