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Insurance Company Accepts Fault for Accident

I was injured in a car accident. The other driver’s insurance company accepts fault and said they will pay for my medical treatment. How does that work? Will they refer me to a doctor?

- STW, California


This is a common source of confusion for car accident victims. Here's how it works and what you need to know: Even if the other driver's insurance carrier accepts fault for the accident, they will:

  • Not refer you to a medical provider, and
  • Not pay your medical bills as you incur them.

The insurance company will only pay you a lump sum, at the end, after you are done treating, and after you agree to accept a settlement offer.

Insurance adjusters aren't straight with you and instead will mislead you on this issue because they're hoping you don't feel the need to hire an attorney. They know that if you hire a lawyer, the insurance company will have to pay you more money.

So how do you find a doctor and pay for medical treatment in the meantime? These are your options:

  • Go through your health insurance, if you have it. Many people are under the misconception that health insurance won't pay for accident-related medical treatment. Wrong. It will. After your case settles, your health insurance company has a right to be paid back (out of the settlement money you receive) for the accident-related medical treatment it paid for.
  • Find your own doctor, pay the bills, and then get reimbursed after your case settles.
  • Hire a personal injury lawyer to represent you on the car accident and have the attorney refer you to a doctor who will treat you on a lien. ("Lien" means the doctor agrees to wait to be paid until your case settles.) If you choose to hire our firm, we can refer you to a medical provider in the local community. We can often get you scheduled to see a doctor within a day or two of hiring us.

Whatever you do, don't delay getting treatment. Insurance adjusters will use against you any delay or gap in getting medical treatment in order to justify a low settlement offer. They will take the position that if you were really hurt, you would have treated sooner and more consistently. Insurance adjusters will even use a three-day-delay (between the date of an accident and the first date of treatment) against you.

Your confusion on this issue plays into the insurance adjuster's hands. While you're trying to figure out how you're supposed to get and pay for medical treatment, the clock is ticking. The longer that delay before you see a doctor → the potentially lower the value of your injury claim because you delayed seeking treatment.

Bottom line: Don't trust the insurance adjuster. Talk to an attorney right away after a car accident to find out about your rights and how not to compromise your injury claim.

This answer does not constitute legal advice, which can only be rendered after a full consideration of the facts of your case which is not possible in this format; nor establish an attorney-client relationship, which can only be done after you and an attorney meet and agree on the terms of that relationship. This answer is intended solely to provide general information about the justice system. Further, it does not provide the basis for making decisions about a course of action. Before making any decisions about a course of action readers are strongly encouraged to contact a lawyer and secure an attorney-client relationship. Readers must also understand that this format does not provide for confidential communication. Moreover, links to information on this site are for your convenience only and are not an endorsement or recommendation of those sites, and no responsibility is taken for any information at these linked sites, nor makes any representation or warranty with respect to these sites or the information contained therein.