Who pays medical bills after a car accident in California?

At first, your own health insurance or optional medical-payments coverage — the at-fault driver's insurer generally pays nothing until the claim resolves. California hospitals that treat crash victims may assert a lien on the eventual recovery under the Hospital Lien Act (Civil Code section 3045.1), and health plans typically hold reimbursement rights repaid at settlement.

California is a fault state, but fault-based payment comes at the end of a claim, not as the bills arrive. Treatment is usually funded in the interim by health insurance, by optional med-pay coverage on the injured person's own auto policy (which pays regardless of fault), or by providers willing to treat on a lien against the case. The accounting happens at resolution: hospitals may assert liens under the Hospital Lien Act (Civil Code section 3045.1), which limits how much of a judgment or settlement a hospital lien can absorb, and health plans hold reimbursement rights that Civil Code section 3040 caps and reduces to account for the attorney fees spent creating the recovery. Medicare and Medi-Cal carry their own statutory recovery rights that must be cleared before funds are disbursed. Because unpaid bills can go to collections while a claim is pending, notifying providers of the third-party claim — and negotiating each lien before settlement is finalized — directly changes what the injured person keeps.

Authority: Cal. Civ. Code § 3045.1