For Mark Gottlierb, life changed when another driver crashed into his car. The accident caused damage to four vertebrae in the upper section of his spinal cord and smashed six teeth. He had his smashed teeth crowned, physical therapy, and chiropractic care for his back pain in the months that followed. His car insurance covered all these expenses and treatments.
The law in New Jersey requires that drivers have personal injury protection and insurance coverage that will take care of their medical expenses in an accident. In our case, Gottlierb got the maximum of $250,000. However, the pain was still present, and as such, his back and spinal cord required surgery. This is exactly when things started to get complicated for Gottlierb, but eventually, he didn’t expect the surprise that was ahead of him.
Also , we will provide you with some informations that are very helpful to deal with similar cases. However, the most important step to take in these situations is choosing a reputable car accident lawyer, as long as the results are mostly linked to the way that a lawyer in handling these type of cases.
After the Accident
He initially wanted the operation to be close to home, but he had to get advanced treatment at the Hudson Regional Hospital in Secaucus. He underwent advanced surgery on his spinal discs on April 3, 2020, and went back home on the very same day.
After the surgery, the pain improved considerably, but this was followed by the bills, which came flooding in. The marketing consultant covered the bills thanks to $250,000 from Geico car insurance and Aetna health insurance. The insurance took care of his medical expenses and allowed for the complex surgery, which helped alleviate the severe pain he was feeling in his back. However, what happened next was a life changing chance for Gottlierb.
Whenever one incurs injuries resulting from auto accidents, car insurance takes care of a portion of the medical bills. Still, it leaves the patients with a load of challenges in covering the rest of the expenses. It is usually straightforward to exhaust the total policy limit, and patients typically end up with massive bills.
Insurance providers usually do not have connections to medical providers, and as such, they cannot work on agreements and discounts for the charges. Health insurers, in contrast, are well connected with the medical service providers and can negotiate deals and highly reduce bills that patients have to cover.
Usually, car insurance providers will have different metrics for their calculations and are also known to set specific payment schedules. In our case, Gottlierb’s $250,000 personal injury protection ran out before he could fully pay for the surgery.
One of the reasons for this was that some of the bill items were not on the state schedule. However, the insurer was able to pay precisely what was charged for most of the expenses, such as the surgeon’s fee and the cost of the surgical screws.
Even though Gottlierb had a PIP fund of $190,000, this ran out by September, and he had to look for other means of covering the surgeon’s charges. Aetna, his health insurance provider, could not cover the surgeon’s bill since the doctor and the hospital were both not in his insurance network. Before the operation, he had not run checks to ensure that the hospital he was receiving treatment at would accept his policy.
As such, Aetna was unable to negotiate the rate with the providers, which, in many cases, would have significantly reduced his hospital bill. However, they managed to make an out-of-network payment of $4051 for the surgeon.
He opted out of the payment plan and is waiting to see whether he will be asked to make any further payments. So far, he has not been sued or asked to pay the amount, and the clinic and surgeon have not responded to many requests for comments.
Did the insurance provider pay too much for the surgery? Other doctors feel that the surgical fees were outrageous even though they were very complex and took many hours to complete. Geico managed to reduce the procedure’s bill from $445,000 to $135,000 for the surgeon and the hospital.
If it had been a different insurance provider such as Medicare, $29,500 would have been paid for the whole procedure, with $1800 getting paid to the surgeon and the rest going to the hospital. In this particular case, the surgeon’s bill was much higher compared to what private insurance providers are willing to pay.
In addition, Gottlierb has also filed many other complaints about his huge bills with lawmakers, regulators in the state, and insurance providers.
Not many people are aware of the differences that exist between auto insurance and health insurance. After an accident, the auto insurance takes effect immediately and covers for any damages and injuries that have been injured as a result of the incident. However, it is also good that you are aware of how the policies coordinate, especially in events when the accident causes you to require significant treatment.
If there is an amount in your car policy that covers personal injury, the medical bills should be moved over to your health policy. When undergoing major treatment and operations, you should also check with your health insurer’s network to see whether your medical services provider has been covered.
