Who Pays for Ambulance Transportation After a Crash in New Jersey?

A car crash can turn your life upside down in an instant. If you or a loved one is injured, emergency medical care becomes the top priority—and in many cases, that means an ambulance ride to the nearest hospital. But once the dust settles, a pressing question arises: Who pays for the ambulance transportation?

New Jersey’s insurance laws can be confusing, and many crash victims are caught off guard by unexpected medical bills. Below, we explain how ambulance costs are covered, who is responsible for paying, and what steps you can take to seek reimbursement.

Who Pays for Ambulance Transportation?

New Jersey follows a no-fault insurance system, meaning that your auto insurance policy is the first source of coverage for medical expenses, including ambulance transportation. This coverage comes from Personal Injury Protection (PIP), which is required under New Jersey auto insurance policies.

Here’s how it works:

• PIP Coverage: Regardless of who caused the accident, your PIP coverage will typically pay for emergency medical care, including ambulance services, up to the policy limits.
  
• Health Insurance: If your PIP benefits are exhausted or you have selected your health insurance as your primary coverage option, your health insurance may cover the remaining costs.
  
• At-Fault Driver’s Insurance: If another driver was responsible for the crash, you may be able to recover ambulance costs as part of a third-party claim against their liability insurance.

PIP Deductibles and Limits

In New Jersey, PIP coverage typically starts at $15,000 per person per accident, but policyholders can opt for higher limits (up to $250,000) for more protection. However, deductibles range from $250 to $2,500, which means you may still have some out-of-pocket costs.

If your ambulance bill exceeds your PIP coverage or if PIP does not fully cover the charges, you may need to explore additional reimbursement options.

How Does PIP Work in Practice?

For example, if you were injured in a crash and transported by ambulance to the hospital, your PIP coverage would be billed first. If the ambulance ride costs $1,500, but your PIP deductible is $500, you would be responsible for the first $500, and your insurance would cover the remaining $1,000—as long as it falls within your coverage limits. If your total medical bills exceed your PIP limit, then secondary options such as health insurance or legal claims come into play.

Exceptions and Special Circumstances

While PIP is the primary coverage source, certain situations can change who is responsible for ambulance bills:

Uninsured or Underinsured Drivers

If you are hit by a driver who has no insurance or inadequate coverage, your Uninsured/Underinsured Motorist (UM/UIM) coverage may step in to cover ambulance and other medical expenses. New Jersey law (N.J.S.A. 17:28-1.1) requires insurers to offer UM/UIM coverage, though it is optional.

Pedestrian Accidents

If you were a pedestrian hit by a car, your own PIP insurance (if you have an auto policy) will still apply. If you do not have auto insurance, the at-fault driver’s PIP coverage may cover your medical expenses, including ambulance costs.

Medical Necessity Denials

Some insurance providers deny ambulance claims, arguing that the transport was not medically necessary. If an EMT at the scene determined that an ambulance was needed, this decision can often be challenged with legal assistance.

Many people do not realize that ambulance providers sometimes bill patients directly when an insurance claim is denied. This can leave accident victims with unexpected expenses, even if they were not at fault. If you receive a bill, do not assume you must pay it out of pocket—legal representation can help challenge improper denials.

Public Assistance Programs

If you do not have health insurance or sufficient PIP coverage, Medicaid or Medicare may assist with ambulance costs, depending on eligibility. Low-income individuals may also qualify for New Jersey’s Charity Care program, which offers financial aid for medical services, including ambulance transportation.

Can You Seek Reimbursement for Ambulance Costs?

If your PIP coverage is exhausted or you were not at fault for the accident, you may be able to recover ambulance costs through:

• A third-party claim against the at-fault driver’s insurance
• A personal injury lawsuit if the accident resulted in serious injuries and financial losses
• Filing a claim under MedPay (if you opted for this additional coverage)

Notable New Jersey Cases on Medical Expense Recovery

In Oswin v. Shaw, 129 N.J. 290 (1992), the New Jersey Supreme Court set a precedent for proving serious injury in car accident claims, which can impact whether ambulance costs and other medical expenses are recoverable. Cases like this highlight the importance of legal representation when disputing medical bills.

Additionally, in DiProspero v. Penn, 183 N.J. 477 (2005), the New Jersey Supreme Court ruled that injury victims do not need to meet a specific “verbal threshold” to recover economic damages, further reinforcing the right of accident victims to seek compensation for ambulance and medical expenses.

Steps to Take:

1. Keep All Ambulance and Medical Bills: Documentation is key when seeking reimbursement.
2. File a PIP Claim Promptly: New Jersey law (N.J.A.C. 11:3-25.1) requires PIP claims to be filed within a reasonable timeframe after an accident.
   
3. Consult with a Lawyer: An attorney can dispute unfair denials, negotiate with insurers, and pursue compensation from the at-fault party.
   
4. Review Your Insurance Policy: Understanding your PIP limits and deductibles before an accident can help you avoid unexpected financial strain.

Call Our Expert Lawyers for a Free Consultation

The financial burden of a car crash can be overwhelming, but you don’t have to handle it alone. At Rosengard Law Group, we fight to ensure injured clients receive the compensation they deserve—including coverage for ambulance costs.

If you or a loved one were injured in a car crash and are facing unexpected medical expenses, let us review your case. We work on a contingency fee basis, meaning you pay nothing unless we win compensation for you.

Call us today at (856) 284-6446 for a free consultation.