If you are an innocent accident victim but you also happened to be working when another party causes an auto accident, workers’ compensation will be your primary source of health insurance.
Workers’ comp has certain restrictions that you must follow. For example, you must use the physicians approved by the workers’ comp insurance carrier, you must allow workers’ comp case workers to attend certain medical appointments, and you must also follow all restrictions imposed by the North Carolina Workers’ Compensation Act during the course of care.
Workers’ comp is very helpful for accident victims. You may not need an attorney in the workers’ comp case, and hiring an attorney to present your personal injury claims against those who caused your accident would not require you to also retain counsel to fight your employer or their workers’ comp carrier. However, if the workers’ comp carrier is refusing necessary medical care, pushing you back to work too soon, or otherwise restricting benefits, you may prefer to hire counsel in the workers comp’ claim as well.
Workers’ comp pays for all medical care, and they also pay lump-sum payments for permanent injury and for temporary or permanent income loss due to injury. The workers’ comp carrier does have a right to take a share of the injury claim proceeds. In fact, after twelve months have passed, the workers’ comp carrier has a right to take control over your personal injury case and hire their own attorney to take the lead. Since the workers’ comp carrier’s interests are opposed to yours, you should ensure that you or your attorneys maintain control of all claims against drivers and all other parties who caused your injuries.
Seeking Medical Treatment on Private-Pay/Credit Basis
If you do not have health insurance, you must either find physicians who will treat you on a credit basis or seek to purchase health insurance through the current federal programs, which allow health insurance coverage with no exception for preexisting conditions. If you cannot fund a health insurance purchase, you may be eligible for subsidized care or be qualified for Medicaid coverage that essentially provides free medical care for accident victims. Beyond these choices, up-front payment or treatment with doctors who agree to bill you later are your only options.
It can be very difficult to find doctors who will wait for payment. Orthopedic doctors who handle bone and joint injuries commonly insist on prepayment before an initial evaluation. If you are able to set up a payment arrangement, this is acceptable. Ideally, the physician will leave all charges due and owing and accept assurance from your lawyer or the liability insurance carrier that the charges will be paid from injury case proceeds at time of settlement. Attorneys can offer a letter of protection to these unpaid physicians, essentially promising to include all charges in the injury case and to pay unpaid charges directly from your settlement/verdict funds. Many doctors respond favorably to a letter of protection. They see your lawyer’s involvement as confirmation of the validity of the injury claim, and they also see that your lawyer is promising to protect the doctor’s right to payment directly from your insurance claim proceeds.
Chiropractors commonly provide medical treatment to accident victims on a credit basis. They understand that North Carolina follows a single, lump-sum approach to payment of injury claims. They know that their bills are considered and paid after all treatment is concluded, and they will typically work with patients and provide care without up-front charges or ongoing payment obligations.
Free clinics and other subsidized care facilities can also be very helpful for those with no health coverage. The downside is these clinics often only provide general family medicine, and they are not well suited to deal with serious or lasting injuries.
Despite the money challenges, you should explore every option and make sure that you receive careful medical attention, full diagnosis of all injuries, and thorough medical treatment until you have reached a full recovery. This approach protects your health and supports important legal rights.