I just got my car accident settelment, And I understand that I will have to reimburse my insurance for what they paid, but can I bill them for my premiums?
Total Comments: 7
Posted: Wed May 05, 2010 11:56 pm Post Subject:
My hunch is that you're wanting to know if, in addition to the settlement dollars offered, you can get them to pay your premiums for your car insurance as well?
If that's a correct assumption, the answer would be no. Why not? Simple... you would have made your insurance premium payments regardless of having an accident or not. The other party cannot be held liable for your insurance premiums. Wage loss settlements, as part of your overall settlement process, is paid to you to take care of these exact things.
You make your wages to pay your bills. The insurance premiums is another bill. Therefore, wage loss compensation you were paid is intended to take care of these "bills."
InsTeacher 8)
Posted: Thu May 06, 2010 03:28 pm Post Subject:
Got to give him credit for trying!
It's like saying to the Meat Dept manager at Sam's Club, "I ate every bite of that $6/lb rib eye steak, just to be sure I wasn't happy with it. And I wasn't. Now, please give me my double-your-money-if-you're-not-happy refund."
Posted: Thu May 06, 2010 06:00 pm Post Subject:
I should of made it clear I guess. Sorry. I meant since Im paying back to my medical insurance what they paid for my treatments, can I bill my medical insurance for my premiums?
Posted: Thu May 06, 2010 11:07 pm Post Subject:
Still not sure of what you're looking for. Are you asking your medical coverage plan to pay for your auto insurance premiums? Your medical insurance premiums?
Regardless of which, it's not going to be done. Premiums are the responsibility of the policy owner...always (unless there is some court order dictating otherwise). I don't see any method by which you could get anyone to pay any insurance premium due to this loss.
InsTeacher 8)
Posted: Fri May 07, 2010 09:13 pm Post Subject:
Im asking after I pay everything back to my medical insurance from the settelment that I got from my car accident, can I bill my medical insurance for my medical premiums (o: But you already answer that either way. Thanks.
I wish I found this forum before my settelment.
Posted: Fri May 07, 2010 09:18 pm Post Subject:
I just think that Im paying my premiums for medical insurance so when I get hurt my medical insurance will cover the cost of my medical expence. So if I was in the car accident wouldnt make sence for my medical insurance to cover my treatments and not accept their money to be recovered?
Posted: Fri May 07, 2010 10:47 pm Post Subject:
So if I was in the car accident wouldnt make sence for my medical insurance to cover my treatments and not accept their money to be recovered?
OK . . . this is the common misconception that folks have about their medical insurance. Perhaps it will help if you think about it as you would your collision coverage on your auto insurance. So let's start with that analogy:
If you drive and crash into someone, and the accident is your fault, what component of your insurance pays for the damages to the two vehicles and the injuries?
Your LIABILITY coverage pays for the damage you do to someone else's car/property. Your COLLISION coverage pays for the damage you do to your own car. Your LIABILITY insurance pays for the injuries you cause to someone else, your MEDICAL insurance pays for your own injuries.
If someone crashes into your car, and it's their fault, your COLLISION coverage is not intended to pay for the damage to your car, because the damage is caused by a third party. Their liability insurance pays for your damages -- both to your car and to your body.
For the sake of convenience, your auto insurer will pay your claims with your collision coverage, minus your deductible, and will then work to obtain restitution from the other party's insurer. You must "subrogate" the claim to the insurer, which simply means that you give up the right to go after the offending party for the SAME thing for which the insurance company has already indemnified you. No double dipping.
If the insurer collects the full amount of the damages, including your deductible, you will get a check for your deductible. You would not get anything for having paid your insurance premiums -- you want the coverage, you have to pay for it. If you don't get your deductible back from either company, then you can sue the offending party for their personal liability for your damages -- you should not have to be subject to a deductible if a third party causes your damages.
Now, as far as your medical insurance is concerned, it is provided to you to cover your illnesses and injuries that you (or members of your household) cause/suffer/acquire. You pay them a premium, and they promise to provide your care. They promise to indemnify you so that you are not financially responsible, in whole or in part, for your unintentionally "self-inflicted" damages.
If someone outside your household causes your illness or injury, as for instance a traffic collision, your insurance is not expected to pay for that. Think about Workers' Compensation insurance. You work, if you get hurt at work, your claim is paid by your employer's insurance policy. If you do use your personal medical insurance to pay for a work-related injury or illness, the insurance company will submit a claim to the Workers' Comp carrier for reimbursement, since that is the policy that actually covers the loss.
So in the case of a traffic collision, if you use your own medical insurance to pay for your injuries -- as most people would (at least initially) -- because they are due to a third party's negligence, that party actually has the responsibility to indemnify you -- to restore you financially to the condition you enjoyed prior to the loss. It is not your medical insurance's responsibility to indemnify you for third party damages.
