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Doug Landau
Doug Landau
Attorney • (866) 735-1102 Ext 610

Why must I pay my health insurance company back after I settle my car crash case ?

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If you are ever the victim of a car wreck, bike crash or trip and fall accident you will likely experience a loss of wages, have to pay medical bills, and perhaps have to make repairs to or replace your vehicle. Although some car insurance policies include medical pay, ("Medical Payments" or "MedPay" for short) not all do. Many folks that turn to ABRAMS LANDAU for help use their health insurance to help with the costs of medical visits to treat their injuries, and then access this "MedPay" to pay the deductible, office visit co-pays and other incidental charges. But when the case settles, or is resolved in court, you may receive less compensation than you thought. This can happen when a healthcare provider places a “lien” against your recovery.

Most health insurance policies now require reimbursement from settlement with a third party. Where there is a valid claim for "subrogation," where your health insurance company paid for your medical treatment, it is entitled to get the money back from the settlement, just as you are entitled to reimbursement for your expenses or lost wages. The rules governing, what, if anything, has to be paid back, involve complicated legal issues that must be addressed by your personal injury attorney before any settlement funds may legally be distributed to you. Your attorney may also be able to tell you if the health insurance company is limited to recovery from a particular portion of your recovery – In all likelihood your health insurance contract contains what is called a "subrogation clause." By contract you agree to pay them out of ANY settlement you may receive. If you fail to pay them their subrogation interest, they can file suit against you. An experienced personal injury trial attorney will be able to tell you if this is the case with your health insurance company. At times, your attorney can also help to negotiate a reduced reimbursement. At the Landau Law Shop, we have helped injured clients from Ashburn, Reston, Herndon, Ashburton Farms, South Riding, Great Falls, and Middleburg, Virginia negotiate and reduce these "IOUs" from their own health insurance companies, employers and even their workers comp carriers.

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  1. Mike Bryant says:
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    You are correct that an attorney that is knowledgeable in the subrogation laws can make such a difference. The fear of losing future care needs to be dealt with. We have seen cases here in Minnesota where the unrepresented person lost out where the third party carrier paid subros they didn’t have to.