At Geoffrey B. Gompers & Associates, our car accident lawyers are often asked about the interplay between different types of insurance and how that can affect where an injury victim can treat. There are a number of factors that can affect this decision. Two factors are paramount:
- Do you have PIP coverage?
- Were you injured while at work?
If you have Motor Vehicle Insurance at the time of a Pennsylvania car accident, the law requires insurers to provide $5,000.00 in mandatory automobile medical coverage. This is known commonly as PIP coverage (personal injury protection). PIP coverage allows you to choose your own doctor to treat your accident injuries and have the PIP insurance pay for the bill up to the amount of the coverage which is usually capped at $5,000.00 in most Pennsylvania PIP policies. Be aware, however, that you can purchase extra PIP coverage. In most, but not all, car accident situations, PIP is primary. This means it must be used before your normal health insurance coverage (i.e., Blue Cross, Aetna, United Healthcare, etc.) can be used. Insurers under PIP get a discount under a law called Act 6. This means that while $5,000.00 is the amount of the coverage, it actually will cover more since the gross amount of a medical bill will be discounted under Act 6 before it is paid. Medical providers are required to accept the Act 6 amount as payment in full.
Under your PIP coverage, you can usually choose your own medical providers so long as the treatment is causally related to a car accident. Be careful, however, because once your PIP is exhausted, your secondary or normal Health Coverage comes into play. If you have an HMO, or a designated provider network, your ability to choose your own doctor (and receive payment) may come into play.
A different situation occurs, however, when there is a work-related car accident. When a work car accident occurs, the Workers’ Compensation laws come into play, and your employer usually may require you to treat for the first 90 days with a doctor on a panel that is selected by the employer. In such instances, your employer may be able to require you to treat with a provider taken from a list of at least six health care providers, if they properly post a list with at least six health care providers for you to choose from.
You may choose any of the six doctors and your employer cannot require you to select any particular doctor from that list.
Additionally, your employer must have given you a written document providing you with the names of the doctors on that list and that writing must set forth your rights and duties with respect to medical treatment. After 90 days, you can then treat with any doctor of your choosing in a work-related car accident.
Geoffrey B. Gompers & Associates – Philadelphia Auto Accident Attorneys Who Know How to Advise You Of your Treatment Rights
At Geoffrey B. Gompers & Associates, we investigate every accident case thoroughly to try to gather the right kind of evidence that is needed to win your case. We represent victims of all types of personal injury and we care about your rights. Call us at 215-567-6600 or contact us online the next time you are involved in accident and want an experienced, knowledgeable personal injury attorney at your side. We offer free consultations.