Being involved in a car crash can be a distressing experience, not only due to the immediate physical and emotional impact but also because of the ensuing financial uncertainties.  Of primary concern for injured victims in Washington State is determining who is responsible for covering the medical expenses that result. The laws and insurance policies that govern these situations are complex. To ensure your medical bills are paid promptly and appropriately, it is important to understand the process for payment of medical bills and your rights under the law.

Washington’s varied terrain, enjoyed by residents and tourists alike, brings with it unpredictable traffic patterns and the potential for roadway mishaps. Whether you are dealing with a minor injury from a fender-bender or more severe consequences of a high-speed impact, knowing how to navigate the aftermath legally and financially is vital. Knowledge is a powerful ally against the unforeseen financial challenges that may arise following a collision.   

Immediate Steps Following an Accident

In the chaotic moments following a car crash, prioritizing your health and safety is paramount. Regardless of who is at fault and whether you believe you are insured adequately, obtaining immediate medical attention is essential. Even if you do not feel pain right away, it is crucial to be evaluated by a healthcare provider. Injuries such as whiplash, internal injuries, or concussions, may not present symptoms immediately. Early diagnosis and documentation of any injuries is critical for both your recovery and subsequent insurance claims or legal actions.

Whether or not you have health insurance, seek medical attention immediately. Hospitals and urgent care clinics will treat patients in emergency situations regardless of their insurance status. Explain your injuries resulted from a car accident, as this information is important for medical records and will be useful for insurance claims and potential legal proceedings.

When you receive medical treatment, ensure that all examinations, treatments, and interactions are well-documented. Ask for copies of all medical reports and bills, as these documents will serve as evidence of your injuries and the immediate response to them. This documentation is necessary when filing insurance claims and demonstrating the impact of the accident in legal cases.

How Medical Bills Are Paid in Washington State

Navigating the aftermath of a motor vehicle accident involves more than dealing with vehicle repairs and recovery from injury; it also includes managing the complex web of potential financial liabilities, particularly the medical bills. In Washington State, multiple systems are in place to ensure injured parties receive the medical attention they need without undue financial hardship. However, understanding these systems – their coverage, limitations, and the interaction between personal and third-party insurances – can be daunting.

Your understanding of these coverages, and how they apply, impacts your financial responsibility. Whether you are just seeking initial treatment or are in the midst of ongoing care, being informed about your rights will help ensure that your focus remains on recovery, not on financial strain.

One critical aspect that often surprises many accident victims is the initial responsibility for medical expenses. Despite the existence of various insurance coverages, the responsibility for obtaining and paying for medical treatment initially falls on the injured party. This means that immediately following a crash, you must use your health insurance, Personal Injury Protection (PIP) coverage, or pay out-of-pocket for medical care. You should keep meticulous records of all expenditures related to medical treatment as these can be reimbursed through insurance claims or litigation against the at-fault party later.

2. Personal Injury Protection (PIP)

Personal Injury Protection (PIP) is an auto insurance coverage option designed to cover medical expenses, lost wages, and other incidental costs associated with a motor vehicle collision, regardless of who is at fault. The primary purpose of PIP is to ensure that accident victims can receive prompt medical treatment without waiting for insurance companies to determine coverage and fault, which can be a lengthy process.

In Washington State, PIP coverage must be included on your personal auto policy unless you have signed a waiver specifically excluding such coverage.

PIP coverage typically includes:

- Medical Expenses: This includes costs for hospital visits, doctor consultations, surgery, x-rays, rehabilitation, necessary medications, and sometimes dental and optometric treatment, amongst other types of treatment that is reasonable and necessary.

- Lost Wages: If the injury impacts your ability to work, PIP can compensate you for a portion of your lost income.

- Substitute Services: If injuries prevent you from performing tasks such as household chores, yard maintenance, or even childcare, PIP may cover the costs of hiring necessary help.

- Funeral Expenses: In the worst-case scenario of a fatal accident, PIP can provide coverage for funeral and burial costs.

- Passenger Injuries: PIP also extends to passengers in the insured vehicle, providing them coverage irrespective of fault.

While PIP provides broad coverage, it does have limitations:

  • Coverage Limits: PIP comes with maximum benefit limits, which can vary depending on the insurance policy. Once these limits are reached, the injured party will need to seek other forms of coverage for their medical bills.
  • Exclusions: Certain situations, such as injuries received while driving for a rideshare program or in the commission of a felony, may be excluded from coverage.
  • Time Limits: There are often time limits within which medical treatment must be sought after an accident to qualify for PIP. In Washington, the treatment must occur within 3 years of the date of the collision for PIP coverage to apply.

