Pedestrian Accident: Who Covers Medical Expenses?
Gregg Hollander | February 18, 2025 | Pedestrian Accidents
You might assume that if you suffer an injury in a pedestrian accident, the driver’s insurance automatically pays for your medical expenses. While that’s often true, the process is rarely as straightforward as it sounds. Multiple parties, policies, and factors can influence who ultimately foots the bill for your treatment. Recovering compensation can feel like peeling back layers of complexity, but understanding the system is important.
A pedestrian accident lawyer can sort through the confusion and ensure you’re not left with mounting medical bills. Let’s look at the unique ways medical expenses might be covered, how liability impacts the outcome, and why seeking legal support is a critical step.
What Determines Who Pays for Medical Expenses?
When you suffer an injury as a pedestrian, several factors determine who’s financially responsible for covering your medical costs. The first question is often about insurance. If the at-fault driver has insurance, their state-mandated liability coverage usually pays for your medical expenses. However, drivers don’t always carry adequate coverage. Some may not even have insurance at all.
Your own insurance can also play a role, especially if you live in a no-fault state. In such areas, your personal injury protection (PIP) coverage may cover your initial medical bills, regardless of who was at fault. Even if you don’t own a car or have auto insurance, your health insurance can become a key player in handling your expenses. These overlapping sources of potential coverage often create a confusing maze.
It’s also important to consider the possibility of additional parties being held accountable. For example, if the accident occurred in a poorly maintained crosswalk, a municipality or property owner might share some liability. Identifying all potential sources of compensation is vital to ensuring your costs are fully covered.
Auto Insurance and Its Role in Pedestrian Accidents
Many people think auto insurance only protects drivers and their passengers, but it can also extend to pedestrians. Liability coverage from the at-fault driver’s insurance typically covers injuries sustained by pedestrians. However, the amount of compensation depends on the driver’s policy limits.
If the driver carries only the minimum liability insurance required by law, their policy might not fully cover your medical expenses. For instance, in some states, the minimum required coverage can be as low as $25,000. Severe injuries, surgeries, and extended rehabilitation can easily exceed that amount, leaving you responsible for the difference.
What If the Driver Doesn’t Have Insurance?
When the at-fault driver doesn’t carry insurance, recovering compensation can become significantly more complicated. In this situation, your own insurance may play a bigger role. If you have UM/UIM (uninsured/underinsured motorist) coverage, you can file a claim under that policy. Without it, you may need to rely on your health insurance or explore alternative legal avenues.
Drivers without insurance are often financially unable to pay for the damages they cause. Filing a lawsuit against an uninsured driver might seem like an option, but if they don’t have assets or income to recover, it may not be worth the time and expense. That’s why identifying all possible sources of compensation, including your own policies, is so important.
A pedestrian accident lawyer can identify gaps in coverage and pursue compensation from all available sources. If you’ve never dealt with an uninsured driver before, the process can feel daunting, but there are legal strategies to address it.
Can Health Insurance Cover the Costs?
Your health insurance can also cover your medical expenses after a pedestrian accident. Depending on your policy, health insurance may pay for doctor visits, surgeries, physical therapy, and other necessary treatments. However, health insurance doesn’t operate in isolation when it comes to accidents caused by someone else.
If your health insurance pays for your treatment, they may place a lien on any settlement or verdict you receive from the at-fault driver or their insurance company. This process, known as subrogation, allows your health insurer to recover the money they spent on your care. While it ensures they’re reimbursed, it can also reduce the amount of compensation you ultimately keep.
Understanding how subrogation works is important if your health insurance is involved. You’ll want to ensure that any lien placed on your recovery is fair and accurate. A pedestrian accident attorney can negotiate with your health insurer to minimize the amount they claim, leaving you with more funds to cover your other losses.
How Medical Payments Coverage (MedPay) Can Help
Medical payments coverage, or MedPay, is an optional feature available with many auto insurance policies. It’s designed to cover medical expenses for the policyholder and their family, regardless of who’s at fault in an accident. If you have MedPay, it may apply to your injuries even if you were a pedestrian at the time of the accident.
MedPay coverage can be particularly useful because it pays out quickly and doesn’t require you to prove fault. This can help bridge the gap while you’re waiting for a liability claim to settle or for other coverage to kick in. However, MedPay often comes with low coverage limits, so it’s unlikely to cover all your medical expenses if your injuries are severe.
If you’re unsure whether you have MedPay or how to access it, an attorney can review your policy and explain your options. Understanding every available resource is essential to avoid out-of-pocket costs.
Why the At-Fault Driver’s Insurance May Delay Payments
You might assume that the at-fault driver’s insurance will quickly cover your medical expenses after an accident, but that’s rarely the reality. Insurance companies often take their time investigating claims thoroughly before issuing any payments. They may delay compensation while disputing liability to protect their bottom line. This approach can leave you struggling to pay your bills, especially if you require ongoing medical care.
