In almost every case, your health insurance carrier is what the insurance industry calls the “primary coverage” if you incur medical bills as a result of an automobile accident and even if the accident is not your fault. In other words, although there may be several different sources of recovery for the medical bills, your primary coverage is your major medical health insurance carrier (e.g. Blue Cross Blue Shield).
Think of it this way. Medical bills incurred as a result of the accident may be paid from a variety of resources —– health insurance; at-fault driver’s BI coverage (see above); your MPC coverage (see above); and perhaps under your UM coverage. The order or sequence of these coverages varies from case to case. However, more often than not, your major medical health insurance policy should be first-in–line to pay these bills irrespective of who was at fault and whether or not you or the at-fault driver carries any of the applicable coverages discussed above.
Beware however. Many health insurance companies are now trying to evade their responsibility as “primary” by denying coverage when the provider (usually, the hospital ER) submits its claims. For example, the hospital contacts the health insurance provider who rejects coverage once it learns the injuries occurred in an automobile accident. The hospital then contacts you or other parties to determine whether there is MPC coverage or other liability coverage for the injuries in the accident.
Simply put, your health insurance carrier is delaying because it knows there may be another responsible party to pay the bill. The problem is, it may take months, even years, to sort out who is the responsible, at-fault driver for the accident and most medical providers will not wait that long. While you should cooperate with your health insurance provider, you should insist that your health insurance carrier pay the bills (according to the terms of your health coverage) and insist your medical provider continue submitting the claim to your health insurance.