Auto insurance providers also have their network of medical service providers they cover, and it would be better to ask before undergoing any major treatment. Getting the treatment at a hospital that is not covered would cause big medical bills that insurance will not cover owing to their policies and regulations.
It is also essential that you do some estimations and write down expenses for the non-emergency treatment that might be extensive. You can easily compare your expected expenses with what remains in your auto policy coverage with the estimates. As such, you will be able to avoid spending more than your insurance covers easily.
Spending more means that the additional bills and expenses will spill over to you, and you will have to cover for them by yourself. Better planning before getting the treatment will also help get discounts and other valuable reductions of the medical bills, thanks to agreements made between insurers and medical service providers.
When the expenses are going to be greater than what remains in your insurance policy, you should negotiate with the doctor and the hospital to reduce the charges. You will also manage the expenses better when you have an idea of the amount that you will incur following the treatment.
Some surgeries might be very extensive and will usually rack up hospital bills and expenses very quickly. Without the proper insurance provider to take care of the bills, you will be left paying hospital bills even after you are through with receiving the treatment.
A negotiation before receiving the treatment can help you offset the cost of the surgery and other medical procedures. It also ensures that you are aware of the expenses you will incur when you start the treatment and hospital procedures.
In the case above, Gottlierb had not bothered to check if his health insurance provider covered the hospital he was going to for the surgery. If he had done the necessary background research, he would have been able to avoid the excessive charges that he had to incur due to the operation. He would also have been able to identify a health provider covered by his insurance services, significantly reducing the hospital expenses he had to incur.
Now he doesn’t have to worry about the hospital, and the medical institutions he received his treatment from will pursue him looking for the rest of the amount on his bill. The hospital where he went for the surgery also charged a lot more than what typical medical institutions are supposed to charge, but his insurance was able to cover the expenses even leving him with a massive profit.
The entire bill was about $500,000 reduced to $270,000 by Geico, meaning that the insurance could totally cover the cost by $700,000 leaving him with an incredible bonus.
These days, it is possible to get auto insurance online, and with a simple internet connection and a browser, you can compare several plans. You can also obtain information about the various available coverage plans and cases where each can be useful.
No matter your condition, you can purchase auto insurance online and get auto insurance quotes over the internet. The process is straightforward and only takes a few minutes, getting you accurate information at your fingertips and the latest figures.
In case you are involved in a car accident, insurance can cover most of your medical bills as well as the cost of repairs for your vehicle. The legal process involved in getting a settlement from the other party involved in the accident can also get long and expensive, and when you have insurance to cover you, getting the compensation will take less time.
Get auto insurance quotes online. It only takes a matter of minutes and get you the most up-to-date information available on the internet. They are easy to use and very effective for cases when you need accurate figures from insurance providers to help take care of damages incurred from a car accident.
5 Criterias that your Car Accident Lawyer should have :
1- Clear understanding
A reputable lawyer will make you easily understand what they will do to help you with your case. They will provide you with clear information about their process tasks. They have a direct answer to the point of your questions. You should not move from their office until you make sure that all your points are clear. If they are unable to provide clear insight into their practice during your initial meeting, there will be enough chance you’ll have issues with communication all the way if you choose to work with them.
2– A deep conversation
A good lawyer should be interested in your case. A lawyer that’s not engaged will put in the minimum amount of required effort. You can end up getting a smaller coverage than you could have gotten because of this.
3- Always ready to provide references
Always ask a lawyer for a list of references you can contact and speak to. These references should speak to the reputation of the lawyer. Even if you don’t contact their references, you can have confidence in the fact that they provided them to you. A lawyer that won’t provide you with references shouldn’t be on your list.
4- well-organized office space
The more organized a lawyer’s office looks, the more organized they probably are. Observe how their staff does their work and how neat the lawyer’s desk is. If they have to shuffle through piles of paper in order to find what they’re looking for while their staff struggles to handle incoming calls, they’re probably not very organized, which would reflect on their ability to handle your case.
Always ask the lawyer about their career track. Make sure they have specific experience handling car accident cases. You will also want to be sure they have experience handling cases in court and have a successful record.