A car accident will send a pedestrian to the hospital with serious injuries. It is a scenario that happens over and over again on the streets of New York, Yonkers, White Plains and across the state. Who is responsible for paying the pedestrian’s medical bills? We have litigated a number of such cases in recent years and provide you with a look at the law in New York governing responsibility in a pedestrian knockdown. Medical Bills
In almost all car accidents involving pedestrians in New York, the insurer for the vehicle is obligated under the Insurance law to provide no fault benefits to the injured person. This means that insurance company for the car or truck that strikes the pedestrian is responsible for paying the pedestrian’s accident related medical bills. What if the accident was mostly or entirely my fault?
It can happen. The pedestrian wasn’t paying attention and stepped into the roadway right into oncoming traffic. It doesn’t matter. The obligation for the no fault insurer to pay accident related medical bills is triggered even if it is later determined that the pedestrian was completely at fault for the collision. How much will the No Fault insurer pay
? The maximum is $50,000. However, just because the hospital or provider bills a no fault insurer, does not mean that the insurer will pay the bill in full. The insurer may also decide to terminate benefits following a physical examination by a doctor selected by the insurer when much less than $50,000 has been paid. What if there is a dispute between the provider and the no fault insurer?
The good news for the injured person is that once the provider accepts an assignment of benefits and thus gains the right to receive payment directly from the insurer, the injured person generally does not have to worry about any disputes that may arise between them. Thus, if the hospital bills an amount over and above what the insurer wishes to pay, the hospital cannot go after the patient for the difference. What happens if my bills exceed $50,000?
This can often happen when the accident causes multiple fractures and the injured person has to undergo one or more surgeries or is confined to a hospital for an extended period of time. Once the $50,000 cap has been met, the no fault insurer is not obligated to pay any more of the accident related medical bills or lost wages. If the injured person owns a car or lives in the same home as relative who owns a car, then they can turn to their own insurance company or if none, then the relative’s auto insurer for what is known as Additional Personal Injury Protection (APIP) benefits. APIP can increase the amount of no fault benefits by $100,000. What if I cannot work because of my injuries?
The no fault insurer will pay for lost wages caused by the accident. The employer must return a wage verification form directly to the insurer setting forth the emloyee’s pay and a doctor must submit documentation stating that the person cannot work as a result of the accident related injuries. Why do I need a personal injury lawyer if I am injured in a pedestrian knockdown?
Worrying about each of the topics discussed above is the last thing that someone injured in a car accident needs. We let you focus on getting better while we:
- Make sure that the no fault application is submitted to the carrier on time;
- Communicate with your providers to make that your medical bills are sent to the no fault carrier;
- Communicate with your employer to make sure that the wage verification form is submitted;
- Keep in contact with the no fault carrier to make sure that your benefits are being provided;
- Make sure that the liability adjuster for that same insurer does not take unfair advantage of you