Types Of Insurance
When it comes to paying for the medical expenses associated with brain injury, there are several different types of insurance that may cover some or all costs. Of course, that’s dependent upon the survivor’s coverage. While it may be the last thing anyone wants think about during this time of turmoil, one of the first things that survivors and/or their families should do following a brain injury is to contact carriers for policy details, as well as the survivor’s employer.
Types of insurance that cover medical and rehabilitation treatment for brain injury include:
Health and Accident Insurance
There are all different types of health and accident insurance policies. Some cover everything from annual physicals to major medical, while others just cover catastrophic events. The amount of the deductible, as well as the coverage limits, vary from policy to policy. In addition, some policies cover things like prescription drugs, physical therapy, and special equipment, while other policies don’t. Chances are the survivor and his or her loved ones don’t know some of the nuances of the policy, so it’s always a good idea to contact the insurance provider for details and guidance. Also, check your homeowner’s policy, which sometimes includes a provision for injuries causing disabilities.
Automobile Insurance
About 50 percent of all brain injuries are the result of an automobile accident. In these cases the automobile policy of the survivor, or the policy of another driver that caused the accident, can be used for coverage. Just like health and accident insurance, car insurance varies when it comes to deductible and coverage limits.
Thought it varies state-by-state, insurance requirements in the U.S. generally require some combination of personal injury protection (PIP) and liability coverage. PIP provides “no-fault” coverage for medical and lost wages for the insured, while liability insurance covers injury to the other party. Both PIP and liability coverage are limited to the amount specific in the policy.
But what happens if the survivor has been injured by a driver who has been driving illegally without Personal Injury and Liability coverage? Or if the coverage is insufficient to cover the cost of required medical care? Check to see if the survivor carries an Uninsured/Underinsured Motorist benefit. If he or she does, that benefit would kick in when Personal Injury and Liability wasn’t available or was insufficient to cover medical costs incurred, again, for an amount up to the limit of the policy.
Worker’s Compensation
Under most circumstances, employers are required by law to carry Worker’s Compensation insurance. If the accident that resulted in brain injury happened at work, the survivor is eligible for these benefits. Worker’s compensation covers all medical expenses, provides replacement income, and in some cases also supplies vocational rehabilitation benefits such as job placement assistance and/or job training. The replacement income received is usually two-thirds of the survivor’s average wage, tax free, up to a certain limit. In some cases of brain injury a lump-sum or long-term benefit can also be paid.
Is it possible that a work-related accident won’t be covered by worker’s compensation? Yes, it is. In some states, employers that employ fewer than a certain number of people are not required to carry worker’s compensation insurance coverage. In other states some types of workers—such as unpaid volunteers, independent contractors, and casual workers—are excluded from benefits. If the survivor believes that he or she is entitled to worker’s compensation, the employer should be notified right away.
Short- and Long-Term Disability
These policies are optional for employers, but the amount of employers carrying these policies continues to grow. The survivor or a family member should contact the employer shortly after the accident to determine whether this benefit is offered, and if so what the benefit entails. If this benefit is offered and the survivor has coverage under a short- or long-term disability policy, be prepared to fill out lengthy forms and organize physician documentation.