The bills start arriving before anyone has decided who’s at fault. An ambulance ride, an emergency room visit, X-rays, follow-up appointments, physical therapy. In Alabama, the at-fault driver’s insurance company doesn’t pay those as they come in. It pays once, at the end, if it pays at all. So the question in the first months after a Birmingham crash is how to keep the bills handled while the claim plays out.
Your health insurance comes first, usually
If you have health insurance, use it. Give the hospital and doctors your insurance card, even though someone else caused the crash. Some providers would rather wait and get paid from a settlement, sometimes at full price. That doesn’t help you. Running bills through health insurance usually means discounted rates and less pressure from collections.
Your health plan will likely want to be repaid from any settlement. That’s called subrogation, or a lien, and it’s normal. The amount and the rules depend on the kind of plan. Employer self-funded plans, Medicare, Medicaid and individual plans all handle reimbursement differently. A lawyer can often negotiate these claims down.
Medical payments coverage
Many Alabama auto policies include medical payments coverage, often called MedPay. It pays medical bills for you and anyone riding with you, regardless of who caused the crash, up to a set limit, often a few thousand dollars. It’s quick and it doesn’t depend on fault. Check your declarations page to see if you have it.
If you don’t have health insurance
This is harder. Some providers will treat injured people on what’s called a letter of protection, meaning they agree to wait for payment from a settlement. It can work, but the bills may be higher than insured rates, and the provider expects to be paid even if the case doesn’t go well. Alabama also has hospital lien laws that allow hospitals to claim part of a recovery for care they provided. Ask questions before you sign anything at a clinic.
Alabama’s collateral payment law
Here’s an Alabama twist. In most states, juries never hear that a plaintiff’s health insurance paid medical bills. Alabama is different. Ala. Code § 12-21-45 allows the defense in a personal injury case to introduce evidence that medical or hospital expenses have been or will be paid by insurance. The plaintiff can then show what they paid for that coverage, such as premiums. In practice, that means juries in Alabama may hear about insurance payments, and lawyers on both sides plan their cases around it.
Keeping it organized
The more organized your medical paperwork is, the easier everything becomes, from negotiating with an adjuster to talking with a lawyer.
- Keep one folder, paper or digital, for every bill, explanation of benefits and receipt.
- Write down every appointment, including the date, provider and what was done.
- Save pharmacy receipts, receipts for braces and crutches, and mileage to and from appointments.
- Ask for itemized bills, not just balance statements.
- Keep notes on how you feel day to day. Pain, sleep problems and missed activities are part of the claim, and memory fades.
Gaps in treatment
Insurance adjusters look for gaps. If you were seen in the ER and then didn’t see a doctor for six weeks, the insurer will argue you weren’t really hurt or that something else caused the pain. Life gets in the way, and people skip appointments for good reasons. If you do have a gap, it helps to be able to explain it. If you’re still hurting, keep going to the doctor.
Lost wages
Missed work is a separate part of a claim. Ask your employer for a letter showing your pay rate, the days you missed and any paid time off you used. If you’re self-employed, invoices, tax returns and bank statements help show what you lost.
When the case settles
At the end, the settlement pays the bills and liens that are still owed, the lawyer’s fee and costs if you have a lawyer, and the rest goes to you. Before you agree to a number, it’s important to know roughly what’s owed to health plans, hospitals and providers, so the amount you end up with isn’t a surprise. Our settlement guide explains how the pieces usually fit.
Where to get care around Birmingham
UAB Hospital, St. Vincent’s, Grandview and Princeton Baptist all serve the metro area, along with urgent care clinics across the over-the-mountain suburbs. Go where you’ll get good care, and tell every provider the injury came from a crash so it’s noted from the start.
Help if bills are piling up
When the at-fault driver has little or no coverage
If the driver’s liability limits will not cover the bills, Ala. Code § 32-7-23 treats a vehicle as uninsured when the available bodily injury limits are less than the damages you are legally entitled to recover, and also when the owner’s or operator’s insurer becomes insolvent after the policy is issued. The section requires that coverage on Alabama auto policies unless the named insured rejected it in writing. Recovery under any one contract is limited to the primary coverage plus coverage on additional vehicles, but not more than two additional coverages in that contract. Our UM and UIM guide explains how that claim usually works alongside the medical bills.
If medical bills are going to collections or you’re unsure how a lien works, a lawyer can often help sort it out. Many injury lawyers in Birmingham handle cases on contingency. You can browse attorneys near Redmont Park. If you can’t afford a lawyer for a non-injury legal problem, our legal aid page has free options. This guide is general information, not legal or financial advice.