Who Covers Medical Expenses After a Pedestrian Accident?

According to the Centers for Disease Control and Prevention (CDC), annually, more than 100,000 people seek medical treatment in emergency rooms nationwide for pedestrian accident injuries.

Injuries in pedestrian accidents are often quite severe, including catastrophic brain or spinal cord damage, broken bones, friction burns, deep lacerations, and even internal damage. These types of injuries can quickly and easily result in thousands or even hundreds of thousands of dollars worth of medical treatment.

If you were hit by a car while walking, you might have significant medical expenses. Insurance is the most common payment source for medical expenses resulting from a pedestrian accident, and multiple policies can often be accessed to pay for these expenses. A pedestrian accident lawyer can help you understand who covers medical expenses and pursue compensation to cover your losses.

How Insurance Policies Cover a Pedestrian Accident?

Experienced Pedestrian Accident Attorney near Newburgh NYIn no-fault states (such as Massachusetts, New York, and New Jersey), drivers must purchase a personal injury protection (PIP) policy when registering their vehicles. They must obtain this policy as long as they use their vehicle on public roadways.

Personal injury protection policies extend coverage for medical expenses related to injuries sustained in motor vehicle accidents up to the policy’s limits, regardless of who was at fault. Many people are unaware that this coverage is also available if they or a member of their household are injured in a pedestrian accident involving a motor vehicle.

Only 12 states require personal injury protection. Pedestrians injured in other states, however, can often seek compensation through different types of auto insurance coverage they have, such as uninsured/underinsured motorist coverage, medical payments coverage, or even their own comprehensive and collision coverage. Health insurance policies that the claimant obtained on their own or as an employment benefit also frequently cover medical treatment sustained in motor vehicle accidents.

In tort states (those that do not require a personal injury protection policy), injured pedestrians can also seek compensation by filing a claim against an at-fault driver’s auto liability policy. This option is also available in no-fault states once the claimant’s expenses have exceeded the limits of their personal injury protection or when the injury meets their state’s personal injury threshold for filing a third-party claim.

Receiving compensation through a third-party claim is often a far more time-consuming ordeal than seeking coverage through your own policy because it requires the insurance provider to determine fault.

Determining Liability in a Pedestrian Accident

Liability refers to the legal responsibility that an at-fault party has to compensate those injured as a result of their negligence. Nearly all states require that vehicle owners obtain and maintain an auto liability policy that features coverage of both physical injuries and property damage caused to others due to negligence.

The injured party and their attorney must be able to show the following elements of the claim to prove that a driver was liable for causing a pedestrian accident:

  • The at-fault driver had a legal duty to avoid causing harm to others. This includes a driver keeping their vehicle properly maintained and insured and operating it safely and legally on the roadways.
  • A breach in the duty owed by the at-fault driver occurred when they opted to operate their vehicle in an unsafe or illegal manner.
  • The breach of duty resulted in an accident in which the pedestrian was injured. Their injury resulted in expenses and impacts.

The evidence and documents that a pedestrian accident lawyer may use to support their client’s claim and justify its value include:

  • A police report produced by the officer who investigated the accident.
  • Photographs of visible injuries and the accident scene.
  • Eyewitness accounts from those who saw the accident take place.
  • Medical bills and other information about the medical treatment received after the accident.
  • The at-fault driver’s cell phone data which can reveal if they were talking or texting around the time the accident occurred.

You Know Who Caused the Accident. Now What?

When a pedestrian accident occurs, and the at-fault driver remains at the scene and provides their contact and insurance information to the injured pedestrian or the police officer investigating the accident, the injured party often wonders, “Now what?”

The injured party needs a prompt medical evaluation and must follow their healthcare provider’s treatment plan. Beyond that, the next order of business is usually to hire an experienced pedestrian accident lawyer licensed to practice law in their area.

Although many people balk at the notion of hiring a lawyer, the experience and understanding of the law and the personal injury claims process that an attorney offers are crucial to obtaining the compensation needed. An attorney will investigate the facts of the claim to determine who was liable for the accident and the insurance resources that the liable party has that can be accessed to compensate the claim.

Affording an Experienced Pedestrian Accident Attorney

lawampm_attorney-awards_logos_top-100-trial-attorneysOne of the most common reasons people fail to hire an attorney to help them obtain compensation after a pedestrian accident is that they don’t think they can afford to pay for the attorney’s services. This is definitely an understandable concern, particularly when an individual incurs unexpected expenses related to their injury and is missing work during recovery.

