Can health insurance deny a claim caused by an auto accident? (Claims + Laws)
Does health insurance cover auto accidents? Health insurance won't usually deny a claim caused by an auto accident but may defer to your auto insurance company to cover its share first. Our guide has the details.
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Laura Gunn
Insurance and Finance Writer
Laura Gunn is a former teacher who uses her passion for writing and learning to help others make the best decisions regarding finance and insurance. After stepping away from the classroom, Laura used her skills to write across many different industries including insurance, finance, real estate, home improvement, and healthcare. Her experience in various industries has helped develop both her ...
Insurance and Finance Writer
UPDATED: Nov 27, 2023
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Editorial Guidelines: We are a free online resource for anyone interested in learning more about auto insurance. Our goal is to be an objective, third-party resource for everything auto insurance related. We update our site regularly, and all content is reviewed by auto insurance experts.
UPDATED: Nov 27, 2023
It’s all about you. We want to help you make the right coverage choices.
Advertiser Disclosure: We strive to help you make confident auto insurance decisions. Comparison shopping should be easy. We are not affiliated with any one auto insurance provider and cannot guarantee quotes from any single provider. Our partnerships don’t influence our content. Our opinions are our own. To compare quotes from many different companies please enter your ZIP code on this page to use the free quote tool. The more quotes you compare, the more chances to save.
On This Page
- Health insurance companies cannot deny claims related to auto accidents
- Auto insurance companies can deny claims if you’re at fault
- Health insurance steps in when auto insurance stops paying for claims
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.
If you’re searching for affordable car insurance near you, feel free to enter your ZIP code into our free comparison tool above to get started today.
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.
| States | Average Annual Auto Insurance Rates |
|---|---|
| Virginia | $2,358 |
| Hawaii | $2,556 |
| West Virginia | $2,595 |
| Massachusetts | $2,679 |
| Ohio | $2,710 |
| Maine | $2,953 |
| Idaho | $2,979 |
| Iowa | $2,981 |
| Washington | $3,059 |
| New Hampshire | $3,152 |
| Wyoming | $3,200 |
| Montana | $3,221 |
| Vermont | $3,234 |
| Kansas | $3,280 |
| Nebraska | $3,284 |
| Illinois | $3,305 |
| Missouri | $3,329 |
| North Carolina | $3,393 |
| Indiana | $3,415 |
| Alaska | $3,422 |
| New Mexico | $3,464 |
| Oregon | $3,468 |
| Alabama | $3,567 |
| Wisconsin | $3,606 |
| Utah | $3,612 |
| Tennessee | $3,661 |
| Median | $3,661 |
| Mississippi | $3,665 |
| California | $3,689 |
| Arizona | $3,771 |
| South Carolina | $3,781 |
| Colorado | $3,876 |
| South Dakota | $3,982 |
| Pennsylvania | $4,035 |
| Texas | $4,043 |
| Arkansas | $4,125 |
| Oklahoma | $4,142 |
| North Dakota | $4,166 |
| New York | $4,290 |
| Minnesota | $4,403 |
| District of Columbia | $4,439 |
| Maryland | $4,583 |
| Connecticut | $4,619 |
| Florida | $4,680 |
| Nevada | $4,862 |
| Georgia | $4,967 |
| Rhode Island | $5,003 |
| Kentucky | $5,195 |
| New Jersey | $5,515 |
| Louisiana | $5,711 |
| Delaware | $5,986 |
| Michigan | $10,499 |
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.
Minimum Auto Insurance Coverage Requirements by State
| States | Coverages | Limits |
|---|---|---|
| Alabama | Bodily injury and property damage liability | 25/50/25 |
| Alaska | Bodily injury and property damage liability | 50/100/25 |
| Arizona | Bodily injury and property damage liability | 15/30/10 |
| Arkansas | Bodily injury and property damage liability; personal injury protection | 25/50/25 |
| California | Bodily injury and property damage liability | 15/30/5 |
| Colorado | Bodily injury and property damage liability | 25/50/15 |
| Connecticut | Bodily injury and property damage liability; uninsured/underinsured motorist protection | 25/50/20 |
| Delaware | Bodily injury and property damage liability; personal injury protection | 25/50/10 |
| Washington, D.C. | Bodily injury and property damage liability; uninsured/underinsured motorist protection | 25/50/10 |
| Florida | Property damage liability and personal injury protection | 10/20/10 |
| Georgia | Bodily injury and property damage liability | 25/50/25 |
| Hawaii | Bodily injury and property damage liability; personal injury protection | 20/40/10 |
| Idaho | Bodily injury and property damage liability | 25/50/15 |
| Illinois | Bodily injury and property damage liability; uninsured/underinsured motorist protection | 25/50/20 |
| Indiana | Bodily injury and property damage liability | 25/50/25 |
| Iowa | Bodily injury and property damage liability | 20/40/15 |
| Kansas | Bodily injury and property damage liability; personal injury protection | 25/50/25 |
| Kentucky | Bodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist protection | 25/50/25 |
| Louisiana | Bodily injury and property damage liability | 15/30/25 |
| Maine | Bodily injury and property damage liability; uninsured/underinsured motorist coverage; medical payments | 50/100/25 |
| Maryland | Bodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage | 30/60/15 |
| Massachusetts | Bodily injury and property damage liability; personal injury protection | 20/40/5 |
| Michigan | Bodily injury and property damage liability; personal injury protection | 20/40/10 |
| Minnesota | Bodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage | 30/60/10 |
| Mississippi | Bodily injury and property damage liability | 25/50/25 |
| Missouri | Bodily injury and property damage liability; uninsured/underinsured motorist coverage | 25/50/25 |
