The ambulance ride to the emergency room, the ER visit itself, follow-up appointments, imaging studies, and physical therapy bills keep arriving while you’re still recovering.
The at-fault driver’s insurance company keeps telling you to be patient while they investigate. But the hospital sent a payment demand letter, and your own health insurance is asking questions about how the injury occurred. Understanding who pays medical bills after a Texas car accident, and in what order, prevents financial chaos while your injury claim proceeds.
At Branch & Dhillon, P.C., our car accident attorneys represent injured clients throughout Arlington, Tarrant County, and the Dallas-Fort Worth metroplex who face mounting medical bills and insurance company delays.
Contact us for a free consultation. We work on a contingency fee basis, so you pay no fees unless we win.
Key Takeaways for Medical Bills After Texas Car Accidents
- Texas is an at-fault state where the at-fault driver’s liability insurance should ultimately pay medical bills, but immediate payment rarely occurs
- Personal Injury Protection (PIP) and Medical Payments (MedPay) coverage provide immediate payment for medical expenses regardless of fault, though PIP and MedPay are not required coverage
- Health insurance covers accident-related medical treatment, but may assert subrogation rights to recover amounts paid from any settlement or verdict you receive, reducing your net recovery unless subrogation claims are negotiated down
- Hospital liens in Texas attach to settlements when hospitals provide emergency care within 72 hours of accidents, giving hospitals legal claims to settlement proceeds unless liens are resolved before distribution
- Uninsured and underinsured motorist (UM/UIM) coverage protects you when at-fault drivers lack adequate insurance, covering medical expenses and other damages when the liable party’s coverage falls short of your actual losses
How Texas’s At-Fault Insurance System Works
Texas follows an at-fault system for car accident claims. The driver who caused the crash bears financial responsibility for the resulting damages, including medical expenses. That driver’s bodily injury liability insurance should pay your medical bills—eventually.
The problem is timing. Liability investigations take weeks. Insurance companies dispute fault. Settlement negotiations drag on. You can’t wait months for medical treatment while insurance companies investigate. Bills arrive immediately, and medical providers expect payment within a certain time.
This timing gap creates confusion about who pays medical bills right now versus who ultimately bears financial responsibility. Several coverage sources may pay immediately, with reimbursement sorting out later once liability is determined and settlements are finalized.
Coverage That Pays Medical Bills Immediately
Several insurance types provide immediate medical bill payment without waiting for fault determination or settlement.
Personal Injury Protection (PIP)
Personal Injury Protection coverage pays medical expenses, lost wages, and other costs regardless of who caused the accident.
Texas law requires insurance companies to offer PIP coverage, but drivers can reject it in writing. Many Texas drivers decline PIP to reduce premium costs without understanding the financial protection it provides. If you accepted PIP coverage when purchasing auto insurance, it pays eligible medical expenses quickly.
PIP covers you and your passengers regardless of who was driving. It also covers you if injured as a pedestrian or bicycle rider struck by a vehicle. Bills are submitted directly to your PIP carrier, which pays according to policy terms.
Medical Payments Coverage (MedPay)
Medical Payments coverage functions similarly to PIP but focuses exclusively on medical expenses. MedPay doesn’t cover lost wages or other economic losses that PIP might address.
Like PIP, Texas insurers must offer MedPay coverage, and drivers can reject it in writing. MedPay pays medical bills regardless of fault and works alongside PIP if you carry both coverages.
MedPay reimburses medical expenses, including ambulance transport, emergency room treatment, hospital stays, surgery, doctor visits, physical therapy, and medical equipment. It pays quickly once providers submit proper documentation.
Health Insurance
Your health insurance covers accident-related medical treatment just as it covers illness or non-accident injuries. Health insurance becomes the primary payment source when you lack PIP or MedPay coverage or when medical bills exceed those coverages’ limits.
Using health insurance for car accident injuries triggers several considerations. First, health insurance often involves copays, deductibles, and coinsurance that PIP or MedPay might have covered in full. Second, health insurers usually assert subrogation rights, the right to recover amounts they paid from any settlement you receive from the at-fault party.
Health insurance pays according to your policy terms, applying deductibles and requiring copays. Providers accepting your health insurance bill at negotiated rates, typically lower than billed charges. This rate differential affects settlement calculations because you’re only legally obligated to reimburse the actual amount paid by insurance, not inflated billed amounts.
The At-Fault Driver’s Liability Insurance
The at-fault driver’s bodily injury liability coverage should ultimately pay your medical expenses. Texas requires minimum liability limits of $30,000 per person and $60,000 per accident for bodily injury. Many drivers carry only these minimums, which prove inadequate when serious injuries generate substantial medical bills.
Liability insurance doesn’t pay medical bills as they accrue. Instead, injured parties present all damages during settlement negotiations or litigation. The at-fault driver’s insurer evaluates the claim, and either offers a settlement or defends against a lawsuit.
This delayed payment structure means you can’t rely on liability coverage for immediate bill payment. You must use PIP, MedPay, health insurance, or personal funds while the claim proceeds. Once settlement occurs, you receive reimbursement for medical expenses along with compensation for other damages.
Uninsured and Underinsured Motorist Coverage
Uninsured motorist (UM) and underinsured motorist (UIM) coverage protect you when at-fault drivers lack insurance or carry insufficient coverage. Texas law requires insurers to offer UM/UIM coverage equal to your liability limits unless you reject it in writing.
Uninsured motorist coverage pays when at-fault drivers have no insurance. If someone runs a red light and T-bones your vehicle but carries no liability insurance, your UM coverage pays your medical expenses and other damages up to your policy limits.
