You got hurt in a crash someone else caused. The emergency room sent you home with pain medicine and a note to follow up if things don’t get better. Now what?
Three questions come up over and over from clients at our Houston-area firm:
- What if my medical insurance doesn’t cover this treatment?
- What if I don’t have medical insurance?
- What if the medical bills are higher than the at-fault driver’s insurance can cover?
This article answers all three.
Your First Medical Steps After the Crash
Most people start at the emergency room, urgent care, or their primary doctor. These visits handle the immediate problem. Doctors run scans and send you home with pain medicine and instructions to follow up if you don’t feel better in a few days.
That’s your next decision point. You have two paths for ongoing care after a car accident.
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Option 1: Treating Through Your Health Insurance
You may already have health insurance you trust. If you have a primary care doctor you’ve been seeing for years, or a physical therapist who helped you recover from a different injury and you like them, you can stick with them. We want you to make the choice that’s right for you and your family.
Your primary doctor can refer you to physical therapy. Most plans cover a set number of sessions per week, sometimes with a copay. Some plans don’t cover physical therapy and reserve their dollars for catastrophic injuries or major surgery.
A few wrinkles can make this path harder than it sounds:
- Your insurance may slow down your treatment. Your doctor may want to order an MRI after a month, but the insurer wants three months of physical therapy and a set number of visits before they approve the scan. The same goes for pain relief like injections, which the insurer may refuse to cover until you meet certain conditions. You wait longer to find out what’s wrong and start the treatment you need.
- Some doctors refuse to treat you when a third party caused the injury. They don’t want lawyers subpoenaing their records, and they don’t want to sit for a deposition. Their job is treating patients, not testifying about them.
- Some health insurers may refuse to cover bills tied to a third party’s negligence. Plans like Blue Cross Blue Shield may deny coverage when another driver causes the harm. The insurer wants to avoid double recovery, where they would pay for a medical bill that the at-fault driver’s insurance may also pay for.
If your health insurance and your doctors work for you, and you like them, you can stay the course.
Option 2: Doctors Who Treat Under a Letter of Protection
If you don’t have health insurance, or if your plan won’t cover the care you need, you have a second option. Some doctors will treat injured patients and wait for payment until the case settles or finishes at trial. Lawyers call this arrangement a letter of protection.
These providers cover the full range of care a serious crash can demand:
- Physical therapists and chiropractors
- MRI and imaging facilities
- Pain management physicians
- Orthopedic surgeons and neurosurgeons
Bills under a letter of protection run from a few hundred dollars for basic therapy to hundreds of thousands of dollars for complicated surgery.
Plenty of doctors choose not to take patients on a letter of protection, and the reasons make sense. They might wait years for payment or get nothing. Defense lawyers can drag them into a deposition and do everything they can to make the doctor look untrustworthy or like they don’t know what they’re doing. So when a doctor agrees to treat a person someone else hurt and wait on the bill, that’s a generous decision. They take real financial risk to help people who didn’t ask to be hurt. We respect the doctors who do this work.
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Medical Bills Above the Insurance Limits
Texas requires drivers to carry liability insurance, but the state minimum sits at $30,000 per person. Plenty of people drive with that bare-bones policy. A driver in a sedan with a $30,000 policy can cause the same harm as a driver in an 18-wheeler with a multi-million dollar policy. Once the medical bills climb past the at-fault driver’s coverage, you face a different problem.
The right move for the insurance company is to tender the policy limits as soon as possible. $30,000 isn’t much coverage, and your damages cover more than medical bills. You can also claim pain, mental anguish, physical impairment, lost wages, and lost earning capacity. A smart insurer offers the limits before they end up defending a case worth more than they can cover.
Some insurance companies refuse to pay before they have to. They reject the demand. By doing that, they expose their own insured, the driver who caused the wreck, to a jury verdict that can run far above the coverage.
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The Stowers Doctrine: A Path Beyond the Policy Limits
Texas law has a doctrine for this situation. Lawyers call it a Stowers case, and we cover it in depth in our Stowers Doctrine in Texas article.
Say a jury awards $500,000 against a driver who carried $30,000 in coverage. The insurance company had its chance to pay the $30,000 and close the case. They said no. Now their insured has a $470,000 problem he didn’t create.
That driver can turn around and sue his own insurance company for the gap. The insurance company chose to reject the demand, not the driver. So the insurer owes the difference for putting him in this spot.
The injured plaintiff and the defendant tend to work out an assignment. The defendant signs over his right to sue his insurer in exchange for a promise from the plaintiff not to collect out of his pocket. The plaintiff then goes after the insurance company for the full verdict.
An injury is an injury. The size of the defendant’s policy doesn’t change what happened to your body. Many attorneys tell their clients to stop the medical care they need, because pushing past the policy limits means trial preparation and a lot of hard work. We think that’s the wrong call.
If you need surgery, you need surgery. A ruptured disc in your spine or a torn rotator cuff doesn’t heal because the at-fault driver bought a minimum policy. Your body doesn’t care how much insurance the defense carries. The Stowers doctrine exists for this reason, and we’re willing to take your case to trial to fight for the full value of your injuries.
Talk to a Houston Car Accident Lawyer Who Will Fight for Full Damages
If you got hurt in a Houston car accident and you’re worried about paying for medical care, or the at-fault driver doesn’t have enough insurance to cover your damages, talk to a Houston car accident lawyer who will fight for the full value of your injuries.
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