by Kimberly » Sat Jan 10, 2009 09:09 pm
I was involved in a car accident recently. I live in the state of TX and had the minimum $2,500 Personal Injury Policy because I also have health insurance. I have been using the $2,500 for out of pocket expenses such as copays and deductible amounts because I was injured in the accident and cannot work. My health insurance in now stating that I must pay the $2,500 PIP funding to reimburse them before they continue paying my medical bills, and that I am still responsible for my copays and deductibles. Is this correct and is PIP subrogatable in the state of TX? I understood the a PIP is to protect and help cover additional expenses related to the accident...
Posted: Sat Jan 10, 2009 10:17 pm Post Subject:
PIP is primary so your health insurance should not have been paying for your auto accident related treatment up front. Yes, your health carrier has a right to collect their money back from PIP for this reason.
Posted: Sat Jan 10, 2009 10:36 pm Post Subject:
Kimberly, was this accident your fault or is there another party you will be pursueing an injury settlement against assuming your med. bills eclipse the threshold?
Tcope is of course correct...PIP should've paid out their limit, THEN your health carrier step in, then there would not have been any subro at all (unless there is a third party responsible)...Health carriers always have the right to subrogation, (all I've seen anyway)....did your PIP rep not discuss with you your health carriers responsiblity in this?
Posted: Sun Jan 11, 2009 05:52 am Post Subject: I was involved in a
The accident was my fault, so no other insurance involved.
The PIP was paid directly to me, therefore I applied it toward a few balances remaining on medical bills. I understood that I could apply the PIP payment toward my out of pocket medical expenses and lost wages.
Posted: Sun Jan 11, 2009 01:22 pm Post Subject:
Kimberly, I guess what you need to do now is contact your health carrier, and advised them of this...I'm sure you can prove that is what the money was used for, and see if they will back off after that...You might also ask if they sent a lein or subro demand to your carrier? I don't know if your state would require this or not....if so then the adjuster will have to pay it again....(although I doubt they missed this)....how long ago did you get the demand from your health carrier? and have you talked with them at all?
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