Under Nevada law, someone who wrongfully causes an accident or injury is responsible for the medical expenses of the injured party. These losses may be paid directly by the person or company responsible, or by the liable party's insurer.
If the injured person is unable to wait for compensation from a lawsuit or out-of-court settlement, the cost of medical care can often be covered in the meantime by:
- Private health insurance;
- Medicare, Nevada Medicaid, or Nevada Check Up (SCHIP);
- Nevada “Med Pay” auto insurance; or
- A healthcare provider willing to work on a Nevada "medical lien basis."
And whether you've been injured in a Nevada car accident or a slip-and fall accident, or by a defective product or otherwise, there are steps you can take to make sure your settlement is large enough to cover your medical bills and still leave you something for your pain and suffering.
To help you better understand how to get your medical bills paid after an accident or injury, our Las Vegas personal injury lawyers discuss the following, below:
- 1. Who pays my medical bills after a Nevada accident or injury?
- 2. What if I am an injured in Nevada and do not have health insurance?
- 3. Should I use my health insurance or give a doctor a lien?
- 4. Who pays if I have more than one insurance policy?
- 5. Do I have to pay my health insurer back if I win my case?
- 6. How can Nevada "Med Pay" insurance help?
- 7. Process for submitting medical bills in a Nevada injury case
- 8. What if I had a pre-existing injury?
- 9. What if my settlement is not large enough to cover my medical bills?
If another party is fault for an accident or injury in Nevada, they are ultimately responsible for your medical bills and other damages. Your own auto insurer may also be liable under your Nevada uninsured motorist policy if the other party does not have insurance or is under-insured.
But no matter whose insurance company is liable, chances are the insurer will initially deny liability. Or the adjuster will delay making payment in the hope of making you give up or settle for less money than your case is worth.
In the meantime, you may have several other options for getting your medical bills paid after an accident in Nevada. These include:
- Payment under your Nevada health insurance policy or a government healthcare program such as Medicare,
- Payment under your Nevada “Med Pay” auto insurance coverage (if you have it), or
- Treatment from a doctor or healthcare provider willing to accept a “lien” in lieu of immediate payment.
Under Nevada law, if you do not have health insurance or Medicare, all major hospitals (except for County run University Medical Center (UMC) in Las Vegas) must discount their rates by 30 percent.1
Other providers may be willing to work on a "lien basis."
If a medical provider accepts a lien, it means the provider is willing to delay payment until you resolve your case.
Our Las Vegas injury attorneys can refer you to network doctors, chiropractors and therapists who are willing to work on a lien.
And regardless of who treats you, we will work with your doctors and therapists to make sure your injuries and treatment are properly documented so that you can get all the money you deserve for your injuries.
Often we can even help you negotiate with medical providers to lower your bills so that they don't eat up your entire settlement.
Healthcare providers that accept a lien in a Nevada accident are entitled to payment of their bills out of the proceeds of any lawsuit or out-of-court settlement. This will usually be at the healthcare providers' maximum billing rate (although your Las Vegas personal injury lawyer can often negotiate a discounted rate).
However, you are responsible for any medical bills that exceed the amount of your recovery from a settlement or lawsuit. Private healthcare and government insurers negotiate deeply discounted rates with their contracted Nevada doctors and healthcare providers. Once a provider accepts your private or government insurance, they cannot bill you at a higher rate.
For these reasons, we do not recommend hiring a doctor on a lien unless:
- You do not have private or government health insurance;
- You desire a provider or services not covered under such insurance; or
- You are unable to afford your deductible and/or co-pays.
Note additionally that the other party's insurance will not “punish” you for using a doctor with a discounted rate. They will base the amount of their settlement offer on the full value of your doctor's services.
In some cases, you may have more than one insurance policy that will potentially cover your medical expenses after an accident in Nevada.
Unless there is a good reason not to, you will usually want to submit your bills to ALL the insurance companies that could possibly pay your medical bills, particularly if you have health insurance or Med Pay insurance (discussed below).
Health insurance and Med Pay are "no-fault" insurance policies. They will pay your medical bills on nothing more than a showing that such expenses are genuine.
Additionally, health insurance in Nevada currently has no lifetime maximum cap on payouts. It also has a yearly out-of-pocket maximum. Once your expenses exceed this amount, the insurer picks up 100% of qualified payments.
For these and the reasons discussed in Section 3, above, you should usually submit your claims to your health insurer, even if you will eventually receive payment under the other driver's automobile liability policy or your own Nevada uninsured motorist policy.
Private and government health insurers usually have the right to be reimbursed if you win your lawsuit or receive an out-of-court settlement. This is known as the insurer's "subrogation right in Nevada."2 The details of the subrogation right will be spelled out in your private health insurance policy, or if you have government insurance, in the applicable statute.3
However, this reimbursement right only applies only if you actually get money from another party. Your health insurer has no right to recover this money from you if you lose your lawsuit or your settlement agreement is not large enough.
