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Serious Injury Accidents and Insurance Company Coverage Concerns
Copyright © 2006, Landon Prescott
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A serious injury accident can leave you not only physically
injured, but can also leave you financially injured. Most of us
think that we have insurance to cover such events, and while this
is partly true, the insurance companies are primarily concerned
with paying as little as possible while transferring the burden
of the costs to you.
Many people do not fully understand the in's and out's of how
insurance companies really work. Insurance companies are
generally looking to improve their bottom line and thus their
stockholders shares. Let us take a look at how insurance
companies work with hospitals to save money and transfer costs to
you, the insured.
If you are in a serious injury accident and break your leg, the
insurance company will pay the hospital a percentage of the cost
to treat your broken leg. Hypothetically, if you break your leg
and decide to pay the hospital in full out of your own pocket,
the cost would be $5,000. Now most of us assume that our
insurance company pays the hospital the full $5,000, but that is
not the case. The insurance company will only pay a portion. For
example they may pay $4,000 for the procedure. This happens
because insurance companies create complex contracts with the
hospitals at a discounted rate. If the hospital does not agree
to offer a substantial discount, the insurance company will not
allow the hospital to be in their "covered network" of providers.
This means that the hospital will generally not be able to treat
any of the people covered by the insurance company. This could
potentially be thousands of patients for that hospital.
Due to the insurance companies having the upper hand in contract
negotiations with the hospitals, the hospital always negotiates
and agrees to some form of a discount. Either way, the insurance
company will always pay less than full cost for the procedure.
Depending on your insurance policy and coverage exemptions, you
will most likely be required to pay for a portion of your medical
care. This can include the deductible and any other special
circumstances. Your policy may indicate that you are responsible
for the first $1,000 of an inpatient stay (plus your deductible)
and that the insurance company will pay the remainder. These
amounts vary dependent upon your specific policy.
If your insurance company can, they will shift as much of the
costs to you as possible in a serious injury accident. This can
result in you suffering huge financial difficulties. This is even
truer if your insurance company agrees to only pay a percentage
of the cost of your treatment. For example, they may agree to pay
85% of cost. Now if you have a serious injury accident and the
bill comes to $225,000 (which is not unheard of) then you would
be responsible for $33,750 of the total bill.
If another person is at fault in your serious injury accident
then you face battling that person's insurance company. These
companies will look for quick cheap settlements (or no
settlement) and will try to take advantage of your lack of
knowledge of what you are actually entitled to receive. Another
example would be if both you and the person who is at fault have
the same insurance company. This creates a whole new, and not
uncommon, circumstance where your insurance company will try to
save money on both sides of the issue.
If you suffer from a serious personal injury, you need a
competent and experienced lawyer to watch out for your best
interests. Regardless of whether or not someone else is at
fault for your injury you need a lawyer to help you through the
process. Everyday thousands of Americans are getting a raw deal
from their insurance company and most never even realize it; they
just simply accept it as the way things work. A lawyer will help
sift through the complex insurance coverage policies and will
help you to find the parts of the policy that provide you with
the most comprehensive coverage.
When faced with a serious personal injury the last thing you
should have to worry about is how you are going to pay your
medical bills. Unfortunately, it is a reality that you need to
take steps to make sure that you will not be stuck with an
outrageous bill that your insurance company should cover. A
lawyer is the only one who is truly on your side when you are
faced with a serious personal injury, because he or she is
working for you and no one else.
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Writer's Resource Box:
Landon Prescott writes on topics related to insurance and health.
For over 30 years Michael H. Silvers, A Law Corporation has
handled over 10,000 accident cases, with a success rate of 98.6%.
Michael H. Silvers, A Law Corporation is a premier Personal
Injury Law Firm in the State of California, with the highest
rating possible, that specializes only in handling car accidents,
motorcycle accidents, wrongful death cases, and other personal
injury motor vehicle accidents. http://www.michaelhsilvers.com/
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The article on this page is Copyright © 2006, Landon Prescott
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