Will My Car Accident Injuries be Covered by my Health Insurance?

Written by John D. Hawkins on . Posted in .

A car accident is one of the most difficult events to deal with, especially if you sustain injuries in the accident. Recovering physically and emotionally from car accident injuries is enough of a gauntlet already, which is why dealing with insurance companies in the aftermath can be so draining. It is tricky to make sure you get the medical payments coverage you need, as health insurance companies’ entire business model is to profit by denying as much reimbursement as they feel they can.

One of the trickiest parts of insurance is knowing what kind of insurance covers what aspects of your accident. Knowing that alone can save a lot of time and hassle, but the details can get complicated. Fortunately, HawkLaw, P.A. is here to help you get it sorted out. Learn which insurance you should be using after a car accident to get your medical bills paid in South Carolina.

How Does South Carolina Being an At-Fault State Affect Who Pays?

An at-fault state like South Carolina is one in which liability for an auto accident falls on the person who is responsible for it. Put simply, the one who is responsible for the accident is the one who has to pay for the injuries the accident caused.

Determining the at-fault party can be difficult, and the other driver’s insurance company is going to try and deny your insurance claim if they feel they can get away with it. When that happens, you may have to file a lawsuit to get compensation. For that lawsuit to be successful, however, you will need to prove in court that the other driver was at fault. 

It is important to note that South Carolina uses a modified comparative negligence standard in determining fault. Every party involved will be financially liable only for the portion of the accident in which they are responsible. For example, imagine you were in an accident in which you sustained injuries requiring $10,000 in medical costs. If the court determines you to be 20% at fault for the accident while the other person is 80% at fault, you will only be able to get compensation from the other driver’s insurance carrier up to $8,000 rather than the full $10,000. You will have to cover the remaining 20% of your costs. 

What Type of Insurance Is Needed to Cover a Car Accident?

The at-fault driver will have to cover the costs of the accident, and there are particular kinds of car insurance that are necessary to get the proper coverage. These types of insurance are liability insurance and uninsured motorist insurance. While drivers are legally required to have automobile insurance in South Carolina, there is still a chance that you could get into an accident with someone who has no coverage. That is when uninsured motorist insurance comes into play, and it is the rare scenario in which you would be using your own insurance rather than the insurance of the at-fault driver.

Car insurance requirements in South Carolina are fairly straightforward. Drivers are legally required to have liability and uninsured motorist coverage that extends to $25,000 bodily injury per person, $50,000 bodily injury per accident, and $25,000 property damage per accident. While drivers are, of course, free to get more coverage from their insurance provider if they choose, those are the legal minimum requirements.

Liability insurance specifically exists to cover accidents and even lawsuits related to them. In fact, insurers will pay for your lawyer if someone files a lawsuit against you. If you are the one filing the lawsuit, however, you will need to hire a car accident attorney on your own to combat the one from the insurance company, as they will try to protect their client as much as possible from paying for your medical care. 

If you are in an accident with another driver who is at fault, you will go through their liability insurance coverage for compensation. If the other at-fault driver is an uninsured driver, your compensation will come from your own uninsured motorist coverage. The South Carolina minimum requirements exist to make sure there is always recourse in the event of an accident regardless of who the at-fault driver is and what kind of coverage they have.

Since you might be going through another driver’s insurance, their policy limits can affect you directly. While a successful lawsuit can make them legally entitled to pay the difference that their insurance company will not cover, you still may benefit from underinsured motorist benefits. With this kind of coverage, you can go through your own insurance company to make up the difference if the at-fault driver’s insurance is not enough to cover your medical expenses.

What Is Personal Injury Protection?

Personal Injury Protection, or PIP, is a type of coverage that does not consider fault in what it covers. It is similar to MedPay in South Carolina, but there are some key differences. While both PIP coverage and MedPay will take care of medical and funeral expenses that result from an accident, PIP can cover more than just medical treatment, such as lost wages.

One of the main benefits of PIP is that it is no-fault insurance. Even if the accident was your fault, this insurance will still cover your resulting medical bills. You can also use PIP in addition to what the other driver’s insurer pays out in the event of an accident in which the other driver is at fault. This is especially handy if the other driver’s insurance is not enough to cover your medical bills and you do not have underinsured motorist coverage.

Can You Use Health Insurance If You Do Not Have PIP?

Yes, you can use health insurance absent of PIP. That should not be the go-to scenario since health insurance coverage does not quite work in the same way as PIP or MedPay. PIP and MedPay coverages have several important benefits over health insurance plans that you do not want to miss. The most important benefits are as follows:

No-Fault Coverage

PIP lets you benefit from coverage even if the accident was your fault. If it was not your fault, PIP coverage still applies, so you have coverage no matter the situation. Your health care provider may not offer the same benefit due to the subrogation clause in your contract.

Fills Health Insurance Gaps

Health insurers often leave gaps in their coverage as they try to deny you coverage. With MedPay and Pip, however, copays, deductibles, and any other expenses left out by your health insurance may be eligible for coverage. Not all health insurance policies have these gaps, but most of them do.

Faster Payout

Car accident lawsuits take time, and your medical bills are likely going to start piling up before the case is over. With MedPay, coverage is available right away, allowing you to start paying your bills as soon as possible.

May Pay If You Were a Passenger

You do not necessarily have to be driving to be eligible for PIP coverage. You can still get your bills covered as a passenger or even as a pedestrian who gets hit by a car. This kind of coverage is typically lower than the coverage you would have as a driver, though you can opt for greater coverage at a higher premium if you like.

When to Contact an Attorney?

You should contact a car accident attorney if you feel you are not getting fair treatment from an insurance agent. Remember, insurance companies profit by denying as much coverage as possible, so they may try to lowball any kind of settlement for your accident claim. Call an attorney if you have any disputes with your insurer or the other driver’s insurer after an accident. A personal injury attorney will have the experience necessary to represent you properly.

Are Insurance Adjusters Giving You a Hard Time After Your Car Accident?

At HawkLaw, our personal injury lawyers stand prepared to fight on your behalf after an accident so that you can focus on your recovery. HawkLaw Fights to Win! Call us now so that we can fight for you!

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Written By John D. Hawkins


John David Hawkins is the Founder and Owner of HawkLaw. He has been licensed to practice law in South Carolina since his graduation in 1994 from the University of South Carolina School of Law. Focusing on litigation, Mr. Hawkins is experienced handling Worker’s Compensation, Personal Injury, Social Security Disability, Administrative Law, and Criminal Law matters.

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