Can health insurance deny a claim caused by an auto accident? (Claims + Laws)

Car accidents can be scary. On top of dealing with the injury itself, you’ll also have to think about filing an insurance claim. The last thing you want to worry about is the medical expenses associated with the accident and whether your insurance will cover your treatment. The good news is that car insurance and health insurance don’t cancel each other out after a car crash, but instead work together. 

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Does health insurance cover auto accidents?

You probably understand that health insurance isn’t intended to cover auto accidents because that’s what the medical portion of your auto insurance is for. But if your next question was, “Will health insurance cover a car crash injury?”, the answer is: sometimes, yes. 

The amount varies by state, but in most places, you are required to have a certain amount of coverage when you purchase car insurance. 

How much is full coverage auto insurance? The cost of auto insurance varies by state. Here’s a summary of the average annual rate by each state.

Factors that determine your auto insurance rates include age, gender, marital status, credit history, commute mileage, driving record, coverage level, and area. Each city, county, and town has a unique annual rate. Urban areas tend to have more expensive rates due to the increased risk of an accident, but rural areas generally have cheaper rates.

Health insurance will step in after the limits of your auto policy have been exceeded. This means that your car insurance liability coverage (or the at-fault driver’s coverage) will step in first, and then once those limits are reached your health insurance will generally pay the remaining costs.

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How much is a health insurance company obligated to pay for a car accident?

Health insurance is obligated to pay for any medical expenses if you’re injured, but in the case of a car accident, they will usually defer to your car insurance policy first. Your car insurance is usually your primary insurer for injuries caused by accidents.

This is one reason auto insurance is required by law in most states. 

The data presented below is a summary from the Insurance Information Institute that lists the state minimum requirements for each state.

These limits are the minimum, but auto insurance providers may suggest that policyholders get a higher coverage level in case the coverage limit is not enough to cover the total cost of damage and injuries.

Do car insurance companies pay medical bills directly?

No, as a general rule car insurance companies don’t pay medical bills out directly.

Auto insurance providers don’t typically pay medical bills to doctors, hospitals, or private medical practices, despite who’s responsible for the accident. The auto insurance company will usually pay you – the policyholder – once a settlement is reached between you and the auto insurance provider. 

Your health insurance company may also seek to recover costs from your car insurance provider, or from the other driver if you were not at fault. 

Why are legitimate auto accident injury claims typically denied? 

Sometimes, an auto insurance company will deny a claim based on certain factors. For example, it might decline to pay a medical bill. You’re probably wondering why an auto insurance company would deny a legitimate claim.

Typically, legitimate claims can be denied when you’re at fault in the accident (but typically only with liability coverage). That means if you were the one who caused the accident, your insurance company may deny your claim. However, if you’re found to be not at fault, your claim should likely be approved.

Discuss this with your auto insurance provider as soon as possible so that you can be sure your claim will be approved in the event of an accident based on your coverage. 

Denied by health insurance after a crash?

It is very unlikely that you will be denied a claim by your health insurance company after a crash. In the rare event, it is usually because your car insurance provider is the primary insurer and your health insurer is directing you back to them as a first resort. 

Health insurance will not usually deny claims for any other reason, and car accident injuries are still covered by health insurance. 

Is PIP a replacement for health insurance? 

Personal Injury Protection, or PIP, is a mandatory part of your car insurance in the 12 states that have no-fault insurance laws. All this means is that your own insurance, not the other party’s is responsible for your medical costs. In these states, your PIP is your primary insurer, and they will pay out your claims before health insurance kicks in. As with regular insurance, it will pay until your limit is reached, and then health insurance will kick in. 

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Health Insurance Will Pay For Your Care If You’re Injured in a Crash 

You don’t need to worry about not receiving treatment if you’re injured in a crash. In most cases, your auto insurance will kick in first to help cover the medical costs associated with a car accident. If those costs go beyond your policy limits, then your health insurance will usually step in to cover any remaining costs. 

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