It is important to draw a distinction here between the upfront or initial, provisional payment of medical expenses and bills, and the ultimate responsibility for those charges. If it is ultimately determined that someone is at fault for the injury [e.g. a negligent actor in a personal injury case] then that liable person [or their insurance should they have insurance] is going to be responsible, ultimately, for the medical bills or costs. However, the accounting and process to determine ultimate responsibility for medical expenses often takes years, and potentially litigation, and is of little immediate benefit for an injured individual with mounting bills and unpaid expenses related to an accident. For a person in that circumstance, the far more pressing question is: "how are those bills paid immediately?"
There are essentially five sources of initial, up-front payment for the medical expenses, bills and other costs associated with the provision of medical care in the wake of an injury-causing accident.
- Workers’ compensation insurance- if the injury occurred at work
- PIP or personal injury protection benefits if the accident involved a motor vehicle
- Health insurance
- Government benefits such as Medicare or Medicaid
If the insured individual suffers their accident while at work, the medical expenses related to that injury [potentially for life] are the responsibility of the employer and hence the workers' compensation Insurance company.
If an individual is injured in a car accident, then the personal injury protection insurance covering the vehicle- typically in which they were a driver or passenger- is responsible for the medical expenses for the injury, up to the amount of the policy -generally $2,500
If an injured person has health insurance either through an individual policy or group policy through work, that insurer may pay expenses related to a personal injury-causing event.
If an individual is a recipient of a government-funded health insurance alternatives such as Medicare or Medicaid, those entities may also pay expenses related to a personal injury.
And finally, an individual may, of course, pay their own way. In the context of a personal injury matter, a more practical alternative is for the individual to locate a provider who is willing to defer payments and collection of medical expenses until the conclusion of the underlying case.
Ultimately, however, the individual at fault, if there is an individual or entity that is ultimately deemed responsible for the injury, is correspondingly responsible for these medical expenses. If the injured claimant settles with that negligent or at-fault party, medical expenses will be incorporated into the settlement figure or awarded by a court after trial. In the same fashion, if a private health insurance company, Medicare or Medicaid have paid expenses related to an injury, and another is ultimately deemed responsible, those payors have a right to reimbursement -sometimes called a subrogation right-against that individual and hence a lien, or right to reimbursement, from settlement or judgment proceeds.