Who covers your medical bills after a slip & fall accident?

There are three basic forms of insurance that provide coverage after a slip and fall: (1) the injured party’s private insurance (usually through an employer); (2) the commercial liability policy of the premises in which the fall occurred; and (3) government insurance for individuals who do not have private insurance. Payments for medical treatments after a fall are not limited to the liability policy of the defending party but can be covered by any policy which extends coverage for the injuries sustained.

Commercial Insurance

Commercial insurance provides “medical payment coverage” which pays for the medical payments of anyone who is injured while on the covered premises. Medical payment coverage usually does not require a finding of liability on the part of the premises owner – only proof that an injury occurred on the property. However, there are gaps between this coverage and when the injured party needs case which could result in a coverage gap.

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Private Insurance

When there is a coverage gap, individuals can use their private insurance to cover immediate medical expenses (if the injured party receives compensation for their injury – their medical insurance may seek reimbursement from the other insurer). Using private insurance is advantageous because it allows injured parties to get immediate medical care and assistance – there is no need to wait for the commercial insurer to conduct and investigation and release funds.  You may have to pay private insurance back or reimburse private insurance from your settlement which is called subrogation, however the amount you would have to pay back would be a discounted amount than what you would have had to pay up front without health insurance.

Government Insurance

Finally, individuals who do not have private insurance can get their medical bills paid by Medicare or Medicaid. However, while private insurance may or may not seek reimbursement – government insurance always will. Furthermore, government carriers will seek reimbursement from the injured party. Therefore, individuals who receive a settlement and had their medical bills paid by Medicare must reimburse the government.

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Potential Issues

A common issue presented to injured parties is a release of liability. Commercial insurers, prior to issuing payment, but before a finding that coverage is valid – sometimes offer to pay out faster to the injured party if they sign a release of liability. The release of liability could be a double-edged sword (it allows the injured party to get coverage) but it could also severely reduce the money they are entitled to which can be a significant problem if their injuries are more extensive than originally anticipated.

To negotiate the highest possible settlement, you should have an experienced Las Vegas personal injury attorney on your side.  Call Van Law Firm at (702) 529-1011.