What a car crash can really cost: Medical expenses and insurance coverage explained

After a car accident, the shock and pain can make money worries feel far away. In that moment, most people are focused on getting help, not sorting out insurance paperwork.

Aerial view of emergency services responding to a car accident site. — Bilanol // Shutterstock

Millions of people are hurt in U.S. crashes each year, according to the National Highway Traffic Safety Administration. For many victims, the first concern is simply making sure everyone involved is safe.

Once the immediate crisis passes, the question becomes a practical one: who pays for the medical care, the related expenses and any other costs that follow?

CarInsurance.com examines the financial fallout from a car accident, including medical bills, out-of-pocket costs and possible insurance increases, along with guidance on what different types of coverage may pay.

How much does a car accident really cost?

Motor-vehicle crashes create a huge economic burden, with costs that include lost wages, medical treatment, administrative expenses, vehicle damage and employer costs, according to the National Safety Council.

The total cost of a crash typically falls into three categories:

Medical expenses for injury treatment
Out-of-pocket costs, including deductibles
Higher insurance premiums after the accident

Vehicle repairs often get attention, but bodily injury claims can make up a larger share of insurance payouts than property damage claims. CCC Intelligent Solutions analysis shows that bodily injury payouts now account for more than half of combined injury and vehicle-damage payouts.

Injury claims are less common than other claims, but they can be expensive. The average bodily injury claim is in the tens of thousands of dollars, according to the Insurance Information Institute, and there are fewer than one bodily injury claim per 100 insured vehicles each year.

The first bills: ambulance, emergency room and treatment

One of the earliest costs after a crash is often the ambulance bill. Even with employer-sponsored health coverage, the patient’s share can still be significant, according to the Health Care Cost Institute.

Medical costs after a crash vary widely based on how serious the injuries are, which makes it hard to assign a single average bill to every accident.

The National Safety Council says the average cost per person injured in a motor-vehicle crash is tens of thousands of dollars, and the amount climbs sharply when injuries are visible, disabling or fatal.

Average cost of a crash injury, by severity

The more severe the injury, the higher the average cost. The gap between a possible injury and a disabling injury is especially large.

The chart below shows the average cost of a crash by injury severity, including medical bills, lost wages and other expenses.

Table reporting the average costs by injury type.

Injury definitions:

Possible injury: An injury reported or claimed but not obvious at the scene, such as pain, nausea, limping or a brief loss of consciousness.
Evident injury: A visible injury at the scene, such as bruises, scrapes, a lump on the head or minor cuts.
Disabling injury: A serious injury that prevents a person from walking, driving or carrying on normal activities, such as broken bones, crush injuries or paralysis.

Who pays first: your health insurance or your auto policy?

Which insurer pays first depends on where you live and what coverage you have. In at-fault states, the driver who caused the crash is generally responsible through liability coverage. In no-fault states, each driver’s own policy usually handles medical bills.

There are 12 no-fault states: Florida, Hawai‘i, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah.

In many no-fault states, personal injury protection, or PIP, is the first coverage used for medical care. In at-fault states, your health insurer may pay medical bills while a liability claim is pending, and it may seek repayment from a settlement when allowed. In Michigan, drivers who choose coordinated benefits have their health plan pay first.

In no-fault states, PIP often pays toward your own medical costs. Highway Loss Data Institute data show the average PIP claim and claim frequency for recent model-year vehicles.

Medical payments coverage, or MedPay, is an optional auto policy feature in many states. It can help cover medical costs for you and your passengers, even if you caused the accident. The average MedPay claim is smaller than a PIP claim, but it can still help with immediate expenses.

Which coverage pays which medical bills?

Different parts of an accident bill can be paid by different coverages. Fault matters for bodily injury liability, but it does not necessarily determine whether PIP, MedPay or health insurance pays eligible expenses.

Table reporting which car insurance coverages cover medical bills.

What comes out of your own pocket

Having insurance does not always mean care is free. You may still owe a deductible before coverage begins to pay. According to KFF, most covered workers with single coverage have an annual deductible, and the average amount is in the high hundreds to low thousands of dollars.

That can be a problem if savings are limited. Federal Reserve data show many adults would struggle to cover a modest emergency expense in cash, and a meaningful share of households reported unexpected medical bills or some medical debt.

MedPay can help close the gap by paying eligible expenses up to the policy limit, including deductibles and copays.

What if the other driver has no insurance?

Uninsured motorist coverage can help pay your costs if the other driver has no insurance. Depending on the policy and the state, it may help with:

Your medical bills and your passengers’ medical bills
Vehicle damage in states that offer uninsured motorist property damage coverage

Uninsured motorist coverage is often paired with underinsured motorist coverage, which applies when the other driver has insurance but not enough to cover the damage.

