Pain and Injury Doctors

Best injury doctors in San Antonio.


Who pays for care after a car accident if it isn’t my fault?

Car accident injury severe

Typically, the person who caused the accident will pay, that is of course if they have insurance. If they don’t have an insurance they will still be responsible for care but it will be difficult to get compensation from them.

But before we get into the details of who pays, it’s important to understand that this can be a long process, so let’s start from the beginning.

An accident has occurred, if everyone is okay there is not a need for an ambulance, but it is heavily recommended that you call for the police to have an accident report created.  While this does not seem too important if all parties are okay and there seems to be only physical damage to your vehicles, it is still vital to have because without the report, it comes down to your word versus the responsible party’s word.  I have seen many people talked out of calling the police by the responsible party, by providing their information and promising to fix everything, only to hear from my patients that the responsible party then turned around and claimed it was the other party’s fault.  Most of the time, they are able to get things proven by the damage on the vehicles and the reports of the parties involved, but not always.  This will leave you will possibly having to pay the bills through your insurance or out of pocket. 

However, if a police report was made and it has been proven that you are not the responsible party, then it will depend on whether or not the other party has insurance.  If they are not insured, you may find yourself having to go through your insurance or out of pocket to cover your losses. 

If you have insurance and the other party does not, then you will have to see exactly what coverage you have available.  If you have Personal Injury Protection (PIP)it can be used to cover the cost of your vehicle, treatment or lost wages.  Great news!  But…Wait.  Most PIP plans are only for $2,500.  If you were taken to the hospital after the accident you can rest assured that most of that amount, if not all of it, has been exhausted.  Unfortunately, $2,500 is not a lot of money when it comes to hospital and medical bills but it is a great starting point.  This would be a great time to see if you have PIP coverage within your policy.  If you do not, you should really consider adding it.  For $2,500 of coverage you will normally only pay a few more dollars per month.  At the very least, it will help you cover some of your expenses.  If you already have PIP for the minimum amount, you should greatly consider upping it to $10,000 in coverage.  It will be slightly more per month that it already is, but you be glad you have it if you ever have an accident. 

No PIP?  Well, you can look into your coverage to see if you have something called Uninsured Motorist Coverage.  It is what it sounds like.  Coverage in case you are in an accident with a motorist who does not have insurance.  This is not standard and you will need to see if you have this type of coverage.  It will cost more per month, but will be worth it should you have an accident what a motorist who does not have insurance.

At this point, if the other party does not have insurance and you don’t have PIP or Uninsured Motorist Coverage, you may have to file a claim against your own insurance.  This is called a First Party Claim.  You will need to call your own insurance company and report the facts of the case.  Remember, an insurance company will help you, but their ultimate goal is to save as much money as possible.  Be honest and don’t let them talk you out of care that you may need in order to save you both time and money.  Get the care that you need and that you pay for in monthly premiums.

Now, what do you do if the other person does have insurance? 

If you have filed a police report and the other party has insurance you will need to find a place to treat.  Most family practice doctors, your regular medical doctor who sees you for all of your problems, will not treat you for the injuries that you have sustained.  Many patients I talk to are upset because they don’t understand why their normal doctor won’t see them.  When patients walk into my office, they are still upset and for good reason.  Most emergency room doctors and administrators do not tell patients where to go after they have been treated at the hospital.  In fact, the injured patients are often told to see their family doctors after being released from the hospital.  Thinking that information is correct, many patients will call their doctors and make an appointment.  Often times waiting a week or more to see their physician, only to be told in the waiting room or as soon as they see the physician that they can’t be treated.  The reason – because they are a car accident victim and their office can’t treat car accident victims.  Many times no other reason is given.  I will tell you why they won’t treat you.  It is because they do not accept third party insurance claims. 

A third party insurance claim is a claim by one party against the insurance of another party.  In our case, it will be you, the victim, filing a claim against the other party’s, the person responsible for the accident, insurance company.  Most medical doctor’s offices do not want to deal with this type of claim because it can sometimes become delayed or not paid out at all.  This type of claim is too risky for doctors who don’t deal with the insurance complication often enough, so they will not take the chance of not getting paid. 

Luckily for most patients, there are always a few clinics that take third party insurance claims.  At San Antonio Pain and Injury Doctors, we specialize in third party insurance claims and welcome all patients.  We work with insurance adjusters to ensure that you get the care you need by following state guidelines and getting documentation over for review right away.  Our goal is to get you better as fast as we can.  Many times we can get a person better without affecting their work or school schedules.  We have convenient hours and are open on Saturdays to help get patients in for care. 

I have heard that I need an attorney?  Is that true?

Not always.  I have treated many patients who went the path of the third party insurance claim with no problems.  It is often easier to get the care done and submitted through a third party claim if there are no problems with the case and liability has been accepted by the responsible party. 

Sometimes though, attorneys are necessary.  I would consider an attorney if your injuries are severe or you are already getting friction and trouble from the claims adjuster about your accident and care.  If you hire an attorney, the insurance company must contact them instead of contacting you directly.  This is a good thing if they are constantly contacting you asking for an update or if you have finished care and are ready to settle for a specified amount.  An attorney can also help you by gathering information for your case and getting information ready in case the whole thing has to go to court.  Finally, an attorney is especially helpful at assisting in getting you the care you need.  Most car accident clinics that do third party insurance claims, also accept Letters of Protection (LOP’s) from attorneys.  An LOP is a somewhat promise from the attorney that the medical bills accrued in the process of treating the patient from injuries suffered from the accident will get paid if there is a settlement.  I know LOPs don’t sound too impressive, but many times, that LOP will get patients in the door to get MRI’s or see pain specialists. 

It is important to know which attorney to choose, as not all attorneys are personal injury attorneys.  Plus, you want an attorney that will be willing to go to trial, not all attorneys are ready for that type of commitment.  At San Antonio Pain and Injury Doctors, we work with many experienced trial based attorneys and have several options for patients to choose from should they so desire an attorney to represent them.  Give us a call today if you have any questions regarding your care or your case.  We offer a no-cost consultation to all personal injury victims.  

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