In
almost all injury
cases, when the plaintiff gets injured they seek healthcare almost immediately.
Most times the person’s health insurance company pays the bills generated by an
accident in the first instance. Sometimes, this is a private company like Blue
Cross Blue Shield, and other times it is government provided insurance like
Medicare or Medicaid. In each scenario, both types of insurance will have a
“lien” or right of reimbursement from the settlement an injured party can get
from a third party insurance policy.
Most
commonly, it is a private health insurer like BCBS that pays the bills. As part
of all health insurance contracts, the health insurer reserves a “subrogation”
right through the contract. This allows the health insurer to get paid back
through a settlement or judgment any medical bills that they paid that are
being accounted for in the settlement. The theory is that a person should not
be able to be paid twice for the medical service, which would lead to a sort of
“double recovery”. This is built into the health insurance contract and is only
triggered by the collection of actual settlement or judgment dollars. If you
review your own health insurance contract, you will find this provision likely
under the title “subrogation”.
In
other situations, the health insurer is a governmental agency like Medicare,
Medicaid or Tricare (military insurance). These insurers have a statutory right
of reimbursement. This means that, like the private insurers above, they have a
right to be reimbursed from any settlement or judgment the insured receives for
bills they have paid. Since these are statutory rights of reimbursement, it
becomes imperative to understand these liens and coordinate the benefits in
order to avoid having the plaintiff be sued in the future. This is because
these liens are “automatic” and many people do not understand that such liens
exist. It is very important to identify all types of liens in each case, and
coordinate paying them back prior to reaching a settlement.
This
can also dovetail with a person’s auto insurance coverage in New Hampshire
called Medical Payments coverage. Based on a recent decision by the New
Hampshire Supreme Court, this medical payment coverage can be used to help
off-set the cost of the medical treatment. In the first instance, this can be
used to pay co-pays and deductibles. If money remains on the coverage, it can
be used to reduce the health insurance lien. However, distinct from health
insurance, medical payment coverage has no subrogation rights, and thus should
be maximized in all cases. If you have insurance coverage issues related to an
auto accident or other injury, the experienced lawyers at Parnell, Michels & McKay can help.
Negotiating
these liens can often yield to lower reimbursement amounts, which can only
benefit our clients. Having an experienced personal injury
litigation attorney becomes very important for any potential plaintiff. If you
were injured and need help getting back to normal, contact the experienced
personal injury attorneys at Parnell,
Michels and McKay and put our 50
years of combined experience to use.