Legal Question in Insurance Law in Pennsylvania

Auto Accident Claims reponsibility

I was injured in an auto accident. My PT refused to work with my insurance company and as a result, they refused to pay him. He took my health insurance card knowing he was not a provider in the network. Since he was refused payment, he is now charging me the balance. Can you please advise? The insurance company sent him a letter that he is NOT to seek payment from me. What do I do?


Asked on 8/07/06, 12:22 pm

1 Answer from Attorneys
Richard Teitell Richard K. Teitell, Esquire, P.C.

Re: Auto Accident Claims reponsibility

1. If you have auto ins, your medical bills get paid by your auto ins co 1st under "no fault". All medical providers must bill the auto ins & must accept the amount paid as payment in full, which is 110% of their Medicare reimbursement rate. 2. If your auto ins medical coverage is exhausted, the medical providers should then bill your health insurance. They can only collect a maximum of their 110% Medicare reimbursement rate. Please contact me if you have any other questions. Good luck!!

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Answered on 8/07/06, 3:42 pm


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