by Guest » Wed Nov 07, 2007 10:25 pm
I was hoping someone could provide me some advice in my situation.
I am a 70 year old driver in Oakland, CA who recently got into an accident with another car. I made a left and got drilled. I think he was speeding but my insurance company is still suggesting that they likely will concede the accident is my fault and pay the other driver's claim. (My insurance company's lack of enthusiasm in pursuing exonerating evidence is a whole other issue which I may post about later.)
My question is how do I pay my own medical bills from the accident. My medical care providers are insisting that Medicare requires me to submit a claim against the other guy's auto insurance carrier first and let that play out. I personally would be happier having my bills go through Medicare because of better negotiated rates with care providers, because I don't want to submit a claim to the other guy's carrier in an accident where the tea leaves are pointing towards my carrier accepting fault, because I don't want to incite the other driver in a claim that my carrier is so willing to roll over on, and lastly because I would prefer the other driver to not know the extent of my injuries as he may tread more carefully.
Anybody have any thoughts on what I can do? Is there a way to avoid submittiing my bills to the other driver's carrier?
Thank you
Jared
I am a 70 year old driver in Oakland, CA who recently got into an accident with another car. I made a left and got drilled. I think he was speeding but my insurance company is still suggesting that they likely will concede the accident is my fault and pay the other driver's claim. (My insurance company's lack of enthusiasm in pursuing exonerating evidence is a whole other issue which I may post about later.)
My question is how do I pay my own medical bills from the accident. My medical care providers are insisting that Medicare requires me to submit a claim against the other guy's auto insurance carrier first and let that play out. I personally would be happier having my bills go through Medicare because of better negotiated rates with care providers, because I don't want to submit a claim to the other guy's carrier in an accident where the tea leaves are pointing towards my carrier accepting fault, because I don't want to incite the other driver in a claim that my carrier is so willing to roll over on, and lastly because I would prefer the other driver to not know the extent of my injuries as he may tread more carefully.
Anybody have any thoughts on what I can do? Is there a way to avoid submittiing my bills to the other driver's carrier?
Thank you
Jared
Posted: Thu Nov 08, 2007 05:44 am Post Subject: tell us a bit about other things..
Hi there,
I can empathize with you, but at the same time would be interested to know a bit more about why your carrier is so keen on delivering it to the other party!
Also I'd like you to tell us a bit more about the accident, as to whether you had received a ticket at the spot or not & how many have witnessed your getting injured.
Regards, Fatman
Posted: Thu Nov 08, 2007 06:47 am Post Subject: U now have to try out different things!
Yes, might be he was speeding past but did they get noted as the party at-fault by the police ? Now please tell me if the other party has liability coverage in place ? or is it that they are under insured ?
Obviously I see no reason why you can't pursue this case with the help of an attorney, especially when you had suffered with the injuries as well as the car damage. In case you can establish that you are not at-fault with the police, then you surely stand a chance to get benefited out of the other party's liability. In case they don't have enough liability cover then you may then you may try using your UMBI (Uninsured motorist bodily injury). But yes, if you're already proved to be the party at-fault, then you're into a tricky situation for sure!
PlasmaO'Reilly
Posted: Thu Nov 08, 2007 08:02 am Post Subject:
Now in this case we have to try and understand one thing very care fully- the extent of damages & more specifically the injuries that the other party has suffered.
This would give us an idea as to why your insurer is so keen to pay them out. Because as you may understand that it is the at-fault party's liability-insurer's duty to pay towards the injuries of the other party. This is because even if the other party has an UMBI in place that would come to use if you were an uninsured motorist out there (which you're not in this case).
Wish you'd come out of this mess sooner than I expect! BalconsSS
Posted: Thu Nov 08, 2007 10:37 am Post Subject:
Good morning Jared70 and welcome...
Sorry but the prior two posts (not Fatmans) make zero sense to me, I'm not sure what these posters are trying to say....
Sounds like your carrier will (or has already) accept full responsiblity for the accident and no offense (I've been an adjuster for over 20 years) and nearly every ''left turn wreck'' that I have ever worked the turning party thinks the other driver was speeding. It's because the 'turner' has misjudged the others speed or distance, clearly or they couldn't have thought 'they could beat him' to the intersection and gone ahead with their turn. Even if it's true the other driver is speeding rarely, however can excessive speed be proven though. So that being the case, I really don't understand why medicare is insisting that you file a claim with the other carrier. Except that they need a 'denial' before they can proceed with paying your bills.
This is what I would do, once your company has 'formally' accepted liablity, (call your adjuster and ask), then I would call the other carriers adjuster and tell them that medicare needs a denial from them before they will pay your med bills. They can send you the denial directly and you can then forward it on to medicare. Ok? That should take care of it. You shouldn't have to actually 'submit' the bills, they will just send you a letter denying the entire claim, property damage and any and all medical treatments, ask the adjuster to specifically address/deny the medical portion in their letter of denial to you.
Posted: Thu Nov 08, 2007 05:34 pm Post Subject:
Hi Jared70,
I'm sorry to hear of your situation, and I hope that your injuries aren't that serious. One of the concerns you brought up in your OP was how you were going to get your medical bills paid that occured as a result of the accident.
I'm surprised that none of the responses brought up the idea of Personal Injury Protection coverage, or "PIP." PIP is coverage that will pay for the injuries sustained to those in YOUR car and is applied regardless of fault. You will not normally see a ton of coverage, limits can be as low as $1,000 in certain states. No decent producer that I know of would allow limits that low, I would suggest at LEAST $10,000 or more.
Now, California is NOT a mandatory PIP state, it's an optional coverage (at extra premium) that you may have on your policy. It's primary coverage, and should pick up your medical bills, possibly with a small deductible, up to the limits on your policy.
So...check your contract to see if you have this coverage attached to your auto policy. As well...have you spoken with your agent? He or she should be your main point of contact, and should absolutely be aware of the coverage you have.
Depending on the severity of your injuries, you may not even have to worry about Medicare if you have the coverage on your car insurance!
InsTeacher 8)
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