How a Pedestrian Accident Lawyer Can Help
A pedestrian accident lawyer can effectively counter delay tactics. Attorneys are experienced in challenging insurance companies’ arguments and ensuring your claim is treated fairly. They can provide the necessary evidence to prove liability and the full extent of your injuries, often speeding up the claims process. With a lawyer advocating for you, you have a much better chance of receiving adequate compensation without enduring unnecessary delays.
How Hospitals and Medical Providers Handle Accident Victims
When you’re treated at a hospital following a pedestrian accident, the facility often assumes that your medical bills will eventually be paid by the at-fault party’s insurance. This assumption allows hospitals to provide necessary care immediately without requiring upfront payments from the accident victim.
However, many hospitals also partner with third-party companies that place liens on potential settlements. These liens ensure the hospital secures payment once a settlement is reached, but they can also introduce complications.
Challenges with Medical Liens and Delayed Settlements
While this system can alleviate the immediate financial burden of medical treatment, it may create significant challenges down the road. If your settlement doesn’t fully cover your medical expenses or takes months to finalize, you can find yourself under pressure from creditors or debt collectors. Hospitals, as businesses, often pursue unpaid bills aggressively, even if your claim is still pending. This can lead to financial stress and further complicate your recovery process.
Helping Manage Your Medical Bills
A pedestrian accident attorney can play a critical role in managing medical expenses. Attorneys can negotiate with hospitals and other medical providers to reduce your bills or arrange manageable payment plans. They can also help protect you from aggressive collection practices while your personal injury claim is being resolved. By handling these financial challenges, an attorney ensures you can focus on your recovery without unnecessary stress.
Pedestrian Accidents Involving Government Entities
If a government-owned vehicle strikes you, seeking compensation can involve additional hurdles. Filing a claim against a government agency often requires you to follow strict procedures and meet short deadlines. For example, you may need to file a notice of claim within 90 days of the accident to preserve your right to sue.
Government agencies often have their own insurance policies, which may limit the amount of compensation available. In some cases, they might also be exempt from certain types of lawsuits. Understanding these limitations and requirements is essential if your accident involves a government vehicle or employee.
An attorney experienced in handling pedestrian accident cases can guide you through the complexities of filing a claim against a government entity. They can ensure you meet all deadlines and requirements to maximize your chances of recovering compensation.
The Danger of Accepting a Quick Settlement
Insurance companies frequently aim to settle claims quickly, offering amounts that only address immediate medical bills. While these offers may seem tempting during a time of financial strain, they often fail to account for the long-term costs associated with your injuries. Accepting a low settlement can leave you without the financial resources to cover future medical care, lost income, or the mental and emotional toll of your accident.
How a Pedestrian Accident Lawyer Protects Your Interests
A skilled pedestrian accident lawyer can ensure that every aspect of your losses is thoroughly evaluated and included in your claim. By working with medical experts, financial analysts, and other professionals, an attorney can help calculate the full scope of your economic and non-economic damages.
This comprehensive approach increases the likelihood of receiving adequate compensation that addresses both your immediate and future needs, sparing you from financial struggles down the road.
Why Timing is Critical
Timing plays a critical role when pursuing compensation after a pedestrian accident. Delays in taking action can severely impact your case. Vital evidence, such as surveillance footage, witness statements, and accident reports, can become harder to obtain as time passes. Businesses may erase or overwrite footage, witnesses may forget critical details, and official reports may become less accessible.
Don’t Give the Insurer an Excuse
In addition, medical documentation of your injuries is essential, and any gaps in treatment can be used by insurance companies to challenge the severity of your injuries. Insurance companies often view delays as suspicious. If you wait too long to seek treatment or file your claim, they might argue that your injuries are not as serious as you claim. They may assert that a person with significant injuries would have sought immediate medical attention.
Get Medical Help and Document Everything
These tactics can weaken your case and reduce your chances of receiving fair compensation. To protect your claim, it’s best to act swiftly and document every aspect of your accident and recovery, including medical visits, pain levels, and any impact on your daily life.
A pedestrian accident attorney can provide invaluable assistance by ensuring that critical evidence is preserved and your claim is filed within the required timeframe. An attorney will also meet legal deadlines and avoid procedural errors that can jeopardize your case. Acting promptly is not just a matter of meeting deadlines – it can significantly affect the strength and outcome of your claim.
How Settlements Are Reached in Pedestrian Accident Cases
Reaching a settlement in a pedestrian accident case often involves negotiations between your attorney and the at-fault driver’s insurance company. These discussions typically focus on the extent of your injuries, the costs of your medical treatment, and the impact the accident has had on your life.
A pedestrian accident lawyer can negotiate on your behalf to secure a fair settlement. They can present evidence of your damages, counter low offers, and advocate for the compensation you deserve. If a settlement can’t be reached, they can take your case to court.
Get Legal Help Immediately After a Pedestrian Accident
A pedestrian accident lawyer can help you understand your rights and pursue the compensation you deserve. They can identify all available sources of coverage, negotiate with insurance companies, and protect you from unfair practices. Having an attorney by your side can make a significant difference in the outcome of your case.
No matter how complex your situation may seem, there are solutions. You deserve to have someone fighting for your best interests. A skilled personal injury attorney is standing by to give you a free consultation and help you determine your next steps.