Auto Insurance Claims: Personal Injury Claim, personal injury protection coverage, lump sum settlement


Question
I was recently in an accident after trying to pull over for an ambulance in
snow and ice. I was the driver of my sister's car. I wasn't badly injured but my
mother was. We have filled out all the forms sent to us and sent all bills we've
received but the insurance company hasn't paid for any of her expenses and
refuse to pay my expenses (ambulance and emergency room) as I was the
driver. (They've sent my bills to my insurance company.) My sister had
comprehensive coverage. The insurance company has delayed returning our
calls and just recently called my mother to tell her the claim would not be
paid until all bills are sent in and that she would either need to sign a form
stating there would be no further bills or she would have to sue me or my
sister. The insurance company has passed my mother's bills on to medicare.
We feel my sister paid for auto insurance and it should pay the bills.  Can we
(sister and mother and I) sue the insurance company to get payment for
personal injury?

Answer
Hi Cindy,

Each state has different laws and requirements on how medical bills are to be handled.

If you were not at fault and you are dealing with the at-fault persons insurance company, they will not pay individual medical bills as they are incurred. Instead, they will do a one time lump sum settlement once all of the treatments are completed. You will have to sign a release form in exchange for payment.

If you are dealing with your sisters insurance, how the bills are baid will depend on your state. If she has PIP (Personal Injury Protection) coverage then the bills will be paid. Unless you have your own insurance, then they may be payable by your policy.

It can get very confusing. You should call the insurance company and tell them to send you a letter explaining what bills will be paid, how they will be paid and who is responsible for what. If you still do not feel they are treating you properly, you should seek the advice of an attorney in your area.

I hope this helps
Richard Hixenbaugh