Forum - Questions & Answers

Apr 24th, 2014 - michellediane

Motor vehicle accident, bicyclist hit by car

Patient was on his bicycle and got hit by a car. We live in Florida, a no fault state, so usually when someone's involved in an automobile accident, we submit it to their own auto insurance. However, patient does not have auto insurance. Is this something the patient's health insurance will cover?

Apr 24th, 2014 - Cat1 41 

re: Motor vehicle accident, bicyclist hit by car

I'm in California...wouldn't the victim's health insurance cover his care? Anyone else?

Apr 24th, 2014 - shanbull 51 

re: Motor vehicle accident, bicyclist hit by car

Yes, we have a few patients in this situation (one of whom was hit by a car that drove away without stopping to see if he was ok and has never been identified). There is some mandated coverage from the Uninsured Motorist fund of the plaintiff's insurance even in no-fault states/when the patient wasn't driving, so your patient should definitely file a claim if he hasn't already done so.

We try to bill both the patient's auto insurance/UIM insurance (first) and the health insurance (once we receive a denial from the auto insurance/UIM insurance), remove any payment adjustments and do not bill the patient for copay/deductible/coinsurance. The patient's lawyer enters into arbitration for the remaining balance to be paid by either the patient's UIM or the plaintiff's auto insurance.

You will need to double check your state laws to make sure you can remove adjustments on the payments from both auto insurance and health insurance, I know it's legal here but not sure about other states.

The best thing to do right now is get the patient's attorney's information and stay in contact with the attorney about what is going on with the benefits and arbitration.

More info here: http://www.alllaw.com/articles/nolo/auto-accident/pedestrian-hit-by-car-compensated.html

This is a blog on the subject by a lawyer in Florida: http://www.justinziegler.net/does-a-pedestrian-hit-by-a-car-in-florida-have-a-case/



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