Understanding Insurance Claims

If you have recently been in a motor vehicle crash in southern Illinois or near the metro-east, then you are probably already dealing with medical bills, insurance representatives, and possibly even third-party collection companies. Frankly, it’s not fair. If you were just an innocent driver who was following the rules when someone else decided not to follow them, it’s not fair that you should be stuck holding the bill. Sadly, far too many misunderstand how insurance claims work, thus mistakenly believing that somehow victims are to blame for the rising cost of insurance.

At Jerome | Lindsay | Salmi, LLP, we want our clients to be educated and informed so that they can take an active role in their own success. To help dispel some of these myths, let’s take a look at what really happens when you get into a car accident in Illinois.

The “Rack Rate” For Medical Care

The average cost of a 3-day hospital stay is $30,000, according to Healthcare.gov. Once you are injured in a wreck, you will likely seek medical care. The providers who render that care know that you were in a car accident, so they immediately recognize that some other individual or company may be responsible. Given a number of rules built into insurance law, your provider may choose to bill you instead of health insurance. By doing this, your providers are seeking to recover the FULL PRICE of care, without taking any contractual reductions that would otherwise be required under your health insurance plan.

Standard Reductions

Normally, when you go to the hospital and pay $400-500 for a coinsurance amount or a co-pay, you are covering the majority of the actual charge, because a $10,000 hospital stay may only cost an insurance company around $1,000, after taking a standard reduction under the contract between your health insurance carrier and the hospital or other provider. Therefore, you simply get a better deal WITH health insurance than if they bill you directly. But you don’t always have a choice.

Medical Care is Expensive

Everyone knows that medical care is out of control in America, but to make matters worse, some providers artificially inflate bills in anticipation that an attorney or patient may want them to reduce their outrageous charges. Therefore, the net effect of all of this is that providers end up billing as much as 300-400% more for care when you are in a car wreck than if you just got sick. And to be clear – none of this is the innocent victim’s fault. He or she just wanted to go to the hospital and be checked out.

The Solution Rests With Your Attorney

Attorneys are not miracle workers. We cannot fix the pain, nor can we generally change the law overnight. What an experienced auto accident lawyer CAN do, however, is help to negotiate with healthcare providers to get better deals. Often this can help make a significant difference in the amount of money you receive at the end of your case.

Don’t trust your case to just any lawyer. Call Jerome | Lindsay | Salmi, LLP today to schedule your very own personalized free consultation.




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One part combat veteran, one part former firefighter/EMT and truck driver, and 100% devoted to helping clients achieve the results they desire.