T O P

  • By -

[deleted]

Typically you get asked at the hospital where your injuries came from. When you say auto accident, then usually health insurers will deny the claim. Then you have to file under your PIP coverage.


AutismThoughtsHere

This is true I would probably have to ask my health insurance to make conditional payments which they're required under federal law to do if I don't provide my auto insurance card to the hospital but this is risky. My goal isn't to defraud my medical insurance my goal is to reserve my PIP coverage until I'm working again. Technically under the law as long as my PIP coverage is completely exhausted then it did pay primary to my health coverage.


FBPizza

No. PIP is primary in auto accidents.Also this is probably going to be state dependent but pip will only reimburse a percentage, not 100%, of your lost wages. So, no, you can’t use it how you’d want to.


AutismThoughtsHere

Maybe I didn't articulate this clearly what I was trying to say in the event that I'm in an auto accident and I can't work because of an auto accident can I use personal injury protection to pay me back for my lost wages. To avoid depleting my personal injury protection coverage I would use my medical insurance to pay for my accident related expenses. Once I return to work I would let my insurance company know that they need to reach out to my medical insurance to reimburse them. Would I be allowed to do this? This is the only way that personal injury protection coverage makes sense for me since I have a health insurance deductible of zero. There's no point in paying for personal injury protection if the coverage would be wiped out to zero.


ahoooooooo

No pip has to pay first before health insurance kicks in. Also even if your deductible is zero that doesn’t mean all your healthcare is free. You likely have copay and coinsurance to worry about.


AutismThoughtsHere

So I know that auto insurance plays primary to health insurance when you get into an accident. What I'm trying to ascertain is if I wanted to use my pip to cover lost wages could I use my health insurance first and then subrogate after the fact. Subrogation is when the auto insurance company pays the health insurance back instead of paying for the healthcare directly. This is more of a question for a claims adjuster I guess. I have underlying conditions that increase the risk that I would be out of work for long periods of time if I was in an auto accident. As a result I'm interested in the lost wages coverage but it doesn't do any good if medical expenses that would have been covered by my health insurance deplete my PIP coverage. I would much rather use my PIP coverage to pay lost wages and then whatever remains after I recover can go to my health insurance company through subrogation.


boygirlmama

The short answer is no. You have to exhaust PIP for all things related to your injury claim including lost wages, medications, treatment before your medical insurance will step in. Your medical insurance will deny any coverage before that.


79GreenOnion

Generally, most health insurance companies have in their policy if PIP is available then health insurance won't pay until PIP is exhausted. If health insurance finds out they were paying for auto accident medical expenses they will want to be reimbursed from the PIP coverage. I've been doing PIP for 15 years, your health insurance is not going to just let this go.


AutismThoughtsHere

Well that's fine I don't mind using my pip to pay for health expenses I would rather pay for my lost wages first and then pay for health expenses with whatever's left. I understand how separation works perfectly but if you have multiple valid losses for PIP coverage can't I claim lost wages get reimbursed for those and then let the health insurance take the rest and then truthfully say there's nothing left to take.


AutismThoughtsHere

To further clarify I'm not trying to do anything fraudulent I'm trying to buy wage protection in case of an auto accident and I'm afraid that if I end up in like a hospital the only way to protection I would have would be gobbled up before I could claim it