Under Colorado law, a person injured in an accident has the right to hold the party that caused the accident responsible for his or her medical bills.
To get medical bills paid after a Colorado accident or injury, a person can look to:
- the responsible party directly;
- private health insurance;
- government health insurance, such as Medicare;
- Colorado’s worker’s compensation; or
- a healthcare provider willing to work on a Colorado medical lien basis.
Who Pays the Medical Bills
The person or company that caused the injury should be responsible for your medical bills. Ideally, the responsible party will have sufficient insurance coverage for all your medical bills.
If not, the injured party can file a personal injury lawsuit against the person who caused the injury or accident. In the time between the accident and a successful lawsuit, an injured person may have to look towards other sources, such as those listed above.
What is Included in Medical Bills?
Medical bills are those costs arising out of the necessary care to treat the injury, including but not limited to:
- hospital bills;
- doctor visit invoices;
- medical equipment costs;
- rehabilitation costs;
- long-term care costs;
- ongoing and future medical costs;
- mental health and psychological health care costs; and
- medications.
If the injury had not occurred, these expenses would never have accrued. The person responsible should bear those costs, not the injured person.
What If I Don’t Have Insurance?
An injured person without health insurance will still get treated at a Colorado hospital, and the hospital may be willing to work on a “lien basis.”
This basically means that the hospital takes an interest in the potential personal injury case award up to the amount it is owed for treatment of the injured person. Colorado medical liens must fit code section requirements to be valid.
The following flowchart illustrates the steps for getting a medical lien after an accident.
If I Have Insurance…
An injured person with health insurance will likely have his or her medical bills paid by their insurance company if the responsible party is not yet paying for it.
If so, the injured person’s health insurer will be able to be reimbursed for its costs out of any trial award or out-of-court settlement amount. This is called a right to subrogation.
Proving Your Costs
To prove the costs of medical bills, the injured party should keep all:
- hospital bills;
- medical invoices;
- receipts;
- records of travel;
- records of time lost from work; or
- other costs associated with medical treatment of the injuries.
A successful personal injury lawsuit can result in all or nearly all of your medical bills being covered, as well as other damages, such as:
- lost wages;
- loss of consortium;
- pain and suffering damages; and
- punitive damages (in limited cases).
Below, our Colorado personal injury attorneys address frequently asked questions about getting compensation for medical bills in personal injury lawsuits and the injuries you may have suffered:
- 1. Who pays for medical bills after an accident in Colorado?
- 2. What is a “medical lien basis” for covering my medical bills?
- 3. What if I have health insurance and the responsible party is refusing to pay?
- 4. How do I prove all of my medical bills at my personal injury trial?
- 5. What if had a pre-existing injury?
- 6. What if my winnings or settlement are not large enough to cover my medical bills?
Under Colorado law, a person injured in an accident has the right to hold the party that caused the accident responsible for his or her medical bills.
1. Who pays for medical bills after an accident in Colorado?
The person or company that caused the injury should be responsible for your medical bills. Ideally, the responsible party will have insurance that can cover most if not all of your medical bills.
If not, the injured party can file a personal injury lawsuit against the person who caused the injury or accident. In the time between the accident and a successful lawsuit, an injured person may have to look towards other sources, such as the following:
1.1 Can I use my own health insurance?
A person who is injured should be covered by his or her own health insurance for any injuries if coverage exists.
If the injured person’s insurance pays for the medical bills, the insurance company will have a right to subrogation of any funds won at trial or through an out-of-court settlement.
1.2 Can I use Medicare or Medicaid?
Depending on the injured person’s circumstances, he or she may be able to use Medicare1 or Medicaid to help pay medical bills until the personal injury lawsuit is successful.
Eligibility will often depend upon:
- any private health insurance coverage;
- the injured person’s age;
- the injured person’s financial situation and income; and
- whether the injured person is employed.
“Medicare” in Colorado is taken care of by Health First Colorado. Eligibility is primarily income-based.2
1.3 Can I use Colorado’s worker’s compensation as a source for paying my medical bills?
If the injury or accident occurred in the course of a person’s duties of employment, he or she may be able to use Colorado’s worker’s compensation program to help pay medical bills.3
Worker’s compensation coverage and reimbursement can be incredibly complex and tricky to navigate without the help of an experienced Colorado attorney, but with the right help, an injured person can get appropriate medical bill coverage.