But they'll honor your contract and provide your care, and then they'll have the right to collect 100% of what you would have paid them if you had no insurance (or what you would not have been liable for according to the contract). They'll collect it from the other party's liability insurance carrier, or they'll collect it from you when you settle with that party and/or their insurance company. (And if you deliberately fail to inform them that your injuries are the result of a third party's negligence -- like breaking your arm while playing on your neighbor's slip-n-slide toy -- technically, you are committing insurance fraud.)
It's easier for the medical insurance company to simply sit back, quietly, and wait for you to do all the work for them, and then send you the letter that says, "Oh, by the way, did you know there is a subrogation clause in the contract you have with us? It says that we may collect from you the full amount we pay to cover your care in the event of a third party illness or injury. So that's what this letter is all about. We'd like to collect the $33,218 you owe us from the $35,000 you got from their insurance company."
But guess what? Your medical insurance contract also says if your "damages" are the result of a third party's involvement, even if you don't collect any money from the third party, your insurance company still has the right to come after you for the cost of the care they provided. Because they did not agree to provide the protection to you for things caused by third parties.
Either way, if you don't pay the money to them, they can sue you in civil court for breach of contract. Not the fact that you were injured and used the insurance, but that you received money for your medical bills that were covered by insurance, but the bills are the result of a third party event, and you owe them the money according to the terms of the contract.
If you never paid them a dollar in premium, how would they ever have been responsible for a penny of your medical care? If you are asking them to give you back the premium money, its like saying, "I'll just pay for my insurance if I need to use it. I didn't need to use it because it was my fault, it was someone else's fault and I'd like my money back." You cannot have it both ways. There is no such thing as FREE insurance.
When we pay premiums for any of our insurances, we do so (at least we're supposed to do so) with the understanding that we are trading a small amount of our dollars for the large unknown amount of protection the insurance company is offering. We call that "peace of mind", because life is better if we never have an insurance claim.
I wish I found this forum before my settlement.
Don't you wish you would have read your insurance contract even sooner? That's the bigger issue. That you found this forum and have been able to obtain an answer is great. You'll know where to turn for some advice in the future.
Everyone needs to learn this lesson: You must read your insurance contract. Not only does it tell you how much you are being asked to pay, it tells you what is covered, and it tells you what is EXCLUDED from coverage. It's just as important to know how the insurer deals with third party liabilities, and subrogation.
Posted: Wed May 05, 2010 11:56 pm Post Subject:
My hunch is that you're wanting to know if, in addition to the settlement dollars offered, you can get them to pay your premiums for your car insurance as well?
If that's a correct assumption, the answer would be no. Why not? Simple... you would have made your insurance premium payments regardless of having an accident or not. The other party cannot be held liable for your insurance premiums. Wage loss settlements, as part of your overall settlement process, is paid to you to take care of these exact things.
You make your wages to pay your bills. The insurance premiums is another bill. Therefore, wage loss compensation you were paid is intended to take care of these "bills."
InsTeacher 8)
Posted: Thu May 06, 2010 03:28 pm Post Subject:
Got to give him credit for trying!
It's like saying to the Meat Dept manager at Sam's Club, "I ate every bite of that $6/lb rib eye steak, just to be sure I wasn't happy with it. And I wasn't. Now, please give me my double-your-money-if-you're-not-happy refund."
Posted: Thu May 06, 2010 06:00 pm Post Subject:
I should of made it clear I guess. Sorry. I meant since Im paying back to my medical insurance what they paid for my treatments, can I bill my medical insurance for my premiums?
Posted: Thu May 06, 2010 11:07 pm Post Subject:
Still not sure of what you're looking for. Are you asking your medical coverage plan to pay for your auto insurance premiums? Your medical insurance premiums?
Regardless of which, it's not going to be done. Premiums are the responsibility of the policy owner...always (unless there is some court order dictating otherwise). I don't see any method by which you could get anyone to pay any insurance premium due to this loss.
InsTeacher 8)
Posted: Fri May 07, 2010 09:13 pm Post Subject:
Im asking after I pay everything back to my medical insurance from the settelment that I got from my car accident, can I bill my medical insurance for my medical premiums (o: But you already answer that either way. Thanks.
I wish I found this forum before my settelment.
Posted: Fri May 07, 2010 09:18 pm Post Subject:
I just think that Im paying my premiums for medical insurance so when I get hurt my medical insurance will cover the cost of my medical expence. So if I was in the car accident wouldnt make sence for my medical insurance to cover my treatments and not accept their money to be recovered?
Posted: Fri May 07, 2010 10:47 pm Post Subject:
So if I was in the car accident wouldnt make sence for my medical insurance to cover my treatments and not accept their money to be recovered?
