Medical Treatment, Personal Insurance, Bills, Copays, and Settlement After an Accident in DC, Maryland and Virginia

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I'm getting so much paperwork in the mail -

what's the difference between bills, explanations of benefits,

and subrogation letters?

You're not alone.

Many people are confused by the different aspects of a serious car accident case in DC, Maryland, and Virginia.

You have questions and we have answers!

Medical Treatment

First, medical treatment is the most important thing after a car accident. Don't put it off, don't try to tough it out. It's not going to help you to "be strong" under these conditions. The simple fact is that car accident injuries can fly under the radar and if you're not careful you could wind up with serious injuries that are untreated and you will have a harder time proving your case.

Personal Health Insurance

Go ahead and use your personal insurance to get medical treatment - there is really no way around it unless you have special insurance coverages like "med pay" or something similar. (And you should buy those types of insurances - they really help). But don't forget that the insurance company will only be paying out (if you can prove your case) at the end of your case - so you will need to rely on your personal insurance to get the medical treatment you need.

Bills with insurance payments, deductibles, and leftovers

You shouldn't be getting bills if you are using your insurance, but if you aren't using personal insurance you might want to just stop right where you are because those bills are going to come back to haunt you.

If you are using personal insurance and you are getting "balanced-billed" (invoices that come after you're already paid your co-pay and been seen) you may want to call your personal insurance carrier and check the terms of your insurance. They may be billing you toward a deductible or your doctor may have agreed not to charge more than the insurance company pays, plus your deductible,  so it's just worth checking out.

If you're accident happened while you were working, your company's workers comp insurance company should be paying for all of the medical treatment and you shouldn't be getting bills from anyone (or paying out of pocket at all).  If this isn't the case - call us and we'll help straighten it out.

Explanations of Benefits

Don't worry about Explanations of Benefits, or EOBs. It's just the insurance company giving you the layout of what they've spent on you. If you have a lawyer, though, your lawyer will want to keep track of these because it's an ongoing record of how much the insurance company will probably request back in a lien.  A lien is also called a "right to reimbursement."

Subrogation Letters

You may be frightened by the legalese in a subrogation letter, and if you didn't know that subrogation exists in the first place you might be in a pickle. 

A subrogation letter is also called a demand, and it's going to tell you how much of your car accident settlement actually belongs to your personal insurance company. And this amount could leave you without enough money to cover your future lost wages, your future medical treatment, and other things one doesn't really tend to think about when they are just trying to put one foot in front of the other.

Here is where it gets complicated. Insurance isn't as straightforward as it should be. I mean, you're the one paying the policy right - you should be able to use it however you choose. Unfortunately that is not exactly the case. You had better believe that if you settle with your insurance company after a serious injury in DC, Maryland, or Virginia, your personal insurance company will require repayment. It's stupid, and it's called subrogation, but it's a real thing. 

But not all insurance policies have a right to subrogation and some states (including Virginia) have anti-subrogation laws that may prohibit insurance companies from subrogating.  It's complicated, so be sure to review your policy and the law in your state on this.

Not everybody needs a lawyer, and a lot of lawyers with fewer scruples than us might sign you up even though they can't add value to your case. But we can add value to your case if you have been seriously injured in Washington DC, Maryland or Virginia and you have a certain amount of medical treatment ahead of you which will take you out of work. Lawyers like us can navigate the tricky and overly complicated world of intersectional insurance policies -- something you are probably not prepared to do on your own if you need surgery, or are recovering from surgery or a serious head injury, spine injury, or other type of debilitating injury from your car accident.

If that's you, just give us a call today and find out what we're about. We won't try to trick you, or gimmick you and we certainly won't take your case if it's not the best thing for you.

So, there you have it. Make the right choice and give us a call today at 202-393-3320. Even if we can't take your specific case, you're going to walk away with lots of good information we will give you for free that can help you - because that's just what we do.

202-393-3320 -



Frank R. Kearney, Attorney-at-Law
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Experienced DC Workers' Comp, Long Term Disability & Accident Lawyer
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