If you have health insurance, you should use it to pay your immediate medical bills as you get them. If the other driver is at fault, the bills will be paid back because the other insurance company must do so: Texas is an at-fault state.
While it may be tempting to wait for the other driver's insurance to pay your bills, that payment would not occur until a settlement or judgment is final.
Using your health insurance ensures that your bills do not go to collections, because ruined credit is the last thing you need while dealing with major injuries and a totaled car.
Additionally, by using your own health insurance you might end up paying less. You won’t have to pay each health care provider back separately after settlement or judgment.
Health insurance companies have agreements with most medical providers to pay only partial fees. When the case is concluded, your health insurance company will request reimbursement. This is known as subrogation.
At-fault states require at-fault party to pay for damages
States are either a no-fault state or an at-fault state. Texas is an at-fault state. This means that the person that is at fault in the auto accident must compensate the injured person for the amount that he or she is liable for.
These payments usually come from the at-fault driver’s insurance company. Accident damages that are covered under Texas law include:
Each at-fault state has required minimum insurance coverage that each driver must maintain. In Texas, the current minimum liability limits are:
$30,000 for each injured person
Up to $60,000 per accident
$25,000 for property damage per accident
Remember: This is the bare bones minimum. Depending upon how bad the accident is, personal and property damages could be much higher.
If your damages are worth much more than the other driver’s maximum coverage amounts, you can file suit to collect the difference.
Enjuris Tip: Texas follows a modified comparative negligence rule. You can only collect a percentage of damages that represents your degree of fault in the accident, up to 50%. Also, the injured person cannot collect anything in damages if he or she is 51% at fault in the accident or higher.
Contingency-based medical billing
If you have bills that your health insurance won't cover, your attorney may be able to provide access to doctors that will bill you on a contingency basis.
This means that the lawyer arranges for your medical bills to be delayed until a settlement is reached. The law firm would reimburse the doctor out of the settlement check.
If your attorney cannot make such arrangements for you, you could have to pay for your own medical care.
That huge hospital bill in the mail
Despite your best efforts, you still might open your mail and hit the floor: there’s a $9,000 hospital bill that you owe from your car accident. What should you do?
First, if you had a personal injury attorney on your case, you should call him or her immediately. Something could have fallen through the legal cracks with the billing.
Call your doctor or medical provider that sent the bill. Discuss the situation. The TDI website says that Texas law mandates that medical providers give you an itemized bill upon request. So check those charges carefully. The provider may negotiate on a payment structure.
TDI has a Consumer Help Line (1-800-252-3439) and can usually offer one of two things:
Mediation: TDI can work with the health care provider on a payment plan. Texas law allows most consumers to seek mediation if a bill is more than $500. TDI says it has helped 94% of consumers lower their bill in this stage.
Complaints: TDI helped Texas consumers save $490,518 in excessive medical bills in 2015.
File a complaint
If you think you received an unfair bill and still need help, you should file a complaint with the appropriate state regulator:
You may face ongoing health needs after an accident, particularly if you become permanently disabled. There are resources for people who do not have adequate health insurance coverage in that scenario:
Texans with disabilities may apply for benefits at their local Social Security Office (1-800-772-1213). Social Security forwards the applications to Texas Disability Determination Services (DDS) for a disability determination.
Texas Health Resources is a faith-based, nonprofit health care system that maintains a policy to provide care for individuals in need of financial assistance. Patients who are unable to pay for some or all of their treatment may apply for financial assistance.
Other financial resources
While you are recovering from your injuries, there is a good chance you are missing time from work. While health insurance may cover your medical fees it won't address your rent or mortgage, utilities, groceries or other basic necessities. But there are resources in Texas to assist you during these scary times.
The website NeedHelpPayingmyBills.com offers information on numerous government and private support services offered in the state, including county-specific information. Among those featured:
The Texas Comprehensive Energy Assistance Program utilizes the federal Low Income Home Energy Assistance Program (LIHEAP) to help residents in need pay utility and air conditioning bills, and for energy conservation measures.
Private sector resources
Community Action Agencies (CAAs): CAAs focus on providing services to the unemployed, working poor, low-income and the disadvantaged. Services may include career counseling, assistance with finding a job and services like budget and credit counseling. (Includes a contact list of CAAs across the state.)
Salvation Army: The Salvation Army has dozens of locations around Texas that may be able to provide emergency assistance and funding to the low income families who qualify.
Food Banks: Numerous nonprofits in the state provide produce, dairy products, holiday meals, meats, and more for families in need.
The journey to recovery after an accident can be a long one filled with complicated legal processes and medical appointments. Accessing the proper support services can help your family deal with these logistical hassles so that you can focus on your recovery.
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