More than one in seven drivers were uninsured in 2023, according to the Insurance Research Council. Mississippi had the highest rate, while Maine had the lowest.

The chart below shows the states with the highest and lowest rates of uninsured drivers.

Table reporting the states with the highest and lowest uninsured driver rates.

What if you caused the crash and the bill is over your limit?

Your insurance limit is the maximum amount your insurer will pay for a covered claim. Higher limits mean more protection. Policies are often written in formats such as 25/50/25 or 50/100/50, referring to bodily injury per person, bodily injury per accident and property damage per accident.

With 50/100/50 coverage, your insurer would pay up to $50,000 per injured person, $100,000 total for bodily injury in one accident and $50,000 for property damage.

That matters because even an average bodily injury claim can exceed the minimum coverage required in some states. In places with low liability minimums, a single injury claim could leave the driver personally responsible for the remaining costs.

Raising liability limits can offer much better financial protection, and the added cost may be smaller than expected. State-minimum liability coverage is relatively inexpensive on average, while moving up to 50/100/50 increases the annual premium by a modest amount.

Full coverage increases protection further by adding collision and comprehensive coverage for damage to your own vehicle caused by a covered event. It costs substantially more than liability-only coverage.

How much does more liability coverage cost?

On average, it costs only a few dollars more per month to move from state-minimum coverage to 50/100/50 liability-only coverage, and much more to upgrade to full coverage with 100/300/100 limits.

The chart below shows the average premium increase at each coverage level, from state minimum to 50/100/50 liability-only to full coverage with 100/300/100 limits.

Table reporting car insurance rates for different coverage levels.

Those are national averages, though rates can vary widely by state.

The costs that show up later: higher premiums

Even after the immediate bills are settled, there may be another cost: a premium increase at renewal. That surcharge usually applies when you were the at-fault driver, but you typically will not see the change until your policy renews.

Even a relatively small at-fault crash can increase rates sharply. A second at-fault accident can make a driver look high risk, causing premiums to more than double on average.

How much do rates rise after an at-fault accident?

An at-fault crash can change how insurers price your risk, which is why rates often rise at renewal. One at-fault accident can push premiums up noticeably, while two can cause a much steeper increase.

The table below shows how rates rise after at-fault accidents with different traits, including property damage and injuries.

Table reporting how does an at-fault accident affect your car insurance rate.

How to check how much your policy would pay

You can find your possible payout by reviewing three items on your declarations page:

Bodily injury liability, per person and per accident
Property damage liability, per accident
Uninsured/underinsured motorist coverage, if you have it

Compare those limits with the average bodily injury claim discussed earlier. If your coverage would fall short, you may want to ask your insurer how much it would cost to raise each limit and whether MedPay is available.

The added protection may cost less than you think.

Frequently Asked Questions

Do I have to pay my health insurance back after a settlement?

Often, yes. If your health plan paid bills that another insurer later covered, you may have to reimburse the plan, depending on the plan language and applicable law.

Look for a subrogation clause in your health plan documents. That language allows the plan to recover money it paid when someone else was responsible for the expenses.

Will using MedPay raise my rate?

MedPay helps pay medical expenses for you and your passengers regardless of fault. A MedPay claim alone may not raise your rate, especially if you were not at fault. But if you caused the crash, the accident itself can still lead to a higher premium.

Is MedPay worth it if I have health insurance?

Health insurance covers medical care such as doctor visits, hospital stays and treatments, subject to deductibles and copays. MedPay can help with medical costs for you and your passengers up to your policy limit, and it may also help with those deductible and copay amounts.

Does car insurance cover my passengers' medical bills?

MedPay and PIP generally cover passengers in your car, up to the policy limit. The exact details depend on your policy.

Do I need a lawyer after a car accident?

That depends on whether the claim turns into a dispute that requires legal action. Many people can work through the claim with their insurer. Claims handled with a lawyer often take much longer to close than those without one.

Conclusion

A car accident can lead to three major kinds of costs: medical bills, out-of-pocket expenses and possibly higher premiums later on.

To make sure you have enough protection, review your declarations page and check your bodily injury liability and property damage limits.

If your coverage looks too low, ask your insurer what it would cost to increase your limits and compare that with quotes from other carriers before deciding whether you are paying too much.

Methodology

CarInsurance.com analyzed billions of data points to estimate how much auto insurance rates rise after an at-fault accident.

For consistency, the calculations use male and female drivers age 40 with full coverage, 100/300/100 limits and $500 collision and comprehensive deductibles.

Injury costs, health deductibles, household finances, PIP and MedPay claims, and uninsured-driver rates come from outside sources.