Motor vehicle accidents part 1: how does insurance work?
Updated: Jun 6
Car accidents are an unfortunate fact of life. Most people drive at least some of the time, and many of us will get into a collision of some kind, hopefully small, at some point in our lives. But while getting into an accident can be easy, navigating the insurance system once you do can be very confusing. I was originally going to write an article about treating injuries from car accidents, but the introduction that I was writing about how to navigate the insurance system became its own article. This information is what I have gathered in my decade of practice, as well as talking with friends and colleagues in the insurance industry. I’m not a lawyer, or an insurance expert, so this is designed to be a 30,000-foot view of things. Please consult the relevant experts for more detailed advice.
The first thing to know is that there a secret single-payer healthcare system in this country, and when you get into a car accident you get a temporary membership in it. The payer, in this context, is your car insurance company (or the company of the other driver). You have a lot of options for how to spend their money, and generally little to no guidance for how to do that. Insurance is confusing, partly by design, and getting into accident is scary and overwhelming and can tempt people to throw up their hands and give up. Hopefully you haven’t just gotten into an accident as you read this, but if you have, welcome. We’re going to walk through this together and things are going to be okay.
When a person gets into an accident, one of two things happens: if it was very mild then the at-fault driver might offer the other driver cash to avoid filing an insurance claim. I’m not a lawyer, and I can’t speak to the legality of this option or offer any kind of advice about it, but it happens. If the accident involved injury then someone ends up calling the police. Unfortunately, a police report is needed to file an insurance claim in most states. This is because the insurance company wants an outside party to attest to what happened. If there are bystanders around at the time of the accident then the police will want to speak with them and take statements, so if you find yourself in this situation it’s wise to ask people if they saw what happened and if they are willing to stick around for a bit. Once everyone gives their statement, people tend to go their separate ways if they are able. Your car might be towed away, or it may be drive-able. If you leave in an ambulance then it will definitely be towed. If you are not injured enough to need an ambulance, hooray! However, you should still go to urgent care or the emergency department. The reasons for this are two-fold:
You may be injured but unable to feel it due to the adrenaline in your system. Hours or days later however, you will feel your injuries and want some care
You want to document your injuries for your insurance claim. Having a medical provider create a record of your experience as soon as it happens is the best way to do this. You should also consider taking pictures of any cuts or bruises, both right after and in the days following the accident as the bruises rise to the surface
If you get into a collision you should notify your insurance company immediately, or ask a friend to do so, to create a claim. Your insurance claim is the pot of money assigned to your case. This pot of money is determined by your insurance policy, which brings me to a critical point: it’s worth considering getting more than the minimum personal injury protection (PIP) amount in your policy when you buy insurance. In Oregon the minimum amount is 15K, which is very small compared to most other states, and will often only be enough to cover care for a minor accident. Imagine needing to go to the hospital for a life-threatening issue and only having 15K to spend. That money can vanish in hours, depending on what happens. You’ll still have your normal health insurance, but normal health insurance tends to have high deductibles and co-pays. It’s usually quite inexpensive to get to the middle or even max options in a policy, and if you need it you’ll be glad you did.
Okay, I’m done being a dad.
Once you return from the hospital or urgent care, you get to start the fun process of keeping records about your case. I cannot stress this enough: insurance companies will try to weasel their way out of paying for things. The more that you document your case, the better of a time you will have. Request print-outs of your medical charts, take pictures of your injuries, keep receipts from purchases that you make in relation to your care. Keep all of these items in a folder somewhere. Maybe you’ll never need these items because your insurance company will do a great job. Yay for you if that happens. But if they get fussy, or you need to file a lawsuit against someone to get bills paid, you will want to have this information handy.
This info will also help your providers give you better care, because we can get more details about your exact injuries. People frequently forget the moments, hours, or even days after an accident, which is a totally normal thing that our brains due to shield us from traumatic experience. So keeping these records can be a crucial step in preserving things like diagnosis, after-care instructions, and follow-up appointments.
The other thing you’ll want to keep a record of is the information that you insurance company gives you. You’ll get a claim number, and someone will be assigned to your case to keep track of the money that the company is paying out. This person is called an adjuster, and their phone and fax numbers will be important for your providers to have so that they can stay in contact with your insurance company. Any provider that you contact will want this information, so having it ready in a place that you can easily access will make your life a lot easier.
Stay tuned for part 2, where I actually discuss the fun medicine stuff!