Can an Accident Claim Cover My Medical Bills in Maine?

The information on this site is for general informational purposes only, may be outdated, and is not legal advice; do not rely on it without consulting your own attorney. See full disclaimer.

Can my accident claim pay my medical bills in Maine?

Detailed answer

Short answer: Often yes—your claim against the at-fault party, their insurer, or other sources can pay medical bills from an accident, but how much you actually receive and who gets paid first depends on several things: whether you have health insurance, whether government benefits (Medicare/Medicaid) or workers’ compensation paid some bills, any subrogation or lien rights, the facts of fault and damages, and the ultimate settlement or court award.

1. Who can pay your medical bills?

  • Health insurance. If you have private health insurance, it will usually pay covered medical treatment first. Your insurer may later seek reimbursement from any settlement (a subrogation or repayment claim).
  • Auto insurance. If a motor vehicle crash caused the injury, the at-fault driver’s liability insurance typically pays for medical expenses as part of a bodily-injury claim. If you have MedPay or PIP (where available), those first-party coverages may pay medical costs regardless of fault.
  • Workers’ compensation. If the injury happened at work, workers’ comp usually pays medical bills and lost wages. The workers’ comp insurer may have the right to be reimbursed from any third‑party recovery.
  • Government programs. If Medicare or MaineCare (Medicaid) paid treatment, federal and state law often gives those programs a right to be repaid from your settlement.
  • Direct payment by the at-fault party. If the at-fault person is uninsured and personally responsible, you might recover medical bills through a lawsuit, garnishment, or negotiated payment plan—but recoveries may be limited by the person’s ability to pay.

2. Subrogation, liens, and repayment — what to expect

When an insurer or government program pays your bills, that payer frequently has a right to be repaid from any recovery you obtain from the at-fault party. That process is called subrogation or a lien. Typical consequences:

  • Your health insurer or Medicare may assert a lien on your settlement and require repayment of all or part of what they paid.
  • Workers’ compensation carriers routinely seek reimbursement from third-party recoveries under state law.
  • Medical providers sometimes place liens, seek direct payment from your recovery, or pursue collection actions if unpaid.
  • Many liens can be negotiated down, especially when an attorney shows the case value must cover attorney fees, case expenses, and non‑medical damages (pain and suffering, lost income).

3. How a settlement typically gets distributed

After you reach a settlement or win at trial, the typical order of distribution is:

  1. Attorney fees and case costs (if you hired an attorney on contingency).
  2. Repayment of government programs with statutory repayment rights (e.g., Medicare/Medicaid), where applicable.
  3. Reimbursement to private health insurers or medical providers asserting valid liens or subrogation claims.
  4. You receive the remainder for your out-of-pocket costs, future care, lost wages, and pain and suffering.

Because fees and repayments can substantially reduce the amount you actually receive, an attorney can help calculate a realistic net recovery and negotiate liens.

4. What if you can’t pay medical bills right now?

  • Get emergency and necessary care first. Document everything—records, bills, provider notes, and photos of the accident and injuries.
  • Notify your health insurer promptly and ask about claim procedures and subrogation rules.
  • Tell medical providers you have a pending third‑party claim and ask whether they will accept an assignment, place a lien on future settlement proceeds, or offer payment plans.
  • Ask whether Medicaid or Medicare coverage applies; these programs may pay bills but will expect repayment from any settlement.
  • Consult a Maine personal injury attorney early. Many attorneys handle these cases on contingency (they are paid from the recovery), and they can handle negotiations with insurers, identify potential sources of recovery, and contest improper lien demands.

5. Special situations

  • Uninsured or underinsured at-fault parties: If the at-fault party lacks insurance or has little money, recovery for medical bills may be limited. Check your own UM/UIM coverage if you have it—those coverages can fill gaps.
  • Work-related injuries: Workers’ comp pays medical bills but may limit your ability to pursue the employer; you can still sue a negligent third party and the workers’ comp insurer may seek reimbursement from your recovery.
  • Government programs: If Medicare or MaineCare pays bills, you generally must notify them of any third‑party claim and expect repayment obligations.

6. Timing and statute of limitations

Maine law limits how long you have to file a personal injury lawsuit. Missing that deadline can bar your claim and any ability to use it to pay medical bills. Contact an attorney promptly to preserve your rights.

7. Practical example (hypothetical)

Imagine you’re injured in a Maine car crash caused by another driver. Your private insurer pays $10,000 in ER and follow-up bills. You negotiate a $60,000 settlement with the at-fault driver’s insurer. After paying your lawyer (contingency fee) and case costs, the health insurer asserts a $10,000 subrogation claim. Depending on the ability to negotiate with the insurer and your attorney fees, your actual net recovery could be substantially less than the headline settlement. Skilled negotiation can sometimes reduce subrogation demands so you get fair compensation for future care and pain and suffering.

Bottom line: Your claim can cover medical bills, but expect repayment claims and possible negotiation. Acting fast, documenting carefully, notifying insurers and programs, and consulting an attorney experienced in Maine personal injury claims will maximize the chance that you receive fair compensation and that medical debts get handled properly.

Disclaimer: This article is for general information only and is not legal advice. It does not create an attorney-client relationship. Laws and procedures change; consult a licensed Maine attorney for advice about your specific situation.

Helpful hints — What to do now

  • Get immediate medical care and keep copies of all bills, bills’ itemizations, and medical records.
  • Notify your health insurer and any auto or workers’ comp insurer about the accident right away.
  • Preserve evidence: photos, police reports, witness contact info, and vehicle damage records.
  • Ask providers whether they will place a lien on any future recovery or accept an assignment of benefits.
  • Do not give recorded statements to an at-fault insurer without consulting a lawyer.
  • Consult a Maine personal injury attorney early—most work on contingency and can evaluate your ability to have medical bills covered by a claim.
  • Keep a written log of symptoms, treatments, and how injuries affect daily life to support claims for future medical needs and non‑economic damages.
  • Be aware that government payers (Medicare/MaineCare) have repayment rights—notify them if you pursue a claim so you can address their demands correctly.

The information on this site is for general informational purposes only, may be outdated, and is not legal advice; do not rely on it without consulting your own attorney. See full disclaimer.