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When in an Accident, Who Pays?

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Find out who pays for which costs when an accident occurs.

Accidents are expensive. Every expense, from the price of medical treatments to the cost of missing work, can add up to create a huge financial burden. This is your guide to who pays for what damages in the aftermath of an accident.

Insurance Coverage for Accident Claims

In most accident cases, it’s an insurance company – not an individual – who pays for the damages.

For a car accident claim, there’s auto insurance coverage.

Homeowner’s insurance policies typically cover accidents that happen on residential properties, including dog bites and slip and falls or trip and falls.

Businesses have liability insurance to cover accidents that happen on commercial properties.

Even medical mistakes are covered by an insurer. Doctors and hospitals have malpractice insurance to compensate the victims of any medical errors they commit.

When you want to see the other person pay for what their careless behavior did to you, you may be disappointed to realize it’s the insurance company footing the bill. But ultimately, this system protects you. Most individuals don’t have the money to compensate you for your injuries. When there’s insurance, you know that there is money available – you just need to successfully build a case to attain it.

Suing Individuals

Can you sue an individual for money beyond the insurance coverage that’s available? Of course you can. But in most cases, that’s not a viable option.

Remember, a private citizen probably doesn’t have the kind of money you would win in a personal injury case. Even if the person who caused your accident has some assets, those assets might not be easy for you to access.

For example, the person at fault for the accident might have assets, but they might be in the form of real estate. You can put a lien on a house, so that once the person sells it, they have to pay you what they owe. But you can’t control when they’ll sell the real estate – so you could be waiting decades, if you get money at all.

Is it worth pursuing a case against this individual if you won’t be able to collect? In many cases, no. A better solution is to hire an attorney who can identify all possible parties involved in the case and pursue a claim against every source of insurance available. That way, you’ll walk away with actual compensation, not an impressive-sounding but ultimately meaningless judgment.

How Fault Affects Accident Benefits

Even though the individual who caused your accident isn’t personally responsible for paying the damages, fault still matters. Liability, or legal fault, is one of the first things you must prove to make a personal injury case successful.

Fault for an accident determines which insurance company has to pay for the damages. Sometimes, multiple people are at fault – and that means multiple insurance companies may have to pay some of the costs.

An Example of Fault and Accident Benefits

Take a car accident case, for example. When another driver breaks traffic safety laws and strikes you, it’s that driver’s auto insurance company that will have to pay.

The other driver’s insurer must pay to fix or replace your car or, if you choose to go through your own insurance policy, must repay the cost of repairs – including your deductible.

When you have damages like medical costs, lost wages, and pain and suffering, you’ll pursue a claim against this driver’s insurance company.

Uninsured and Underinsured Coverage

There’s one exception to pursuing a claim against the driver who is at fault for the accident. When this driver has little or no auto insurance, you might end up pursuing a claim against your own auto insurance company.

You only have this option if you purchased uninsured (UM) or underinsured (UIM) coverage as a part of your auto insurance policy. In this case, your own auto insurer takes the place of the other driver’s insurance company.

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In a UM or UIM case, you can pursue compensation up to the policy limits you agreed to when purchasing your coverage.

What You Have to Pay (Even If You’re Not at Fault)

Nothing about an accident is fair – and that, unfortunately, includes paying for it, especially in the cases of car accidents.

Your Responsibilities for Auto Accident Medical Benefits

In New Jersey, Pennsylvania, and other no-fault states, your own insurance company pays for your medical benefits no matter who caused a crash. Your insurer will minimize its financial burden by making you pay a deductible and copayments.

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Depending on what deductible you selected, you could end up paying thousands of dollars for an accident that isn’t your fault – even with insurance.

Paying for Medical Care in Other Types of Accidents

In cases that don’t involve motor vehicles, you may have to pay for medical care out-of-pocket and then seek compensation afterward. This means many victims of slip and falls, dog bites, and similar accidents often struggle to afford care.

Your health insurer might pay, if you have health insurance – but it might also demand repayment from you later.

So what can you do? Talk to an accident injury attorney.

  • We’ll find out if the homeowner’s or commercial property insurance policy includes medical benefits coverage that you can access now, while you’re still treating.
  • If not, we’ll look for other ways to help – like having your doctors wait to bill you until the end of your claim or helping to negotiate down the costs of your medical care.

Still have questions about who should be paying for your accident? Contact us today for help.

Disclaimer: Results may vary depending on your particular facts and legal circumstances.

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This article was professionally reviewed by Richard P Console Jr, an attorney licensed to practice in New Jersey, New York, and Pennsylvania.

Mr. Console has more than twenty years experience practicing personal injury law and successfully resolving vehicle accident claims on behalf of his clients.

Learn more About Richard P Console Jr.

While this information was reviewed for accuracy, it should not be considered legal advice. Every claim is different. If you are thinking of pursuing a personal injury claim and have a question contact us directly. 

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