Legal Question in Personal Injury in Oklahoma

A few weeks ago, my mom was in an auto accident wherein another car broad-sided her through an intersection. It was raining heavily, at night, and the storms had knocked out the power to the street lights in Edmond, which I guess have no backup power. She was behind two other cars, who also did not see the street lights or that they were crossing an intersection, and proceeded through unharmed. Another vehicle, driving on the intersecting road, ran through the intersection (having to cross three lanes of road to do so) and broad-sided my mom's car, totaling it. When my mom was much younger, she had breast implants, and because her airbag deployed, she thinks that one has ruptured. She went to her doctor for a mammogram, who said she could not use her insurance, because she was in an auto accident, and her auto insurance company told her that they wouldn't cover it because, unbeknownst to her, she didn't have personal injury insurance added to her policy. I always thought that your insurance covered everything, no matter what the cause. That is definitely something the salesman doesn't tell you when he's getting you the "best deal". Does she have any recourse here? Are all her doctor bills going to have to be out of pocket?

Asked on 5/30/13, 9:44 am

1 Answer from Attorneys

Paul Kouri Travis Law Office

The short answer is: your mom really needs to consult with a personal injury attorney.

The longer answer is: If your mom was at fault, her damages will only be covered by auto insurance if she, or the car she was in, has "medical payments" coverage. Most, but not all, auto policies have some small amount of such coverage ($1000-5000 is typical). If your mother was not at fault and the other driver was at fault, the other driver's insurance (if any) should pay your mother's losses. Unfortunately, the other driver's auto insurance will not pay to send your mother to a doctor, but will instead pay a single settlement amount at the end of its assessment of her total claim. That means your mother will have to find a way to get her medical treatment on her own, to be reimbursed later in any recovery she makes from the other driver. If your mother has health insurance she should use that to get her treatment. Her health insurance will not refuse to pay for her treatment simply because she was in a wreck, though many medical providers will refuse to bill her health insurance because they usually get paid more if they collect from auto insurance. Maybe her health insurance can help her find someone willing to provide the treatment. They should have contracts with providers that require them to bill her insurance. If not, she should call some other providers until she finds one willing to bill her insurance. She will have to pay back at least some of what the health insurance company pays if she makes a recovery from the other driver. good luck to you and your mother!

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Answered on 6/07/13, 3:45 pm

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