Who Pays Medical Bills After a Car Accident in California?
After a car accident in California, medical bills can come from multiple directions at once: emergency care, follow‑up treatment, therapy, and prescriptions. Understanding who pays those bills—and in what order—is critical for injured people trying to recover physically and financially.
The at‑fault driver’s responsibility under California negligence law
California follows a fault‑based system for car accidents. An injured person generally has the right to seek compensation from the driver whose negligence caused the crash, including reimbursement for reasonable and necessary medical expenses. See Cal. Civ. Code § 1714(a).
In practice, this usually means making a claim against the at‑fault driver’s liability insurance, which is designed to cover bodily injury damages up to the policy limits. If the value of the injury claim exceeds those limits, the injured person may also have claims directly against the at‑fault driver’s personal assets, although collecting beyond insurance can be difficult in many cases.
Your health insurance and medical providers
Even though the at‑fault driver is ultimately responsible, medical providers will usually bill the injured person or their health insurance first. Private health insurance, employer plans, Medi‑Cal, and Medicare can all pay for accident‑related care, subject to deductibles, co‑pays, networks, and utilization review.
When health insurance pays for accident treatment, the insurer often acquires a right to be reimbursed from any settlement or judgment related to the injury. California and federal law impose specific rules on reimbursement and subrogation for different types of plans, including ERISA plans, Medicare, and Medi‑Cal. These reimbursement claims are sometimes called “liens” and must usually be addressed before the injured person receives the net proceeds of a settlement.
Medical payments (MedPay) coverage under your auto policy
Many California auto policies offer optional “medical payments” or “MedPay” coverage, which pays reasonable medical expenses for the insured driver and passengers regardless of who was at fault in the crash. MedPay limits are often modest—such as $1,000, $5,000, or $10,000 per person—but can provide quick help with deductibles, co‑pays, and out‑of‑pocket costs while liability issues are still being resolved.
MedPay payments do not depend on proving the other driver was negligent, but policyholders must still comply with notice and proof requirements in the policy. Some insurers may have subrogation or reimbursement rights if the injured person later recovers from the at‑fault driver, although California law limits certain attempts to recover directly from MedPay benefits in specific contexts.
Uninsured and underinsured motorist coverage
If the at‑fault driver has no insurance, too little insurance, or cannot be identified (as in some hit‑and‑run crashes), uninsured/underinsured motorist (UM/UIM) coverage on the injured person’s own policy can become a key source of payment for medical bills and other damages. California policies that include UM/UIM typically allow an injured insured to recover up to the UM/UIM limits when an uninsured or underinsured motorist’s negligence causes the collision, subject to policy conditions.
UM/UIM claims often proceed through negotiation or arbitration rather than open court, but the measure of damages—including past and future medical expenses—is generally the same as in a liability claim against another driver. Health insurance and lienholders may still seek reimbursement from UM/UIM recoveries, depending on plan language and governing law.
Medical liens and delayed payment arrangements
In some California personal injury cases, especially where the injured person is uninsured or underinsured for health care, medical providers may agree to treat on a lien basis. Under a lien arrangement, a provider agrees to wait for payment until the personal injury case is resolved and is then paid out of the settlement or judgment, often at negotiated rates.
Liens can come from hospitals, doctors, physical therapists, imaging centers, and others. They increase access to treatment after a crash but can significantly affect the net amount an injured person receives once the case is resolved, making careful review and negotiation of liens an important part of the claims process.
The role of California’s comparative negligence system
California uses a pure comparative negligence system, which means an injured person’s damages—including medical expenses—can be reduced by their percentage of fault but are not automatically barred if they were partially responsible for the crash. See Cal. Civ. Code § 1714(a). For example, if an injured driver’s reasonable medical bills total $50,000 and a jury finds the plaintiff 20% at fault and the defendant 80% at fault, the recoverable medical expense portion would be reduced to $40,000.
Comparative negligence principles also influence insurance negotiations and lien resolution, because all parties must account for the final net recovery and the plaintiff’s share of responsibility when allocating payments.
Putting it together after a California car accident
In a typical California car accident case, medical bills may be paid initially by a combination of health insurance, MedPay, and, in some circumstances, lien‑based providers, while the injured person pursues compensation from the at‑fault driver’s liability insurance and any available UM/UIM coverage. Liability carriers and UM/UIM insurers then reimburse or compensate for those medical expenses as part of a settlement or judgment, subject to policy limits and comparative negligence.
Because multiple payers and lienholders may be involved—each with different rights under contracts and statutes—injured people benefit from early advice about how these pieces fit together and what steps to take to protect their financial recovery. A California personal injury lawyer can help evaluate coverage, coordinate benefits, and negotiate liens so that as much of the final settlement or judgment as possible ends up where it belongs: with the injured person who has lived through the crash and its aftermath.
