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If you’ve been injured in an auto accident, your physician may recommend physical therapy as part of your treatment plan. However, physical therapy can quickly become costly, especially if you must attend regular sessions over an extended period. If your doctor has prescribed physical therapy, you might wonder who will pay for the necessary rehabilitative care, especially if someone else caused the car accident in which you were injured.
New York No-Fault Auto Insurance Covers Physical Therapy Costs
All New York motorists must carry at least $50,000 in personal injury protection (PIP) coverage, otherwise known as no-fault insurance. As one of a handful of no-fault auto insurance states, New York insurance laws require motorists to turn to their own PIP policy for coverage after an accident, regardless of fault.
New York’s no-fault rule aims to expedite compensation for auto accident victims by eliminating the need for back-and-forth negotiations before a claim is paid. If you need physical therapy for an injury that you sustained in a car accident, your PIP provider will cover the cost of medical expenses and rehabilitative care up to your policy limits.
If your medical and physical therapy costs exceed your PIP coverage amount, you could turn to any supplemental auto insurance you purchased to cover additional costs. After you’ve exhausted your auto policy limits, you could use your healthcare insurance to cover the difference.
Who Pays for Physical Therapy If Someone Else Caused the Accident?
While New York is a no-fault state and injured motorists must turn to their PIP policy for coverage first, there are exceptions to the no-fault rule. If you sustained a serious injury as defined by New York state law, and you have reached your personal policy limits, you could recover additional compensation for rehabilitative care and other losses by filing a claim against the at-fault party’s liability insurance provider. All New York motorists must carry a minimum of $25,000 in bodily injury liability coverage per person.
To obtain compensation through a third-party claim against the at-fault motorist, you’ll have to prove that your injury meets the requirements set out by the state and that the driver caused the accident. If you successfully establish their liability, the at-fault party’s insurance company should provide compensation for physical therapy expenses and other medical costs beyond your policy limits. Furthermore, you could also receive compensation for non-financial losses, including the physical pain and emotional trauma you suffered from the accident.
Still, third-party claims can take a significant amount of time to resolve before you see a payout. And if the insurance company contests your claim or won’t offer a fair settlement, you might have to move forward with a personal injury lawsuit against the at-fault driver. This can put additional pressure on the insurer to settle.
While your claim or lawsuit is ongoing, you could continue turning to your public or private health insurance to cover rehabilitative care costs. Just remember that your health insurance policy will most likely have a subrogation clause that allows them to seek reimbursement for physical therapy expenses they covered before your personal injury case was resolved.
What Is a Serious Injury in New York?
As mentioned above, your ability to pursue compensation from an at-fault driver is dependent on whether you suffered serious injuries. While the term might sound vague, New York state law defines it very specifically. Any of the following injuries meet its threshold:
- Dismemberment
- Serious disfigurement
- Fractured bones
- Loss of fetus
- Permanent loss of use of an organ, member, or system
- Permanent limitation of use of an organ, member, or system
Additionally, your injuries could qualify as serious if they meaningfully disrupt your daily life and a medical doctor attests to this fact.
What If I Don’t Have Health Insurance to Pay for Physical Therapy?
If you’ve exhausted your policy limits and you don’t have health insurance to cover your remaining physical therapy costs, you may have to pay for your care out of pocket. Many physical therapy offices are understanding when patients don’t have health insurance and will work with you to help them get the care they need at an affordable rate. You should also ask if your physical therapist offers a sliding-scale payment plan, which would allow you to make interest-free payments over an extended period rather than all at once.
If you suffered a serious injury, have a strong case against the at-fault party, and are expecting to receive compensation from their insurance provider, you might be able to seek rehabilitative care on a medical lien basis. Similar to a subrogation claim from a health insurance provider, a medical lien gives the physical therapist a right to collect payment for their services from any settlement you receive and allows you to get the care you need while your claim is still being processed or your lawsuit is in litigation.
You may be more likely to get a physical therapist to treat you on a lien basis if you have a personal injury lawyer representing you. Your attorney can negotiate a repayment plan with the physical therapist and help mitigate your out-of-pocket costs if they end up exceeding the settlement amount you receive.
Remember, your physical health is extremely important, and putting off care could make your injury worse or turn it into a long-term health problem. Receiving physical therapy when you need it can also help as you pursue compensation, as it demonstrates to the insurance company that you are taking your recovery seriously and that your injuries are legitimate.
Contact a New York Car Accident Lawyer
If you need physical therapy after being injured in a car accident in New York, the attorneys at Finz & Finz, P.C. can help you seek the compensation you need to pay for it. We can evaluate your potential compensation options and negotiate with your insurance provider while you concentrate on your rehabilitation. Contact us today for a free consultation with a New York City car accident lawyer by calling 855-TOP-FIRM.
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Finz & Finz, P.C. is a New York and Long Island personal injury law firm based out of Mineola, NY. It was founded in 1984 and is highly rated, with many honors and awards of excellence.
