Understanding Texas’s At-Fault System
In Texas, the law makes it clear: the driver who causes an accident is legally responsible for covering the resulting damages. That includes medical bills, lost wages, and other costs. This is known as an at-fault system. However, while the law sounds straightforward, the reality for victims is often anything but simple.
Insurance claims can take weeks or even months to resolve. During that time, hospitals, doctors, and ambulance companies still expect payment. Many accident victims are surprised to find themselves caught between needing urgent care and facing mounting bills long before any settlement arrives.
According to the Texas Transportation Code §550, drivers are required to report accidents involving injury, death, or significant property damage. Yet reporting is just the first step. When it comes to medical expenses, knowing who pays—and when—can make a huge difference in managing the financial aftermath of a crash.
TL;DR – Key Takeaways
- Texas follows an at-fault system, but victims often face medical bills before insurance payouts happen.
- Health insurance, PIP, MedPay, hospital liens, and subrogation claims all impact how and when bills are paid.
- Hospital liens and insurance subrogation can take a big bite out of your settlement unless properly negotiated.
- Acting quickly and working with an attorney can protect your financial recovery.
What to Do Right After a Car Accident
After a crash, your first priority should always be your health. Seek emergency medical treatment immediately, even if you think your injuries are minor. Some serious conditions, like concussions or internal injuries, may not show symptoms right away.
Once you’re safe, notify your own insurance company about the accident. Gathering evidence at the scene—such as photographs, witness contact information, and a police report—will help support your insurance claim or personal injury case later.
It’s also important to understand that your medical providers will expect payment regardless of fault. If you have Personal Injury Protection (PIP) or Medical Payments (MedPay) coverage as part of your auto policy, you may be able to use these benefits to pay for early medical expenses without waiting for a fault determination.
Who Pays First? A Breakdown of Medical Coverage Options
The question of “who pays” depends on your insurance coverage, your health insurance, and the specifics of the accident.
Health Insurance
Your health insurance may cover some accident-related treatment, but many policies require reimbursement from any settlement you receive. This process is called subrogation. While health insurance can provide a financial safety net early on, you should be prepared for possible payback obligations later.
Personal Injury Protection (PIP)
In Texas, PIP is an optional type of auto insurance that covers medical expenses and lost wages, no matter who caused the accident. PIP typically offers at least $2,500 in coverage but can go higher if you opted for increased limits when purchasing your policy.
Medical Payments Coverage (MedPay)
MedPay functions similarly to PIP but only covers medical expenses—not lost wages. It can be used to pay ambulance fees, emergency room visits, and follow-up care. Like PIP, MedPay pays regardless of fault.
Out-of-Pocket or Payment Plans
When insurance options fall short, many accident victims pay bills out-of-pocket or enter into payment plans with healthcare providers. In some cases, hospitals may place a lien against your future settlement to ensure they are reimbursed.
Hospital Liens, Subrogation, and Your Settlement
Many Texans are surprised to learn that hospitals can legally place a lien on any settlement or court judgment you might receive after an accident. Under Texas Property Code §55, hospitals have the right to claim a portion of your recovery to cover the cost of emergency care. However, they must follow strict rules about timing and filing to enforce these liens properly.
Subrogation, on the other hand, involves your health insurer stepping in to claim reimbursement from your settlement if they paid your accident-related medical bills. Negotiating hospital liens and insurance subrogation demands is one of the many ways a personal injury attorney can protect your recovery. Without negotiation, you could end up handing over a large portion of your settlement to pay these third parties.
What Happens When the At-Fault Driver’s Insurance Delays or Denies Payment?
Even when liability seems clear, insurance companies often delay payments by claiming to investigate further or disputing certain expenses. Some insurers may offer settlements that fail to cover the full extent of your medical bills, leaving you financially exposed.
If the at-fault driver is uninsured or carries only minimal coverage, you may need to rely on your own Uninsured/Underinsured Motorist (UM/UIM) coverage to fill the gap. In severe cases, filing a lawsuit against the driver personally may be the only option for seeking full compensation.
Throughout this process, having a legal advocate on your side can make a substantial difference in the outcome of your claim.
Why Legal Help Matters After an Accident
After an accident, bills can pile up faster than insurance claims are processed. Medical providers, insurers, and lienholders may all demand payment long before you see a dime from a settlement. Without experienced legal guidance, many victims find themselves overwhelmed, stressed, and unsure of where to turn.
At Angel Reyes & Associates, we understand the financial pressure and emotional strain that follow a serious accident. Our team works hard to protect our clients by coordinating medical billing issues, negotiating hospital liens and insurance subrogation claims, and ensuring clients recover the maximum compensation available. We offer free consultations, and you pay no fees unless we win your case.
If you’ve been injured in a Texas car accident, don’t wait for the insurance company to make the next move. Let us help you secure the financial support you need to recover fully and move forward with confidence.
FAQs About Medical Bills After a Texas Car Accident
Do I have to pay medical bills if the accident wasn’t my fault?
Yes, you’re still responsible for your own medical bills upfront, even if someone else caused the crash. You can seek reimbursement through insurance claims or a personal injury lawsuit, but that takes time.
Can I negotiate my medical bills after a settlement?
Yes. Hospitals and insurance companies often accept reduced payments through lien and subrogation negotiations. A lawyer can negotiate on your behalf to help maximize your final payout.
What if I don’t have health insurance?
You still have options. PIP, MedPay, or payment plans may help cover costs. Some providers also work with attorneys on a “letter of protection” basis—delaying payment until after your case settles.
What is a letter of protection (LOP)?
A letter of protection is an agreement between your lawyer and a healthcare provider to defer medical payments until your injury case settles. It allows you to get treatment now without out-of-pocket costs.
Should I use my health insurance or wait for a settlement?
Using health insurance can help you get care quickly. However, your insurer may later seek reimbursement from your settlement. A personal injury attorney can help weigh the pros and cons based on your situation.