OK . . . this is the common misconception that folks have about their medical insurance. Perhaps it will help if you think about it as you would your collision coverage on your auto insurance. So let's start with that analogy:
If you drive and crash into someone, and the accident is your fault, what component of your insurance pays for the damages to the two vehicles and the injuries?
Your LIABILITY coverage pays for the damage you do to someone else's car/property. Your COLLISION coverage pays for the damage you do to your own car. Your LIABILITY insurance pays for the injuries you cause to someone else, your MEDICAL insurance pays for your own injuries.
If someone crashes into your car, and it's their fault, your COLLISION coverage is not intended to pay for the damage to your car, because the damage is caused by a third party. Their liability insurance pays for your damages -- both to your car and to your body.
For the sake of convenience, your auto insurer will pay your claims with your collision coverage, minus your deductible, and will then work to obtain restitution from the other party's insurer. You must "subrogate" the claim to the insurer, which simply means that you give up the right to go after the offending party for the SAME thing for which the insurance company has already indemnified you. No double dipping.
If the insurer collects the full amount of the damages, including your deductible, you will get a check for your deductible. You would not get anything for having paid your insurance premiums -- you want the coverage, you have to pay for it. If you don't get your deductible back from either company, then you can sue the offending party for their personal liability for your damages -- you should not have to be subject to a deductible if a third party causes your damages.
Now, as far as your medical insurance is concerned, it is provided to you to cover your illnesses and injuries that you (or members of your household) cause/suffer/acquire. You pay them a premium, and they promise to provide your care. They promise to indemnify you so that you are not financially responsible, in whole or in part, for your unintentionally "self-inflicted" damages.
If someone outside your household causes your illness or injury, as for instance a traffic collision, your insurance is not expected to pay for that. Think about Workers' Compensation insurance. You work, if you get hurt at work, your claim is paid by your employer's insurance policy. If you do use your personal medical insurance to pay for a work-related injury or illness, the insurance company will submit a claim to the Workers' Comp carrier for reimbursement, since that is the policy that actually covers the loss.
So in the case of a traffic collision, if you use your own medical insurance to pay for your injuries -- as most people would (at least initially) -- because they are due to a third party's negligence, that party actually has the responsibility to indemnify you -- to restore you financially to the condition you enjoyed prior to the loss. It is not your medical insurance's responsibility to indemnify you for third party damages.
But they'll honor your contract and provide your care, and then they'll have the right to collect 100% of what you would have paid them if you had no insurance (or what you would not have been liable for according to the contract). They'll collect it from the other party's liability insurance carrier, or they'll collect it from you when you settle with that party and/or their insurance company. (And if you deliberately fail to inform them that your injuries are the result of a third party's negligence -- like breaking your arm while playing on your neighbor's slip-n-slide toy -- technically, you are committing insurance fraud.)
It's easier for the medical insurance company to simply sit back, quietly, and wait for you to do all the work for them, and then send you the letter that says, "Oh, by the way, did you know there is a subrogation clause in the contract you have with us? It says that we may collect from you the full amount we pay to cover your care in the event of a third party illness or injury. So that's what this letter is all about. We'd like to collect the $33,218 you owe us from the $35,000 you got from their insurance company."
But guess what? Your medical insurance contract also says if your "damages" are the result of a third party's involvement, even if you don't collect any money from the third party, your insurance company still has the right to come after you for the cost of the care they provided. Because they did not agree to provide the protection to you for things caused by third parties.
Either way, if you don't pay the money to them, they can sue you in civil court for breach of contract. Not the fact that you were injured and used the insurance, but that you received money for your medical bills that were covered by insurance, but the bills are the result of a third party event, and you owe them the money according to the terms of the contract.
If you never paid them a dollar in premium, how would they ever have been responsible for a penny of your medical care? If you are asking them to give you back the premium money, its like saying, "I'll just pay for my insurance if I need to use it. I didn't need to use it because it was my fault, it was someone else's fault and I'd like my money back." You cannot have it both ways. There is no such thing as FREE insurance.
When we pay premiums for any of our insurances, we do so (at least we're supposed to do so) with the understanding that we are trading a small amount of our dollars for the large unknown amount of protection the insurance company is offering. We call that "peace of mind", because life is better if we never have an insurance claim.
I wish I found this forum before my settlement.
Don't you wish you would have read your insurance contract even sooner? That's the bigger issue. That you found this forum and have been able to obtain an answer is great. You'll know where to turn for some advice in the future.
Everyone needs to learn this lesson: You must read your insurance contract. Not only does it tell you how much you are being asked to pay, it tells you what is covered, and it tells you what is EXCLUDED from coverage. It's just as important to know how the insurer deals with third party liabilities, and subrogation.
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