What happens if medical expenses exceed auto insurance coverage after an auto accident?

Answer 1

1. Most states have a requirement that a registrant of an auto maintain "personal injury protection" (PIP) coverage (altho the name may be different). This is the essence of so-called no-fault auto insurance. Essentially, it pays a percentage of the insured's own medical bills and lost wages, up to a maximum amount, arising from an auto collision. It pays those expenses irrespective of fault for the collision.

2. Most insurers also offer a Medical Payments coverage. This is often an optional coverage. It pays an additional amount toward medical expenses , and often coordinates with the PIP coverage. Therefore, if the PIP coverage pays 80% of the medical bills, up to the policy limits, the medical payments coverage will pay the remaining 20% up to its policy limits.

3. If medical expenses exceed #1 and #2, one's major medical insurance is triggered. The auto insurance is "primary" in the sense that its benefits have to be exhausted before major medical insurance is called upon to pay. This is because auto insurance is required by state "financial responsibility laws" and for the further reason that it and the major medical insurance contain "coordination of benefits" provisions making the auto insurance primary.

4. If medical expenses still exceed the total available auto insurance and major medical insurance (including, if there is no major medical insurance), the injured party/insured is personally responsible for unpaid amounts. In this situation, the health care provider frequently is willing to work out payment arrangements. Alternatively, the unpaid amounts may be discharged in bankruptcy, but this is a very drastic step and should be avoided if at all possible.