It may have the right to "step into your shoes," however, and sue for recovery on your behalf. This is just one reason why it is a good idea to hire your own attorney in a Nevada accident or injury case. Your attorney will look out for your interests, not just those of your insurer.
Medical payments coverage -- known as Nevada "Med Pay" for short -- is optional auto insurance. You must elect it and pay a separate premium in order to get it.
If you have Med Pay, your auto insurer is obligated to cover your medical expenses regardless of fault up to the limit of your coverage – usually $1,000, $2,000, $5,000 or $10,000 per person.
Med Pay is desirable for several reasons, including the fact that:
- There is no deductible on medical payments;
- The insurer must pay your claims even if you were at fault;
- Med Pay covers practitioners, such as chiropractors, that may not be covered under your health insurance (particularly if you belong to an HMO or have a plan under the Affordable Care Act / Obamacare);
- Med Pay covers passengers in your vehible;
- Med Pay applies when you are a pedestrian or a passenger in someone else's vehicle and
- Amounts paid under Med Pay cannot be used to reimburse your health insurer.4
You should usually open a claim with both your private or government insurer and Med Pay. In Nevada, a health insurer may not legally claim reimbursement from amounts you receive under a Med Pay policy.5
This means that even if your health insurer has already paid your medical bills, you will be able to pocket any recovery for those expenses obtained under your Med Pay policy.
To get your medical bills paid, the other party's insurer will need copies of your bills, as well as a diagnosis from your doctor, and a copy of test results such as x-rays or MRIs.
It is a good idea to ask your doctor or therapist to keep detailed records tying your treatment to your accident or injury in order to avoid a delay. If you have an attorney, he/she will typically organize this process for you.
You will also usually be asked to provide relevant medical records going back at least five years.
For instance, if you are claiming a spinal injury in Nevada, you would need to supply at least five years worth of records from orthopedic doctors, chiropractors and any other providers that treated you for similar injuries.
You do not need to provide unrelated records (such as those from gynecologists or optometrists) unless you are claiming damages in those areas.
For instance, you would need to provide psychologist records only if you were claiming damages for emotional distress, pain and suffering, anxiety, insomnia or a similar, non-physical injury.
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 might help your case – such as witness statements or declarations of friends, family, or co-workers setting forth what you are no longer able to do since you were injured.
If your injuries existed before the accident, you will usually not be able to recover for them. This is why the other side requires 5 years worth of medical records.
However, if you had a Nevada pre-existing injury but it was made worse by the accident, you are entitled to recover.
Example: Claude is a delivery person for UPS. Two years ago, he threw his back out delivering a large package and was on worker's compensation for one month. He still has to go to the chiropractor once in a while when his back really starts hurting.
As Claude is driving home from work one night, he is rear-ended by a driver who is texting. His back goes out again and he has to miss six weeks of work. Even though Claude's back was already injured, because it was made worse by the accident, Claude is entitled to have the other person's insurance pay his medical bills as well as his lost wages from missed work.
Often the responsible insurer will offer you a settlement that is not large enough to pay your bills. This can leave you in the position of having to accept less than you are on the hook for or having to turn the offer down and take the risk of not getting a better one or losing a lawsuit.
One reason retaining an experienced Las Vegas injury lawyer is so important is that your lawyer can help you evaluate the strength of your case and your bargaining position. But a lawyer can do even more for you.
Often we are able not only to negotiate a larger settlement, but to negotiate with your medical providers to reduce their bills.
The important thing is not so much the size of your settlement, but how much of it ends up in your pocket. Our goal is always to get you an amount that covers your bills but still leaves you something for your pain, suffering and inconvenience.
Injured in Las Vegas? Call us for help…
If you or someone you know has been injured in an accident or other wrongful act in Las Vegas, we invite you to contact us for a free consultation.
Our compassionate Reno or Las Vegas injury attorneys will work to make sure your settlement is large enough to cover your medical bills and still leave you something for your pain and suffering.
To schedule your free consultation call us at 702-DEFENSE (702-333-3673) or fill out the form on this page.
Don't pay more than you have to or risk not getting your medical bills covered. Contact us today.
- NRS 439B.260.
- An exception is a Nevada hospital. Under NRS 449.758, a hospital that provides care to a person who has third party health insurance under a contract with that third party is limited to whatever that policy provides. The hospital has no right to reimbursement from the proceeds of a lawsuit or any insurance other than the health policy, save for any unpaid deductibles and co-pays.
- See, e.g., 42 U.S.C. 1395y(b)(2) [Medicare] and NRS 422.293 [Medicaid].
- The Nevada Supreme Court has held that to do so would violate public policy. Maxwell vs. Allstate Insurance Co., 102 Nev. 502, 728 P.2d 812 (1986).