QuestionHello from a fellow "All Expert" Walt DIsney World.
I have a general question regarding health insurance coverage as a result of a motor vehicle accident if you could be of any assistance.
My wife was involved in a MVA this past week.
When we set up our policy here in NJ, we chose to have our personal insurance company set as our primary provider for injuries (As per NJ No Fault Law). For some reason we still had to choose a PIP deductible with our auto insurance company. Because we chose our private carrier as primary I of course elected the higher PIP deductible ($2500). My wife was treated and released in the Emergency Room.
We are in the process of submitting a claim now and our auto insurance company is telling us that we will be required to pay the $2500 deductible. Our personal state health benefits plan is telling us that we will only be required to pay our normal $25 co pay for an ER Visit. It seems as if that I cannot get a straight answer from either organization. Can you provide any insight?
AnswerThe answer is "apples and oranges"....
You are fortunate to have BOTH Mo Fault (Personal Injury Protection (PIP)) and HealthCare coverage.
As you carry a $2500 PIP deductible any bills BELOW that amount should be subject to and handled/paid by your HealthCare carrer and subject to their "rules of the road" re deductibles, co-pays, etc..
IF you get to the point where you incur more than $2,500 in bills from this accident then technically your auto carrier would be on the hook for any bills over $2,5000 and up to your PIP limit.
IF you were to then exceed/exhaust your PIP limit of liability then any bills over that amount would revert back to your HealthCare provider.
I know it tends to be confusing but try and think of your coverage as layers with one sitting on top of the other.
Hope and trust that the above answers your question.
Feel free to get back to me any additional issues/questions relative to this matter.
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Thanks