Understanding the specifics of your PIP coverage is crucial. Policyholders are advised to thoroughly review their insurance contracts and discuss with their insurer the extent of the coverage provided under their specific PIP policy.

2. Health Insurance and Coordination with PIP

In cases where PIP coverage is unavailable or insufficient to cover all medical expenses, health insurance becomes a safety net for further medical treatments. Here’s how health insurance coordinates with PIP and what you need to know:

- Role of Health Insurance: Once the limits of PIP are reached, or if there is no PIP available, health insurance takes over to cover additional medical costs. This is especially important in managing high-cost treatments or long-term rehabilitation that exceeds PIP coverage limits. Victims should inform their healthcare providers about their PIP coverage and health insurance so that billing can be directed appropriately from the onset.

- Coordination of Benefits: Coordination of benefits is an important aspect of managing claims and payments between your PIP and health insurance. This process determines which insurance pays first (primary coverage) and which pays any remaining amounts (secondary coverage). Typically, PIP coverage will act as the primary payer for immediate medical expenses following an accident, and health insurance will cover additional costs once PIP benefits are exhausted.

- Deductibles and Copays: Patients must be aware of their health insurance deductibles and copays. After PIP coverage is used up, any further medical treatments will be subject to the deductible and copayment terms of your health insurance policy. These out-of-pocket expenses can add up, especially if long-term care is needed.

- Subrogation Rights: Subrogation is where one insurance company recovers the costs of claims it has paid out when third-party is responsible for the injuries and expenses. For example, if health insurance covers medical bills after PIP coverage is exhausted, and later it is determined another driver was at fault, your health insurance company may seek reimbursement from the at-fault driver’s insurance company through subrogation.

3. Liability Insurance of the At-Fault Driver

Once PIP and personal health insurance possibilities are exhausted liability insurance becomes a critical factor in covering remaining medical expenses. Liability insurance of the at-fault driver is intended to compensate the injured party for damages and loses, including medical costs, that result from the collision.

Coverage by the At-Fault Party’s Insurance: Liability insurance covers damages such as medical bills, lost wages, and pain and suffering incurred by the injured party. The coverage limit depends on the policy of the at-fault driver, which might not always fully cover all the damages, especially in severe injury cases.

Claim Process: The process of claiming compensation from the at-fault driver’s insurance involves several steps –

- Fault Determination: It must be established that the other driver was at fault. This typically involves police reports, witness statements, and sometimes further legal investigation.

- Claim Filing: A claim must be filed with the at-fault driver’s insurance company, detailing the damages and the required compensation.

- Negotiation: Often, there will be negotiations between the injured party (or their representative) and the insurance company. This stage can determine how much compensation will be received and will require evidence of injuries and expenses.

- Litigation: If a satisfactory settlement cannot be reached in negotiations, a lawsuit may be required allowing a judge or jury to determine the compensation.

Challenges in dealing with the insurance company of the at-fault driver may include: 

- Insufficient Coverage: The at-fault driver’s policy limits may not be adequate to cover all medical and related expenses and damages, especially in cases of serious injury.

- Disputes Over Fault: The insurance company may dispute their client’s liability, complicating and delaying the claims process.

- Disputes Over Extent of Injuries: Insurance companies will use anything they can to establish that the injuries being claimed were due to some cause other than the incident in question, including the prior medical and treatment history of the injured party.

- Delayed Payment: Insurance companies may delay payment processing as they review the claims, which can be challenging for victims dealing with immediate medical expenses.

Understanding your rights and the responsibilities of different insurance carriers is crucial to ensuring that your medical expenses are properly managed without undue financial burden. If you find yourself overwhelmed by the intricacies of insurance claims, liability disputes, or simply need guidance on the best course of action post-accident, consulting with an experienced car crash injury lawyer is highly advisable. Don’t face this journey alone.

Lloyd Injury Law understands the challenges you face during these trying times. Our dedicated injury lawyer is committed to fighting for the compensation you deserve. We ensure personalized service, tailored to the specific needs of your case, helping to alleviate the burden so you can focus on your recovery. With offices in both Monroe and Leavenworth, we can provide expert legal services to injured victims all over Washington State.

Contact Lloyd Injury Law today for a FREE CONSULTATION and let us help you secure the peace of mind that comes with having expert legal support by your side. Our experience is your advantage in the complex landscape of personal injury claims. Take the first step towards securing your rights. Reach out to us at Lloyd Injury Law – where your recover is our priority.


For more information about Personal Injury Protection (PIP) visit FAQ: How do my medical bills get paid in a personal injury case?

For more information about Lloyd Injury Law and our injury lawyer visit About: Crystal R. Lloyd