"Can you receive double medical coverage if you're in an auto accident?"

I just received an email with the question, “can you receive double medical coverage if you’re in an auto accident?”

Here’s my email reply:

I’m not sure what you mean exactly by “double medical coverage,” but I’m assuming your question is along the lines of:

I was injured in a car accident that was not my fault. My health insurance paid for all my medical bills, so can I keep the whole settlement I get from the other driver’s insurance company?

Short answer: Probably not. You may be able to get double recovery if you have ‘medical payments coverage’ under your own car insurance company. If you are a named insured, medical payments coverage is not subject to subrogation. Otherwise, if you don’t have medical payments coverage, then generally you cannot get ‘double recovery,’ unless the health insurance company does not have a subrogation provision. Insurances companies often have what’s called “a right to subrogation.” This simply means that they have a right to be reimbursed for what they pay (when someone else is at fault). Note that your insurance company only has a right to be reimbursed for the medical bills. So, they shouldn’t “touch” any recovery you get for lost income or pain and suffering. Here are a few examples:

  1. Cliff wasn’t paying attention while driving and runs in to Bob. Bob goes to the ER, gets some x-rays, and then is prescribed physical therapy for a few weeks. After a month or so, Bob is completely healed. His medical bills total $4,000 and his insurance company paid everything as they occurred. Bob ends up settling on his own with Cliff’s insurance company for $6,000. Bob’s health insurance company will likely want to be reimbursed the whole $4000, however, oftentimes we’re able to negotiate a reduced amount for the payment to the insurance company.
  2. Same facts, except the car accident causes Bob to require immediate shoulder surgery. With surgery, physical therapy, and rehab, Bob’s medical bills total $30,000. He’ll also likely have issues with his shoulder the rest of his life. Cliff carries the required minimum coverage in Oklahoma (“$25,000/$50,000”), so his insurance company offers this to Bob. Does Bob’s health insurance company get to keep the whole settlement and leave Bob with nothing for his pain and suffering (and likely missed income)? Probably not. This is where Bob (or his attorney) will need to negotiate with his insurance company to get their subrogation claim reduced.
  3. Same facts as 2), except Bob’s medical providers have not been paid by any health insurance company. In this case, if the bills of the medical providers are in excess of $25,000, Bob may not get to keep any of the insurance settlement proceeds. This is likely where Bob would be kicking himself for not having uninsured motorist (UM) coverage and medical payments coverage on his car insurance policy.

Although car accidents do occur, it is important to get proper legal representation that can help you if you have sustained severe personal injuries. Contact our car accident lawyers today for a free consultation at 405-698-3040, or contact us online.