Years ago, when you went into the emergency room after an automobile accident, the facility asked for your health insurance and proceeded to bill your carrier for the services rendered. You might be responsible for your deductible if it had not been reached for the year, or your co-pay. That was it! Fast forward to 2026 and your visit to the ER looks totally different. Once you tell admitting that you were in an automobile accident (or are brought in by ambulance with a history of auto accident), your insurance no longer comes into play.
Most hospitals refuse to submit their billing to a patient’s health insurance once they know the facts of your injuries. This is because once they submit their bills to your carrier, they must accept the carrier’s reduced, negotiated rates. Meaning they must accept the same payment amount they would receive if the patient was NOT injured in an auto accident.
These hospitals are basically “voiding” a patient’s health insurance coverage and instead are placing a hospital lien on the patient’s auto accident claim. But, if you have medical pay coverage, the hospital will certainly access those funds. Unfortunately, medical providers have a limited time to present their billings to health insurance carriers, Medi-Cal, Medicare, or Worker’s Compensation carriers.
So, what happens to you if your carrier is not billed and the time limit for making a claim has passed? If you hire an attorney to sue the party who caused the accident: The ambulance, hospital and emergency room doctors will NOT bill your carrier and will put a lien on your case. If you receive less money in settlement, judgment, or arbitration that doesn’t cover these bills, you will have large medical bills that you will be responsible for even though you would have been completely covered with health insurance had those bills been timely submitted. If you don’t hire an attorney: The ambulance, hospital and emergency room doctors will NOT bill your carrier. Under both of the above scenarios, you should follow-up with those medical providers and insist they bill your insurance company. You will most likely have to call them numerous times INSISTING they bill.
In the past, Traut Firm has sued the hospital on very large bills that were not billed to clients’ medical insurance. If a client comes to us after the time limit for billing insurance has run, we will negotiate to reduce these medical bills and, if necessary, sue the hospital if not reasonably reduced.