2. What is a “medical lien basis” for covering my medical bills?
An injured person without health insurance will still get treated at a Colorado hospital, and the hospital may be willing to work on a “lien basis.”
This basically means that the hospital takes an interest in the potential personal injury case award up to the amount it is owed for treatment of the injured person. Colorado medical liens must fit code section requirements to be valid.
Medical liens have certain requirements that must be met to be valid4, but an experienced attorney can help make sure you are covered.
3. What if I have health insurance and the responsible party is refusing to pay?
While an injured party is pursuing payment by the responsible party, the injured party’s health insurer is likely to pick up the bills in conformance with the insurance policy.
In Colorado, health care providers and insurers have a right to subrogation on any personal injury claim against the responsible party.5 This means that those providers will take out of the “winnings” from the personal injury case any amount to which they are entitled.
4. How do I prove all of my medical bills at my personal injury trial?
To prove the costs of medical bills, the injured party should keep all:
- hospital bills;
- medical invoices;
- receipts;
- records of travel;
- records of time lost from work; or
- other costs associated with medical treatment of the injuries.
A successful personal injury lawsuit can result in all or nearly all of your medical bills being covered, as well as other damages, such as:
- lost wages;
- loss of consortium;
- pain and suffering damages; and
- punitive damages (in limited cases).
4.1 What other important information should I keep track of?
Other things that can bolster faster payment of your medical bills include:
- the names and contact info of all parties and witnesses to the accident;
- the police accident report and your insurer’s report;
- photos and/or videos of the accident scene or defective product;
- photos of your injuries (if visible); and
- anything else that may help your case, like witness statements or declarations of friends, family, or co-workers setting forth what you are no longer able to do since you were injured.
Information you keep and give to your attorney saves you both time and money. Further, it provides the best evidence of your claim, making the chance of success much better.
4.2 What medical evidence may be used at my personal injury trial?
Medical evidence is crucial to winning a personal injury case, and getting compensation for medical bills. The injured party and his or her attorney can use any of the following at trial:
- x-rays;
- copies of MRIs;
- CAT scan results;
- doctor’s notes;
- pictures of injuries;
- psychological treatment reports;
- pictures of the accident;
- treating doctor or nurse testimony; or
- expert medical testimony concerning the injured person’s injuries.
Proper use of medical evidence can help build a strong and eventually successful personal injury case.
5. What if had a pre-existing injury?
Any injuries or medical issues that were present before the accident are not eligible for compensation. The other party is responsible only for those medical bills directly caused by his or her negligence.
However, if a pre-existing injury is made worse because of an accident, the difference in cost for treatment from before to now is compensable.
Example: Stan is a firefighter. Three years ago, he hurt his back while moving a door aside while fighting a fire. He still goes to the chiropractor once in a while when his back really hurts him.
As Stan is driving home from a date one night, he is rear-ended by another driver. His back goes out again, and he incurs significant medical bills. Even though Stan already had a bad back, it was made worse by the other driver’s negligence.
6. What if my winnings or settlement are not large enough to cover my medical bills?
In some cases, what the injured person wins at trial or accepts as a settlement may not be enough to satisfy all of the medical bills. Sometimes, something is better than nothing.
However, with an experienced Colorado personal injury attorney you can better understand the strength of your case and assess your bargaining position.
It is important to have a realistic idea of what amount you can expect to be compensated depending on the insurance and the at-fault party’s financial capabilities outside of insurance.
Call us for help…
For questions about getting compensation for medical bills or to confidentially discuss your case with one of our skilled Colorado personal injury attorneys, do not hesitate to contact us.
We represent clients in and around Denver, Colorado Springs, Aurora, Fort Collins, Lakewood, and several nearby cities.
Legal References:17
- The Official U.S. Government Site for Medicare.
- Health First Colorado. Home.
- Colorado Department of Labor and Employment. Worker’s Compensation.
- Jeffrey L. Wainscott, Personal Representative of the Estate of Donald L. Wainscott; and Rena Wainscott v. Centura Health Corp., 2014 COA 105 (Ct. App. Div. I).
- CRS 10-1-135. Reimbursement for benefits–limitations–notice–definitions–legislative declaration.