Satellite Beach, FL asked in Health Care Law and Insurance Defense for Florida

Q: In florida can health insurance pay for medical care due to an accident if auto insurance refuses to pay?

In the state of Florida I received medical treatment due to an auto accident, had it billed to my auto insurance as a Personal Injury Protection claim, and the auto insurance is refusing to pay due to the deductible not being met, is it legal for me to have it billed to my personal health insurance instead since the auto insurance wont pay? The urgent care center says its illegal but the auto insurance company and health insurance say otherwise. I understand that it must at least initially be billed as an auto insurance claim.

1 Lawyer Answer
Jeffrey Snyder
Jeffrey Snyder
  • Jacksonville, FL
  • Licensed in Florida

A: So your PIP deductible is likely $500.00 or $1,000.00 and the bill you refer to are under that amount. Therefore, until your medical billing related to the auto accident go over your deductible, your auto insurance will not pay anything. However, your health insurance company should pay the bill. You need to provide them a copy of the bill and EOB from your auto insurance showing that it was under the deductible and they should pay. What is likely happening is the facility is not wanting to bill health insurance because they get paid a lot less than self-pay or auto insurance PIP payments.

What you should really do is hire a personal injury attorney to help you out if you were not at-fault in the accident.

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