Can health insurance deny a claim caused by an auto accident? (Claims + Laws)

Health insurance won't usually deny a claim caused by an auto accident but may defer to your auto insurance company to cover its share first.

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Rachel Bodine graduated from college with a BA in English. She has since worked as a Feature Writer in the insurance industry and gained a deep knowledge of state and countrywide insurance laws and rates. Her research and writing focus on helping readers understand their insurance coverage and how to find savings. Her expert advice on insurance has been featured on sites like PhotoEnforced, All...

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Written by Rachel Bodine
Feature Writer Rachel Bodine

Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years (BBB A+). He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com and Safeco. He reviews content, ensuring that ex...

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Reviewed by Daniel Walker
Licensed Auto Insurance Agent Daniel Walker

UPDATED: Jun 13, 2022

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Here's what you need to know...

  • Health insurance companies cannot deny claims related to auto accidents
  • Auto insurance companies can deny claims if you’re at fault
  • Health insurance steps in when auto insurance stops paying for claims 

Car accidents can be scary. On top of dealing with the injury itself, you’ll also have to think about filing an insurance claim. The last thing you want to worry about is the medical expenses associated with the accident and whether your insurance will cover your treatment. The good news is that car insurance and health insurance don’t cancel each other out after a car crash, but instead work together. 

Does health insurance cover auto accidents?

You probably understand that health insurance isn’t intended to cover auto accidents because that’s what the medical portion of your auto insurance is for. But if your next question was, “Will health insurance cover a car crash injury?”, the answer is: sometimes, yes. 

The amount varies by state, but in most places, you are required to have a certain amount of coverage when you purchase car insurance. 

How much is full coverage auto insurance? The cost of auto insurance varies by state. Here’s a summary of the average annual rate by each state.

Average Annual Auto Insurance Rates by State
StatesAverage Annual Auto Insurance Rates
Virginia$2,358
Hawaii$2,556
West Virginia$2,595
Massachusetts$2,679
Ohio$2,710
Maine$2,953
Idaho$2,979
Iowa$2,981
Washington$3,059
New Hampshire$3,152
Wyoming$3,200
Montana$3,221
Vermont$3,234
Kansas$3,280
Nebraska$3,284
Illinois$3,305
Missouri$3,329
North Carolina$3,393
Indiana$3,415
Alaska$3,422
New Mexico$3,464
Oregon$3,468
Alabama$3,567
Wisconsin$3,606
Utah$3,612
Tennessee$3,661
Median$3,661
Mississippi$3,665
California$3,689
Arizona$3,771
South Carolina$3,781
Colorado$3,876
South Dakota$3,982
Pennsylvania$4,035
Texas$4,043
Arkansas$4,125
Oklahoma$4,142
North Dakota$4,166
New York$4,290
Minnesota$4,403
District of Columbia$4,439
Maryland$4,583
Connecticut$4,619
Florida$4,680
Nevada$4,862
Georgia$4,967
Rhode Island$5,003
Kentucky$5,195
New Jersey$5,515
Louisiana$5,711
Delaware$5,986
Michigan$10,499
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Factors that determine your auto insurance rates include age, gender, marital status, credit history, commute mileage, driving record, coverage level, and area. Each city, county, and town has a unique annual rate. Urban areas tend to have more expensive rates due to the increased risk of an accident, but rural areas generally have cheaper rates.

Health insurance will step in after the limits of your auto policy have been exceeded. This means that your car insurance liability coverage (or the at-fault driver’s coverage) will step in first, and then once those limits are reached your health insurance will generally pay the remaining costs.

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How much is a health insurance company obligated to pay for a car accident?

Health insurance is obligated to pay for any medical expenses if you’re injured, but in the case of a car accident, they will usually defer to your car insurance policy first. Your car insurance is usually your primary insurer for injuries caused by accidents.

This is one reason auto insurance is required by law in most states. 

The data presented below is a summary from the Insurance Information Institute that lists the state minimum requirements for each state.

