Legal Question in Insurance Law in Texas
Is our personal health insurance company liable for this?
Several months ago, my wife was involved in a MVA. The other driver came out of a parking lot, crossed two lanes of traffic and t-boned her car, totaling both vehicles. My wife was taken to the ER where x-rays of her neck and head were done. Soft tissue injuries were diagnosed and she underwent short term P.T. Two months later she was admitted for severe back pain. An MRI was done and two herniated disks were discovered. She has never had back problems before and all Doc's attribute this to the MVA. Total stay was 10 days. She was re-admitted for 7 days last week for sever back pain again. The diagnosis was the same and again, all Doc's say it was from the MVA. If the other person carries the minimum insurance, and the bills are more, is our personal medical insurance liable?
Thanks in advance.
3 Answers from Attorneys
Re: Is our personal health insurance company liable for this?
Yes.
Re: Is our personal health insurance company liable for this?
Your personal medical insurance is responsible for the medical expense even though it is covered under the responsible party's liability insurance. Your personal medical insurance MAY BE entitled to reimbursement. In some cases, your wife must be made whole, that is, if her damages exceed the amount of recoverable liability insurance, then there is a question about whether or not your hospitalization carrier is entitled to reimbursement.
In addition, your wife should make a claim under her Uninsured/Underinsured endorsement on your auto insurance on your vehicle. You should know that you must obtain the consent of your auto insurance carrier BEFORE you settle with the third party's insurance carrier in order to preserve your right to make a claim under the underinsured/uninsured endorsement of your personal auto policy.
Joe D. Gregory
Re: Is our personal health insurance company liable for this?
Yes. However they have subrogation rights which can be discounted. Additionally your U/M benefits should pay. Call me at 214-520-0000 for additional help.
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