When people start getting medical bills after a car wreck in Kentucky, they quickly learn a couple of things:
- They have something called “no-fault” or PIP or BRB benefits; and
- Every provider wants their medical bills paid by PIP.
Unfortunately, this is sometimes all people find out, as their PIP benefits are quickly eaten up by providers, sometimes just by the hospital.
What is PIP?
First – if you are in a car wreck in Kentucky, and the vehicle is insured, there will be at least $10,000.00 available in PIP coverage to pay medical expenses and lost wages.
Why Do Providers Bill PIP?
Why do providers want to bill this coverage rather than your health insurance after your wreck?
Simple – if your health insurance paid a medical bill from the hospital, they would first “adjust” the bill. This means that instead of paying your hospital bill at face-value, your health insurance company will pay less than 100% of the bill, often sometimes between 20%-60% of the bill.
Most auto insurance isn’t like that. They pay 100% of the billed amount. This means, often, that a single hospital visit can use all of your no-fault benefits, causing you to be out of pocket for your remaining medical bills, deductibles and co-pays.
You can’t really blame the providers – if you could collect 100% of your bill versus 20%, you would want to bill auto insurance instead of health insurance too!
Is There a Better Way to Use PIP?
Yes! We think there’s a better way – In Kentucky, you have the right to “reserve” your PIP benefits to only be paid at your direction. You do this by sending a written letter to the auto insurance carrier on the car you were in that states that you are “reserving PIP benefits” and that they are not allowed to pay any bills “without my express direction”.
Then, you tell the provider to bill your health insurance. If there’s any co-pay, you can tell your PIP carrier to reimburse you for that out of pocket expense. You also can collect up to $200/week in lost wages from the PIP carrier. At the end of the case, you tell PIP to pay Health Insurance back, often at a reduced rate.
This makes PIP benefits go further. Instead of getting $10,000 in medical treatment, you can often get twice as much using this method.
Again, it’s simple: 1. Tell PIP carrier not to pay any charges without your permission; 2. Tell your providers to bill health insurance; 3. Tell PIP to pay you for lost wages, co-pays and deductibles; 4. Tell PIP to pay health insurance after you are done treating.
What If My Provider “Can’t” Bill Health Insurance?
Don’t let a provider tell you that they “can’t” bill health insurance – it is much more likely that they “won’t” because they want to collect more from PIP. Call an attorney to verify if this is true.
What If I Don’t Have Health Insurance?
Obviously, this doesn’t work if you don’t have health insurance (but if you lose your job, you may be entitled to Medicaid, which will cover accident related bills). If you get Medicaid, you can use this procedure.
Sometimes, you will want pay a provider from PIP directly. But for most people, most of the time, this is the best procedure.
And remember, if you are in a car CRASH, preserve the evidence:
Reach for cellphone to take pictures and video;
Always get Report Number/Contact Info for Witnesses;
Stop and check for injuries; and
Head to the Hospital