Minimum Auto Insurance Liability Requirements by State
StatesCoverage TypesCoverage Limits
AlabamaBodily injury and property damage liability25/50/25
AlaskaBodily injury and property damage liability50/100/25
ArizonaBodily injury and property damage liability15/30/10
ArkansasBodily injury and property damage liability; personal injury protection25/50/25
CaliforniaBodily injury and property damage liability15/30/5
ColoradoBodily injury and property damage liability25/50/15
ConnecticutBodily injury and property damage liability; uninsured/underinsured motorist protection25/50/20
DelawareBodily injury and property damage liability; personal injury protection25/50/10
Washington, D.C.Bodily injury and property damage liability; uninsured/underinsured motorist protection25/50/10
FloridaProperty damage liability and personal injury protection10/20/10
GeorgiaBodily injury and property damage liability25/50/25
HawaiiBodily injury and property damage liability; personal injury protection20/40/10
IdahoBodily injury and property damage liability25/50/15
IllinoisBodily injury and property damage liability; uninsured/underinsured motorist protection25/50/20
IndianaBodily injury and property damage liability25/50/25
IowaBodily injury and property damage liability20/40/15
KansasBodily injury and property damage liability; personal injury protection25/50/25
KentuckyBodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist protection25/50/25
LouisianaBodily injury and property damage liability15/30/25
MaineBodily injury and property damage liability; uninsured/underinsured motorist coverage; medical payments50/100/25
MarylandBodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage30/60/15
MassachusettsBodily injury and property damage liability; personal injury protection20/40/5
MichiganBodily injury and property damage liability; personal injury protection20/40/10
MinnesotaBodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage30/60/10
MississippiBodily injury and property damage liability25/50/25
MissouriBodily injury and property damage liability; uninsured/underinsured motorist coverage25/50/25
MontanaBodily injury and property damage liability25/50/20
NebraskaBodily injury and property damage liability; uninsured/underinsured motorist coverage25/50/25
NevadaBodily injury and property damage liability25/50/20
New HampshireFinancial responsibility only25/50/25
New JerseyBodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage15/30/5
New MexicoBodily injury and property damage liability25/50/10
New YorkBodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage25/50/10
North CarolinaBodily injury and property damage liability; uninsured/underinsured motorist coverage30/60/25
North DakotaBodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage25/50/25
OhioBodily injury and property damage liability25/50/25
OklahomaBodily injury and property damage liability25/50/25
OregonBodily injury and property damage liability; personal injury protection; uninsured/underinsured motorist coverage25/50/20
PennsylvaniaBodily injury and property damage liability; personal injury protection15/30/5
Rhode IslandBodily injury and property damage liability25/50/25
South CarolinaBodily injury and property damage liability; uninsured/underinsured motorist coverage25/50/25
South DakotaBodily injury and property damage liability; uninsured/underinsured motorist coverage25/50/25
TennesseeBodily injury and property damage liability25/50/15
TexasBodily injury and property damage liability; personal injury protection30/60/25
UtahBodily injury and property damage liability; personal injury protection25/65/15
VermontBodily injury and property damage liability; uninsured/underinsured motorist coverage25/50/10
VirginiaBodily injury and property damage liability; uninsured/underinsured motorist coverage25/50/20
WashingtonBodily injury and property damage liability25/50/10
West VirginiaBodily injury and property damage liability; uninsured/underinsured motorist coverage25/50/25
WisconsinBodily injury and property damage liability; uninsured/underinsured motorist coverage; medical payments25/50/10
WyomingBodily injury and property damage liability25/50/20
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These limits are the minimum, but auto insurance providers may suggest that policyholders get a higher coverage level in case the coverage limit is not enough to cover the total cost of damage and injuries.

Do car insurance companies pay medical bills directly?

No, as a general rule car insurance companies don’t pay medical bills out directly.

Auto insurance providers don’t typically pay medical bills to doctors, hospitals, or private medical practices, despite who’s responsible for the accident. The auto insurance company will usually pay you – the policyholder – once a settlement is reached between you and the auto insurance provider. 

Your health insurance company may also seek to recover costs from your car insurance provider, or from the other driver if you were not at fault. 

Why are legitimate auto accident injury claims typically denied? 

Sometimes, an auto insurance company will deny a claim based on certain factors. For example, it might decline to pay a medical bill. You’re probably wondering why an auto insurance company would deny a legitimate claim.

Typically, legitimate claims can be denied when you’re at fault in the accident (but typically only with liability coverage). That means if you were the one who caused the accident, your insurance company may deny your claim. However, if you’re found to be not at fault, your claim should likely be approved.

Discuss this with your auto insurance provider as soon as possible so that you can be sure your claim will be approved in the event of an accident based on your coverage. 

Denied by health insurance after a crash?

It is very unlikely that you will be denied a claim by your health insurance company after a crash. In the rare event, it is usually because your car insurance provider is the primary insurer and your health insurer is directing you back to them as a first resort. 

Health insurance will not usually deny claims for any other reason, and car accident injuries are still covered by health insurance. 

Is PIP a replacement for health insurance? 

Personal Injury Protection, or PIP, is a mandatory part of your car insurance in the 12 states that have no-fault insurance laws. All this means is that your own insurance, not the other party’s is responsible for your medical costs. In these states, your PIP is your primary insurer, and they will pay out your claims before health insurance kicks in. As with regular insurance, it will pay until your limit is reached, and then health insurance will kick in. 

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Health Insurance Will Pay For Your Care If You’re Injured in a Crash 

You don’t need to worry about not receiving treatment if you’re injured in a crash. In most cases, your auto insurance will kick in first to help cover the medical costs associated with a car accident. If those costs go beyond your policy limits, then your health insurance will usually step in to cover any remaining costs. 

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