However, due to the contingent fee billing method most personal injury lawyers use, anyone needing help with a personal injury claim can afford to hire an attorney.

The contingent fee billing method works like this:

  • An injured pedestrian attends a free case evaluation with a personal injury lawyer with experience in this type of claim. At the end of the evaluation, the injured party determines if they would like to hire an attorney to assist them with their claim.
  • For the attorney and their legal team to begin working on the case, the claimant and the attorney must enter into a contingent fee agreement. This legally binding agreement designates a percentage of the compensation received for the claim as payment for the attorney’s services.
  • Work begins on the claim, and the claimant can focus on recovering from their physical injuries as the attorney and their legal team work on gathering evidence and communicating with the insurance provider. The claimant is not billed for this work while the case is active.
  • After the claim, the attorney collects the compensation on behalf of the claimant and places it in a trust. From the trust, the attorney withdraws the amount designated for their payment and the amount needed to satisfy any medical liens placed on the award by healthcare providers or insurers. The remainder of the compensation is then given to the claimant.

The Pedestrian Accident Claims Process

Once the claimant’s medical condition has stabilized and there is a clearer picture of the expenses they incurred due to the injury, their attorney will establish a value for the claim. The types of expenses in the claim’s value include all medical expenses related to the injury, lost wages, and lost earning capacity if the claimant’s injuries are permanent and likely to impair their ability to earn an income.

Additionally, the claim’s value may include compensation for the psychological impacts that the claimant experienced as a result of the accident or injury. This is commonly called non-economic damages and can include physical pain and suffering, emotional distress, and loss of enjoyment of life.

To put a dollar amount on psychological impacts, the claimant’s attorney will consider factors such as the amount of insurance the at-fault party has, the level of recklessness the at-fault party exhibited that led to the accident, the severity of the claimant’s injury, and the presence of permanent injuries that affect their livelihood or independence.

Once the claim has been valued, a demand will be sent to the at-fault party’s insurance provider. The insurance provider will assign a claims adjuster to value the claim, with the ability to either pay the claim outright, deny the claim with a reason for the denial, or offer to settle the claim out-of-court for less than its established value.

Initial settlement offers are generally far lower than the value of the claim. A pedestrian accident lawyer will manage communication with the at-fault party’s insurance claims adjuster to have meaningful negotiations in the hopes that the insurance company will increase their offer to fairly compensate the claimant for the expenses and impacts of their injury.

Suppose the insurance provider fails to resolve the claim by engaging the claimant in a settlement agreement. In that case, a legal complaint (lawsuit) can be filed in civil court within the state’s statute of limitations for pedestrian accident claims.

The insurance company can still offer a settlement at any time before a judge or jury reaches a verdict. The claimant’s attorney will also be working on preparing the case for trial. If a settlement has still not been reached by the time the trial date arrives, the claimant’s attorney will present their case to the court in order for a judge or jury to determine whether the at-fault party is liable for the pedestrian accident, as well as how much compensation is owed to the claimant as a result of that liability.

How to Cover Medical Expenses Before Your Claim Concludes?

As noted, many insurance coverages can be used to pay for medical expenses incurred while treating pedestrian accident injuries. However, these insurers will often want repayment for the coverage they provided if it is proven that the at-fault driver was liable for the accident.

The process of one insurer recovering the cost of coverage from the at-fault party’s insurer is called subrogation. In some cases, the insurer seeking to recoup the cost of the treatment they pay for will even be able to recover the cost of the deductible for their insured.

Paying for Medical Expenses With Compensation From Your Claim

In some cases, the injured pedestrian simply doesn’t have an insurance policy of their own that can cover the costs of medical treatment. However, their attorney can often help them secure medical care without upfront payment. When an individual receives medical care while in the process of a legal claim, the cost is often repaid through a medical lien placed on the claimant’s compensation through a negotiated settlement or a court verdict.

Where to Get Answers About Your Case?

The information provided here involves how pedestrian accident claims are generally resolved. However, contact a personal injury lawyer for answers to the questions you have about your specific claim. Most lawyers offer free case evaluations, which provide you time to meet with an attorney, discuss the details of your case, and determine whether the attorney can offer the services you need to effectively seek compensation.

You are under no obligation to hire a personal injury attorney in New York after the free case evaluation, but you will have a better picture of the legal options that are available for you as you seek compensation after a pedestrian accident.

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