| Montana | Bodily injury and property damage liability | 25/50/20 |
| Nebraska | Bodily injury and property damage liability; uninsured/underinsured motorist coverage | 25/50/25 |
| Nevada | Bodily injury and property damage liability | 25/50/20 |
| New Hampshire | Financial responsibility only | 25/50/25 |
| New Jersey | Bodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage | 15/30/5 |
| New Mexico | Bodily injury and property damage liability | 25/50/10 |
| New York | Bodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage | 25/50/10 |
| North Carolina | Bodily injury and property damage liability; uninsured/underinsured motorist coverage | 30/60/25 |
| North Dakota | Bodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage | 25/50/25 |
| Ohio | Bodily injury and property damage liability | 25/50/25 |
| Oklahoma | Bodily injury and property damage liability | 25/50/25 |
| Oregon | Bodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage | 25/50/20 |
| Pennsylvania | Bodily injury and property damage liability; personal injury protection | 15/30/5 |
| Rhode Island | Bodily injury and property damage liability | 25/50/25 |
| South Carolina | Bodily injury and property damage liability; uninsured/underinsured motorist coverage | 25/50/25 |
| South Dakota | Bodily injury and property damage liability; uninsured/underinsured motorist coverage | 25/50/25 |
| Tennessee | Bodily injury and property damage liability | 25/50/15 |
| Texas | Bodily injury and property damage liability; personal injury protection | 30/60/25 |
| Utah | Bodily injury and property damage liability; personal injury protection | 25/65/15 |
| Vermont | Bodily injury and property damage liability; uninsured/underinsured motorist coverage | 25/50/10 |
| Virginia | Bodily injury and property damage liability; uninsured/underinsured motorist coverage | 25/50/20 |
| Washington | Bodily injury and property damage liability | 25/50/10 |
| West Virginia | Bodily injury and property damage liability; uninsured/underinsured motorist coverage | 25/50/25 |
| Wisconsin | Bodily injury and property damage liability; uninsured/underinsured motorist coverage; medical payments | 25/50/10 |
| Wyoming | Bodily injury and property damage liability | 25/50/20 |
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.
Searching for affordable car insurance and not sure where to start? Just enter your ZIP code into our free quote comparison tool below to begin shopping today.
Frequently Asked Questions
Can health insurance deny a claim caused by an auto accident?
Yes, health insurance providers can deny a claim caused by an auto accident, depending on the circumstances and the terms of your policy.
Why would health insurance deny a claim related to an auto accident?
Health insurance may deny a claim for an auto accident if it falls under certain exclusions or limitations specified in your policy. For example, if your policy explicitly excludes coverage for injuries sustained in motor vehicle accidents, your claim could be denied.
What are some common exclusions in health insurance policies for auto accidents?
Common exclusions related to auto accidents in health insurance policies may include no-fault auto insurance coverage, coverage for injuries sustained while driving under the influence of alcohol or drugs, or injuries sustained during the commission of a crime.
How can I find out if my health insurance policy covers auto accident-related claims?
To determine if your health insurance policy covers auto accident-related claims, review the terms and conditions of your policy or contact your insurance provider directly. They can provide you with specific information about your coverage.
Are there any alternative options for covering medical expenses from an auto accident if health insurance denies the claim?
Yes, there may be alternative options available to cover medical expenses from an auto accident if health insurance denies the claim. These options may include filing a claim with the at-fault driver’s auto insurance, pursuing a personal injury lawsuit, or utilizing any other applicable insurance coverage you may have, such as auto medical payments (MedPay) coverage.
What steps should I take if my health insurance denies a claim related to an auto accident?
If your health insurance denies a claim related to an auto accident, you should consider taking the following steps:
- Review your policy: Carefully review the terms and conditions of your policy to understand why the claim was denied.
- Contact your insurance provider: Reach out to your health insurance provider to seek clarification and ask for a detailed explanation of the denial.
- File an appeal: If you believe the denial is incorrect, you can file an appeal with your insurance company. Follow their appeal process and provide any necessary documentation or evidence to support your case.
- Seek legal advice: If your claim is still denied after the appeal or if you encounter difficulties in the process, it may be beneficial to consult with an attorney who specializes in insurance or personal injury law.
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Laura Gunn
Insurance and Finance Writer
Laura Gunn is a former teacher who uses her passion for writing and learning to help others make the best decisions regarding finance and insurance. After stepping away from the classroom, Laura used her skills to write across many different industries including insurance, finance, real estate, home improvement, and healthcare. Her experience in various industries has helped develop both her ...
Insurance and Finance Writer
Editorial Guidelines: We are a free online resource for anyone interested in learning more about auto insurance. Our goal is to be an objective, third-party resource for everything auto insurance related. We update our site regularly, and all content is reviewed by auto insurance experts.