Serious Injury Accidents and Insurance Company Coverage Concerns
A serious injury accident can leave you not only physically injured, but can also leave you financially injured. Most of us think that we have insurance to cover such events, and while this is partly true, the insurance companies are primarily concerned with paying as little as possible while transferring the burden of the costs to you.
Many people do not fully understand the in’s and out’s of how insurance companies really work. Insurance companies are generally looking to improve their bottom line and thus their stockholders shares. Let us take a look at how insurance companies work with hospitals to save money and transfer costs to you, the insured.
If you are in a serious injury accident and break your leg, the insurance company will pay the hospital a percentage of the cost to treat your broken leg. Hypothetically, if you break your leg and decide to pay the hospital in full out of your own pocket, the cost would be $5,000. Now most of us assume that our insurance company pays the hospital the full $5,000, but that is not the case. The insurance company will only pay a portion. For example they may pay $4,000 for the procedure. This happens because insurance companies create complex contracts with the hospitals at a discounted rate. If the hospital does not agree to offer a substantial discount, the insurance company will not allow the hospital to be in their “covered network” of providers. This means that the hospital will generally not be able to treat any of the people covered by the insurance company. This could potentially be thousands of patients for that hospital.
Due to the insurance companies having the upper hand in contract negotiations with the hospitals, the hospital always negotiates and agrees to some form of a discount. Either way, the insurance company will always pay less than full cost for the procedure.
Depending on your insurance policy and coverage exemptions, you will most likely be required to pay for a portion of your medical care. This can include the deductible and any other special circumstances. Your policy may indicate that you are responsible for the first $1,000 of an inpatient stay (plus your deductible) and that the insurance company will pay the remainder. These amounts vary dependent upon your specific policy.
If your insurance company can, they will shift as much of the costs to you as possible in a serious injury accident. This can result in you suffering huge financial difficulties. This is even truer if your insurance company agrees to only pay a percentage of the cost of your treatment. For example, they may agree to pay 85% of cost. Now if you have a serious injury accident and the bill comes to $225,000 (which is not unheard of) then you would be responsible for $33,750 of the total bill.
If another person is at fault in your serious injury accident then you face battling that person’s insurance company. These companies will look for quick cheap settlements (or no settlement) and will try to take advantage of your lack of knowledge of what you are actually entitled to receive. Another example would be if both you and the person who is at fault have the same insurance company. This creates a whole new, and not uncommon, circumstance where your insurance company will try to save money on both sides of the issue.
If you suffer from a serious personal injury, you need a competent and experienced lawyer to watch out for your best interests. Regardless of whether or not someone else is at fault for your injury you need a lawyer to help you through the process. Everyday thousands of Americans are getting a raw deal from their insurance company and most never even realize it; they just simply accept it as the way things work. A lawyer will help sift through the complex insurance coverage policies and will help you to find the parts of the policy that provide you with the most comprehensive coverage.
When faced with a serious personal injury the last thing you should have to worry about is how you are going to pay your medical bills. Unfortunately, it is a reality that you need to take steps to make sure that you will not be stuck with an outrageous bill that your insurance company should cover. A lawyer is the only one who is truly on your side when you are faced with a serious personal injury, because he or she is working for you and no one else.