How much can an emergency room visit cost out of pocket

amother

Wed, May 24 2023, 1:32 pm

My husband was in a car accident and was taken to the emergency room for blood work and CAT scans. BH he is fine besides for some bruising and achiness. Everyone we're talking to says not to report it to the insurance cuz then our car insurance will go through the roof. The other person is at fault and their insurance already offered to pay 5K for his pain, but it's known that insurance will raise the rate even if you're not at fault.

I know this is true because we had an incident where someone walked into our car and threw a fit and the police told us to report to the insurance. Even though absolutely nothing happened to anybody and the claim was dropped the insurance raised us anyway. And that claim cost nobody anything, this one will be expensive.

From what I'm looking at it looks like in New York it's illegal to try to bill regular health insurance without first billing car insurance. I have no idea what it's going to cost, is there any chance that it's going to be less than 5K?

amother

Blue

Wed, May 24 2023, 2:15 pm

Definitely don’t accept their first offer, not so quickly. How long ago did this happen that the insurance was already in touch with you? You can try to call the hospital billing department to see when the bill will come or if they can even tell you the amount it will be.

Separately, if the other guy is admitting fault to the degree that they are offering you money, your insurance rates really likely won’t go up. A person walking into your car is harder to prove innocence because they’re a pedestrian, plus there were expenses for lawyers until the point that the case was dropped. It wasn’t necessarily proven that you were not at fault if the case was dropped.

Amarante

Wed, May 24 2023, 2:24 pm

What does your health insurance benefits state as costs for emergency department visits. Every policy is different so that would be a start.

If they offered $5000 they think the claim is worth more than that. Wasn't there damage to your car as well as damage to your husband?

My friend was hit by another car and her car was totaled and she also had lots of pain but no permanent damage. She hired a personal injury attorney. Her case was a bit complicated because the other person had no insurance so she had to use her own insurance - she had under insured/uninsured on her policy - which is a good thing anyway.

I don't think you are quite correct in terms of it being "illegal" to bill health insurance. It isn't a law but it is a way that insurance coverage operates. Most people use their own health insurance - private, Medicare or Medicaid if they are hurt. When you use insurance, you are asked whether it is because of an accident. If it is, your insurance will collect from the other party's insurance - or attempt to. If you collect money from the accident, they will collect that money from your settlement so the actual amount you receive will be reduced by all of the medical expenses.

amother

Wed, May 24 2023, 2:39 pm

justforfun87 wrote:

You can open a claim just under their insurance. Do NOT accept 5k. Your bill will probably exceed it.

We are definitely going to try to get more money than that but this is the guaranteed minimum.

New York law is written so that medical attention will be given right away and states that medical injury in most cases goes to no fault insurance which is your insurance not the other person's.

Any money is for pain and damages not medical bills.