Casey is a founding partner at River Run Law Group. Casey has tried numerous cases across the Commonwealth in both General District Court and Circuit Court. He has earned millions of dollars for his clients through trials, mediations, and settlements.
The crash is over, but the costs are just beginning. The tow truck hauls away your car. You’re in the emergency room, filling out forms with one hand while your other arm is in a sling. The pharmacy wants payment before handing you pain medication. Days later, you’re still paying out of pocket while the insurance company delays your claim.
Virginia drivers often face thousands in out-of-pocket expenses after a car accident before they ever see a settlement. If you’re injured, sidelined from work, and covering bills on your own, here’s what you need to know right now.
Medical Costs in Virginia That May Fall on You
Medical bills are often the most significant out-of-pocket expense following a car accident in Virginia. Whether you go to the emergency room, visit a specialist, or undergo physical therapy, your health insurance will determine how much you pay immediately.
Some common out-of-pocket medical costs reported throughout Virginia include:
- Ambulance transport—$800 to $1,500;
- Emergency room visits—$1,000 or more, before tests;
- Imaging scans (MRI, CT, X-rays)—$500 to $3,000 each;
- Pain management medications—costs vary weekly;
- Physical therapy sessions—$75 to $150 each; and
- Orthopedist, neurologist, or surgeon evaluations—$300 to $500 per visit.
Virginia does not require Personal Injury Protection (PIP), so many drivers do not have no-fault coverage that could accelerate payments for medical care. Unless you purchased Medical Payments Coverage (MedPay) through your auto insurance policy, these expenses become your responsibility until another policy accepts liability.
Vehicle-Related Costs That Are Delayed or Denied
After a crash, your car may be towed and stored at a lot, leading to daily charges. If the at-fault driver’s insurer is slow to accept liability, you may have to cover these expenses directly:
- Towing within Virginia cities—$100 to $225;
- Daily storage at a tow yard—$35 to $50 per day;
- Rental car—$30 to $80 per day, depending on availability and coverage; and
- Collision deductible—$500 to $1,000 on your policy if you file under your carrier first.
There’s also no legal obligation for the at-fault party’s insurance to cover a rental car while your vehicle is being evaluated or repaired. If your vehicle is totaled, you may have a gap between the vehicle’s fair market value and what you owe on your loan.
Loss of Wages and Work-Related Interruptions
Missing work after a collision has consequences for your income. Virginia employers are not required to provide paid leave for injury-related time off unless it is part of their existing benefits.
Workers who are hourly, self-employed, or who rely on variable revenue often experience delays returning to full income. Recovering from injuries can take weeks or months, and delayed wage replacement increases credit card balances, past-due notices, and missed bills.
Transportation to and from treatment appointments adds another layer of expense. Ride-share fares, fuel costs, or mileage for a family member driving you can all stack up throughout recovery.
Examples of Out-of-Pocket Expenses Beyond Medical Care
Medical and vehicle costs are only part of the financial impact of a crash. There are additional out-of-pocket damages that can affect your financial health while you recover.
Some typical examples of out-of-pocket expenses that injured Virginians have reported after collisions include:
- Shower chairs, grab bars, or portable ramps when injuries limit movement;
- Short-term house cleaning, laundry services, or grocery delivery;
- Childcare services during recovery, including paying trusted family members to assist;
- Workstation modifications, ergonomic cushions, or medical supplies not covered by insurance; and
- Basic mobility tools, like braces, canes, compression wraps, or heating devices.
These expenses are linked to the injury and would not be necessary without the crash. Keeping receipts and making detailed lists of purchases helps preserve the claim value during insurance negotiations or legal proceedings.
What Virginia Law Says About Coverage Gaps
Virginia drivers often assume insurance will cover major losses, but state minimums lag behind actual medical and financial costs.
Previously, the law required just $30,000 in bodily injury liability per person and $60,000 per accident. Starting January 1, 2025, those minimums increased to $50,000 per person and $100,000 per accident. A single ambulance ride and specialist care can exceed those limits in days, and if multiple people are injured, per-accident limits are divided among everyone involved.
A former opt-out option let drivers register a vehicle without insurance by paying a fee, but that allowance ended July 1, 2024. All registered vehicles in Virginia must have liability insurance, closing the gap that once allowed legal uninsured driving.
How to Manage Immediate Out-of-Pocket Damages
Documenting out-of-pocket expenses after a car accident helps strengthen your injury claim. Save receipts, take photographs of purchased supplies or modifications, and keep organized transportation logs for medical visits.
Speak with your insurance provider to clarify whether you have MedPay. This add-on can cover early medical expenses, but it must already be in place before the collision.
Consider requesting written estimates for long-term costs like physical therapy, specialized equipment, and in-home care. These figures help calculate claim value when preparing for a settlement or lawsuit.
River Run Law Helps You Pursue Compensation for Out-of-Pocket Costs
The first weeks after a crash are often the most expensive. Medical care, lost income, transportation, and home adjustments can’t wait for a settlement. These costs fall on the injured person, even when someone else caused the crash.
River Run Law helps injured clients across Virginia pursue compensation for these early expenses and the ongoing costs that follow. We’ve been recognized in the 15th edition of Best Law Firms® for our work on complex personal injury cases throughout the state.
If you’re trying to manage the financial impact of a car accident, contact River Run Law to discuss your options in a free consultation.
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