QuestionQUESTION: My son had an no-fault accident. His tire blew out and lost control and the car is totaled. He was taken to the emergency room and treated and we have had 2 follow up visits. My car insurance company will pay $5K on his expenses. I just received the first bill from the hospital and it is $4K. This does not include ambulance. He has health insurance with a $3500 deductible. I have not sent in any bills to anyone yet but the car insurance company is waiting for me to send the bills. Can I also file on the health insurance to pick up the remaining amounts after the car insurance pays the $5000 and will that be considered as the $3500 deductable on the health insurance already paid? I'm just trying to get these bills covered since we will already have to replace the car (liability only).
ANSWER: Hello Susan,
I am going to assume that the $5000 from your car insurance is your No-Fault Arkansas coverage. Almost always, health insurance coverage is secondary to auto coverage. In other words, health insurance will not pay until the auto coverage is exhausted. That being said, I am going to assume that your limit for no fault is $5000. One that is paid, your son would be entitled to health insurance benefits.
Usually the health provider will send the billings directly to your auto insurance carrier for payment. However, if that has not been done, make certain you forward those bills without delay.
As for the deductible for the health insurance, I can't say for sure, but I believe it is unlikely that your No Fault coverage would serve as a deductible for health insurance. But I would suggest that you check your son's policy, or have him call for details. I presume, though, that the $3500 deductible will be deducted from the benefits he does eventually receive.
I wish you well. Let me know if you need further information.
Jane Pytel
http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com
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QUESTION: Actually they told me he was covered medically under the "underinsured" part of our policy. That's another thing I don't understand because he is on my insurance as the 02 driver. We only had liability on that particilar vehicle so I don't expect them to pay for the car. I just don't understand why his medical would be covered as "underinsured". I had also noticed on several posts that the advice given was to always file on your health insurance first.
AnswerHello Susan,
Understand that I do not have a copy of your policy, but I also find it confusing that he would be covered under "underinsured". Underinsured like uninsured, is protection from an uninsured or underinsured driver. But in this case, your son was involved in a one car accident. I would suggest that you read your policy definitions and also call your adjuster to answer your questions. As I stated before, if you purchased No Fault insurance, I would assume that would be the coverage applicable.
I have never heard of filing with health insurance first when there is auto-injury coverage available. In my experience, auto insurance is always primary. The exception would be in a state where there is only a tort system, that is, bodily injury liability. In that case, yes, one would file with health insurance. However, you live in a state where your auto insurance is responsible for at least some of the medical billings, making it primary.
Again, I suggest you read your policy and then speak directly to the adjuster.
Good luck.
Jane Pytel
http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com