Underinsured motorist coverage pays when at-fault drivers carry insurance, but their limits don’t cover your full damages. UIM coverage pays the difference between the other driver’s coverage and your actual damages, up to your UIM policy limits.
UM/UIM coverage becomes crucial in Texas because many drivers carry only minimum liability limits or drive without insurance entirely. Without UM/UIM protection, you’re left pursuing compensation from defendants who lack assets to pay judgments, even if you win in court.
Pursuing the At-Fault Driver Personally
When the at-fault driver lacks insurance or carries insufficient coverage, you retain the legal right to pursue them personally for damages through a lawsuit. A court judgment establishes their liability and the amount owed, but obtaining a judgment and actually collecting money are two different matters.
Uninsured drivers typically lack insurance because they can’t afford premiums. The same financial constraints that prevented them from maintaining coverage usually mean they lack assets to satisfy judgments. Wage garnishment, bank account levies, and property liens theoretically provide collection mechanisms, but these prove ineffective when defendants earn minimal wages, maintain little savings, and own no valuable property.
Even when you win a judgment, collection becomes a prolonged, expensive process with uncertain results. Some defendants file bankruptcy, discharging judgment debts and leaving you with nothing. Others simply ignore judgments, forcing you to invest in collection attorneys and enforcement actions that rarely recover meaningful amounts.
This reality underscores the importance of UM/UIM coverage. When you carry adequate uninsured and underinsured motorist coverage, your own insurance fills the gap that financially unstable at-fault drivers can’t pay.
What If You Can’t Afford Treatment While Claims Proceed
Car accident injury claims take months to resolve. Medical treatment can’t wait. Several options exist for obtaining necessary care when coverage is insufficient or nonexistent.
Medical Provider Liens
Some doctors, physical therapists, and other providers treat car accident victims on a lien basis. They provide treatment without upfront payment, accepting payment from eventual settlement proceeds. Medical liens function similarly to hospital liens—providers have contractual rights to settlement proceeds before you receive payment.
Medical lien arrangements allow treatment access when you lack sufficient insurance coverage. However, lien amounts accumulate without payment, potentially consuming large settlement portions. We work with lien-based providers to negotiate reasonable charges that don’t disproportionately reduce net settlements.
Letters of Protection
Attorneys can provide letters of protection to medical providers, guaranteeing payment from settlement proceeds. These letters reassure providers they’ll receive payment, encouraging them to treat clients who couldn’t otherwise afford care.
Negotiating with Providers
Medical providers sometimes accept negotiated payment plans or reduced fees when patients demonstrate an inability to pay in full. Discussing financial difficulties honestly with providers may produce flexible payment arrangements.
Why Legal Representation Is Important for Medical Bill Issues
Insurance companies know most accident victims don’t understand coverage coordination, subrogation, liens, and reimbursement rights. They exploit this confusion to reduce payouts and shift costs onto injured parties.
At Branch & Dhillon, P.C., we handle all medical bill aspects of car accident claims:
- Identify available coverage sources, including PIP, MedPay, and UM/UIM policies
- Negotiate with health insurers to reduce subrogation claims
- Resolve hospital liens for reduced amounts
- Coordinate with medical providers accepting lien-based treatment
- Write demands that include all medical expenses incurred and anticipated future costs
Our experience handling Arlington car accident cases, crashes throughout Tarrant County, and collisions across the DFW metroplex provides insight into how local medical providers, hospitals, and insurance companies operate.
When insurance companies dispute coverage or refuse fair settlement, we prepare cases for trial. Many claims settle favorably once defendants recognize we’ve documented all medical expenses, secured supporting records, and built compelling cases proving both liability and damages.
FAQ for Medical Bills After Car Accidents
The at-fault driver’s liability insurance ultimately pays medical bills, but immediate payment comes from PIP coverage, MedPay coverage, or your health insurance because liability claims take weeks or months to resolve. You use available immediate coverage, then seek reimbursement plus additional damages through the liability claim once fault and damages are established.
PIP and MedPay typically pay first because they’re designed for immediate accident-related expense coverage regardless of fault. Health insurance generally functions as secondary coverage, paying expenses exceeding PIP or MedPay limits. Review your specific policy terms because coordination of benefits clauses vary, affecting payment order and responsibility.
No, PIP is not required in Texas. Insurance companies must offer PIP coverage, but drivers can reject it in writing. Unless you specifically rejected PIP in writing when purchasing your policy, you may have this coverage.
Yes, Texas law allows hospitals to place statutory liens on personal injury settlements when they provide emergency care within 72 hours of accidents. The hospital files notice of the lien, and settlement proceeds must address the lien before distribution. Hospital liens are negotiable, and experienced attorneys routinely reduce lien amounts during settlement processes.
Most health insurance policies include subrogation clauses giving insurers rights to recover amounts they paid for accident-related treatment from any settlement or judgment you receive. Subrogation claims reduce your net settlement proceeds but are negotiable with the assistance of a knowledgeable lawyer.
Navigating Medical Bills and Insurance Claims
Medical bills after car accidents create immediate financial pressure while insurance claims proceed slowly through investigation, negotiation, and potential litigation. Understanding which coverage pays now, what reimbursement obligations exist, and how liens and subrogation affect net recovery prevents costly mistakes that reduce final compensation.
At Branch & Dhillon, P.C., we represent car accident survivors throughout Arlington, Tarrant County, and the Dallas-Fort Worth area who need guidance coordinating coverage, negotiating liens and subrogation claims, and pursuing fair compensation from at-fault parties.
Medical bills shouldn’t force you into a financial crisis while pursuing justice. Contact us today for a free consultation.