Hello, my name is Enrico De Maio. I'm an attorney here at the office of Pellegrini, Seeley, Ryan, and Blakesley.  I'm going to be discussing one of the most common questions I get from my motor vehicle accident clients. That being,

Who's responsible for paying my lost wages and medical expenses?  

Here in Massachusetts, it doesn't matter who's at fault for the accident. It's your auto insurance carrier that's going to pay the initial portion of the medical bills and lost wages up to a certain dollar amount.  

In the first scenario, if you have MassHealth, Medicare, an ERISA plan, or no health insurance coverage, your auto insurance carrier will pay the initial portion of the medical bills and 75% of your lost wages, up to a combined total of $8,000.  

In the second scenario, if you have private health insurance like Blue Cross Blue Shield, Aetna, Cigna, just to name a few, and you pay an annual yearly premium then your auto insurance carrier will pay only $2,000 towards your initial medical bills.

However, the auto insurance carrier will pay an additional $6,000 above and beyond that for very specific items. Those items being 75% of your lost wages, out-of-pocket deductibles, coinsurance, co-payments, and any medical treatment your regular insurance might not pay for, such as acupuncture or massage therapy.  

In both scenarios, once your auto insurance carrier has paid what they're required to by law, as we have discussed, any medical bills and lost wages above that would get submitted to your regular health insurance carrier or your disability insurance carrier respectively.  If you have medical expenses and lost wages out-of-pocket above and beyond that then you have to seek to recoup those from the at-fault driver and his or her insurance company, either through settlement or an award at trial in your favor.

These are the general rules as to who pays for your lost wages and medical expenses in a motor vehicle accident case; however, there are exceptions to these rules and that's why you should always speak with a licensed attorney as to what your rights are under the law.

I hope you enjoyed this video and found it to be helpful.  Should you have any further questions, regarding this issue or others, please feel free to contact me directly or any other attorney in our office.