ANSWERS: 3
  • Reimbused by whom?? If the insurance is covering it, who else would reimburse you? Are you suggesting that she was in an accident that was someone else's fault such as a car accident or workplace accident? If in a car accident, your insurance company will go to bat with the guilty parties insurance company (unless VA is a no-fault state) to get their money back. You can go to the offending party or their insurance company to recoup whatever your insurance doesn't cover (your co-pays and anything beyond your cap). You can also ask for lost wages, pain and suffering etc. If a work place injury, your wife's employer should be covering her medical bills thorugh their liability and workmans comp insurance. If you are asking if you can "double-dip" and get both the insurance AND the repsonsible party to pay for the same bills, uh....NO.
  • In some states, your Automobile insurance will have a Personal Injury Protection (PIP) or MedPay benifit which will cove any insured driver. In Texas, PIP benifits can not be "subrogated" (taken) by another carrier as payment for medical services. You can literally have the medical bills paid by your health insurance, submitt the same bill to your PIP carrier, and get a check for those services paid directly to you. It is complete legal and it forms the basis by which an attorney is able to make money on a automobile case. In my opinion it only exists only to insure that trial lawyers are able to carve out a living on these cases until their "BIG" civil settelement case leads them into retirement. But thats another story..... lol
  • If you are asking whether you can sue the party that caused the accident and recover the medical costs from them (even though your medical costs were paid by your insurance), the answer is YES. The reason for this is because the law wants to encourage people to be careful and avoid harm. However, even though you can sue and collect, you must reimburse the medical insurance company. Thus, you cannot get any extra benefit. Note: the duty to repay the medical insurance provider is based on contract law, and therefore the duty (in theory) only exists if such a term is in your policy (this is called a subrogation clause). However, nearly every policy in existence has such a clause, and recently courts have been holding that such a clause is implied.

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