Why Would Health Insurance Insist on Filing with Auto Insurance?

Question from Mea, Why Would Health Insurance Insist on Filing with Auto Insurance?

Answer from AI:

When your daughter was hit by a car while riding her bicycle, it created a situation where multiple types of insurance could potentially cover her medical expenses. Here’s why your health insurance company might insist that you file a claim with your auto insurance first:

Understanding Insurance Coordination

Insurance companies often have agreements about which policy should pay first in the event of an accident. This is known as “coordination of benefits.” Here’s how it generally works:

• Primary Insurance: The insurance policy that pays first.
• Secondary Insurance: The insurance policy that pays after the primary insurance has paid its share.

In many cases, auto insurance is considered primary for injuries resulting from a vehicle-related accident, even if the injured party was not in a car at the time.

Auto Insurance Coverage

Auto insurance policies often include coverage for injuries to pedestrians and cyclists. This can include:

1. Personal Injury Protection (PIP): Covers medical expenses and sometimes lost wages, regardless of who was at fault.
2. Uninsured/Underinsured Motorist Coverage: Provides coverage if the at-fault driver does not have sufficient insurance.

Since your daughter was hit by a car, your auto insurance might have provisions that cover her medical expenses, making it the primary insurance in this scenario.

Health Insurance Policies

Health insurance companies often have clauses that require policyholders to seek coverage from other applicable insurance policies first. This helps them manage costs and avoid paying for claims that another insurer should cover.

Steps to Take

Here are some steps you can take to address this situation:

1. Contact Your Auto Insurance Company: Inform them about the accident and provide all necessary details.
2. File a Police Report: If not already done, file a report with the police to document the hit-and-run incident.
3. Gather Evidence: Collect any evidence, such as witness statements or surveillance footage, that might help in identifying the driver.
4. Consult with a Legal Professional: Given the complexities of insurance claims and potential legal issues, it’s advisable to consult with an attorney who specializes in personal injury or insurance law.

Legal Considerations

In the United States, laws and regulations regarding insurance claims can vary by state. For example, some states have “no-fault” insurance laws that require your own insurance to cover your injuries regardless of who was at fault. Other states follow “fault” insurance laws, where the at-fault party’s insurance is responsible for covering damages.

When to Seek Legal Advice

Given the complexities involved in insurance claims, especially in hit-and-run cases, it’s crucial to seek legal advice. An attorney can help you navigate the claims process, ensure that you receive the appropriate compensation, and advise you on any potential legal actions against the at-fault driver.

For more detailed information, you can refer to resources like the [National Association of Insurance Commissioners (NAIC)](https://www.naic.org/) or your state’s Department of Insurance.

Remember, while this information provides a general overview, consulting with a legal professional will give you personalized advice tailored to your specific situation.