Getting medical care after a crash

The first hours and days

1. Call 911 if anyone may be hurt. Let paramedics check everyone at the scene. You can still decide about going to the hospital after they look.
2. If you don't go by ambulance, get checked soon at an urgent care clinic, an emergency room or your own doctor. A visit the same day or the next creates a record that ties what you feel to the crash.
3. Tell the provider it was a car crash. It goes into the record, and it tells the billing office that auto coverage may pay.
4. Follow the care plan and keep the appointments. If something starts to hurt in the days after, get it checked then and mention the crash again.

This is not medical advice; your providers decide what care you need. The insurance point is narrower: an adjuster pays for injuries that records connect to the crash. A first visit weeks later, or a long gap in care, gives the insurer room to argue that something else caused the problem.

Who pays the medical bills

Several coverages can pay, in roughly this order. Which ones you have depends on your state's law and the options on your policy.

• PIP is required in no-fault states and some others. Florida's PIP pays up to $10,000 per person; Pennsylvania requires at least $5,000 of first-party medical benefits; Oregon's PIP pays medical expenses up to $15,000 per person. Texas insurers must offer at least $2,500 of PIP, which applies unless you reject it in writing.
• MedPay pays whoever caused the crash. In the standard ISO policy form it pays reasonable expenses for necessary medical and funeral services for services received within 3 years from the date of the accident.
• Health insurance may pay first or second depending on your state and plan. If it pays and you later recover from the other driver, your plan's terms may give it a right to be repaid from that recovery, so read the plan and tell the adjuster who paid what.

How these coverages fit together, and what to send each one, is in PIP and MedPay claims. Your state's no-fault rules, if any, are on its page in claim rules by state.

Deadlines that can cost you benefits

Medical claims have their own clocks, and some are much shorter than the deadline to sue. Three examples from our state pages:

Lawsuits over injuries have a separate deadline. In most states it is two or three years, but it runs from 1 year in Tennessee to 6 years in Maine, Minnesota and North Dakota. Talking with an adjuster does not pause it.

Keep your own medical file

The insurer will ask for records, but your own file lets you check what it receives and catch bills that go to the wrong place. Start it after the first visit:

• A visit log: date, provider, what was done and what comes next.
• Every bill and statement, including the explanation of benefits from your health plan and any notice from PIP or MedPay.
• Prescriptions, devices and receipts for anything a provider told you to buy.
• Time off work: a note from your employer with the dates and the pay you lost.
• A short weekly note in your own words of what you can't do yet, such as lifting a child or sleeping through the night.

Under the federal HIPAA privacy rule you have a right to copies of your health records. A provider must act on your request within 30 days, with one extension of up to 30 more, and may charge only a reasonable, cost-based fee for copying, supplies and postage.

What the insurer can ask of you

In the standard personal auto policy, a person seeking coverage agrees to be examined by a doctor the insurer chooses, at the insurer's expense, and to authorize the insurer to get medical records and other relevant information. Your policy may word this differently.

Before a recorded statement about your injuries, read giving a recorded statement, and say plainly what you don't yet know about your recovery.

Questions people ask