When someone has been hurt in a Pennsylvania auto accident, financial responsibility for medical care falls to the insurance companies. Because of the complex way Pennsylvania has implemented no-fault auto insurance, each driver’s insurance carrier will be the primary source of compensation for everyone injured in that driver’s car.
Let’s assume, for the sake of example, that a Harrisburg car crash left you with a fractured right humerus (the upper arm bone) including a crack in the head that fits the shoulder socket joint. The emergency room doctor has looked at the x-ray and warned you that surgery might be required to implant a partial metal joint replacement in your shoulder.
Your auto insurance company will automatically cover the basic costs of your emergency care. Even so, you know that you will be responsible for the initial deductible amount for your claim and a co-payment of about 20 percent of all medical costs. That could add up to a significant amount. However, under Pennsylvania law, if an injured party was not at fault for causing the traffic accident, then he may seek additional money from the negligent driver to cover any out-of-pocket medical costs. If you were not responsible for the accident, you should not have to bear the burden of paying to make things right.
The limits to medical care compensation
The law doesn’t supply you with an endless pot of gold even when you have a valid claim against another person. There are some strict categories of medical care you can expect to be covered—and some that definitely won’t be. As a rule of thumb, you should seek out medical treatment that is reasonable, necessary, and prudent for someone in your condition. Among the things you can expect to be covered:
- Emergency care, including ambulance transportation
- Hospital stays
- Medical tests and imaging
- Surgery, including reconstructive surgery for disfigurements
- Surgical devices, surgical implants, and prosthetic limbs
- Doctor’s bills, including necessary specialist consultations and treatment
- Nursing care, both in the hospital and by a visiting home health care professional
- Prescribed medication and oxygen
- Assistive devices and medical supplies such as walkers, canes, crutches, bandages, and braces
- Psychological counseling
- Physical, vocational, and rehabilitative therapy
- Vision and hearing evaluation and treatment
There are some things you can expect will not be covered, such as:
- Nonstandard treatments and therapies not generally recognized as appropriate for your condition
- Experimental treatments
- Treatment for preexisting conditions not related to your accident
- Purely cosmetic surgery
Dealing with insurance company claim denials
In many cases, of course, insurance companies are not eager to pony up the compensation you may deserve for your medical care after an accident. Health care costs are rising every year, and insurance companies don’t maintain high profits by generous payouts. What will you do if your doctor or hospital tells you that the bills aren’t being paid?
You do what your neighbors have been doing for years: you turn to Schmidt Kramer for help. Our car crash attorneys in Harrisburg stand ready to help you get fair compensation for your medical claim after a serious traffic accident in Pennsylvania. Call us at 717.888.8888 or 888.476.0807 toll-free to schedule a free consultation about your case, and take the time to download our FREE report, Who Pays The Bills When You Are Injured In An Automobile Accident?