Injured in An Automobile Accident? Who Will Pay Medical bills and Lost Wages?

Under Delaware’s No-Fault Law, persons injured in an automobile accident can send their medical bills and lost wages to their own automobile insurance company.

To do, so you must:

1. Contact your automobile insurance carrier and request an Application for Benefits and a claim number.
2. Give the claim number to your doctors and any other medical providers.

Most insurance companies require, that you pay for prescriptions and supplies yourself, and then submit the bills for reimbursement. The insurance companies will pay you, not the pharmacist.

Delaware Personal Injury Protection (PIP) covers more

Delaware law requires every automobile to carry Personal Injury Protection coverage or “PIP.” It is also often called “no-fault” insurance. Delaware law requires that at a minimum, each automobile or truck registered in Delaware must carry insurance coverage of at least $15,000 per person and $30,000 per accident.

Your PIP pays your medical bills and lost wages for 2 years after your injury, or until all the coverage maximums are depleted. You are required to register your vehicle and purchase this insurance for your vehicle.

PIP will pay for the following, provided it is deemed necessary, reasonable (medically and fiscally), and that the need was caused by the accident:

• Medical expenses such as doctor and hospital bills, surgery, medical tests, x-rays, ambulance service, and physical therapy and chiropractor charges.
• Dental expenses.
• Medicine, prescriptions, medical supplies and items like crutches, prosthetic devices, soft collars, and more.
• Lost wages you would receive after taxes, even if you are self-employed.
• Costs of hiring someone to do the things you would have done if you were not injured, like laundry, lawn mowing or household chores. You will need a note from your doctor stating that you were not able to do these things along with billing statements for the services provided.
• Funeral services, including all customary charges and the cost of a burial plot for one person, up to $5,000.

Remember these important points about PIP

• PIP coverage applies to all occupants of a car.
• In general, PIP applies to your relatives living in your household who may be in an accident in a car that does not have no-fault coverage.
• If you are a pedestrian or riding a bicycle and are injured by a vehicle, you are entitled to PIP coverage from the vehicle that hit you.
• Your insurance company cannot raise your rates if you make a PIP or no-fault claim.
• Although PIP lasts for two years, all medical bills and requests for wages must be submitted to the insurance company within 27 months of the accident.
• The Statute of Limitations for a PIP case is three years after the insurance company refuses to pay expenses they should have paid.
• Any expenses paid by PIP cannot be awarded in a settlement or trial against the at-fault driver.
• If your medical bills and lost wages go beyond your maximum PIP, or last longer than 2 years, they can be collected against the at-fault person’s insurance provider.
• You can purchase additional coverage, up to the amount of the liability coverage you choose. So, for example, if you purchased more liability coverage than the minimum required by law, say 100/300, then, you have not only more- realistically insured yourself from the claims of others, you also can protect yourself with additional PIP insurance up to 100/300 as well.
• You can still collect compensation for “pain and suffering” and medical and wage expenses not covered by PIP.

Your insurance company may try to limit your right to medical bill and lost wage payments by sending you to their doctor for an examination to determine whether their doctor thinks you should continue to have treatment or if you can return to work. If the insurance company doctor writes a letter that conflicts with your own doctor’s opinion, your insurance company will not pay your PIP benefits. The Delaware Insurance Commissioner has a procedure to have disputes like this decided.

Pennsylvania law differs from Delaware

• Pennsylvania law requires that an auto insurance policy provide First Party Medical Benefits of at least $5,000. That means that if you are involved in an accident, whether it was your fault or not, your insurance company will pay the first $5,000 of your medical bills.
• Although Pennsylvania law does not require First Party Wage Loss Coverage, if you choose to purchase it, this coverage will pay a portion of your wages in the event you are injured in an auto accident.
• Your ability to successfully recover compensation from the “at fault” driver depends upon your insurance. When selecting your auto insurance coverage, you will be asked to choose either “full tort” or “limited tort.” Limited tort is less expensive coverage, but substantially restricts your rights if you are the victim of an auto accident. You may seek only “economic damages” against the “at fault” driver, including medical expenses, lost wages and other out-of-pocket expenses, unless you sustain a “serious injury.” This means you are barred from obtaining any compensation for your “non-economic damages,” such as pain and suffering.

MacElree Harvey has attorneys experienced with the laws in both Delaware and Pennsylvania. This is just one of the many advantages of working with a regional law firm.

The following article is informational only and not intended as legal advice. Speak with a licensed attorney about your own specific situation. © Copyright 2011 MacElree Harvey, Ltd. All rights reserved.