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Do I Have To Pay Back My Health Insurance For What They Paid After A Car Accident?

If you have been involved in a an SUV or car accident in the Tampa Bay area call Tampa Personal Injury Attorney, Martin J. Hernandez of Fernandez & Hernandez at 813-229-5353.
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Yes, you have to pay back health insurance for whatever your health insurance paid if you make a recovery. The health insurance carrier (whether it is Medicaid, Medicare, Aetna, Florida Blue, UnitedHealthCare, etc). It is fairly common for personal injury or accident victims to have liens attached to their case settlement or judgment recovery. After paying in advance for services like medical treatment, lienholders such as hospitals, doctors, medical facilities and government entities may take the steps to place a lien. There are limits to a lienholder’s recovery under certain circumstances, but an attorney can help explain those and assist you to manage any liens involved in your case. Sometimes we can get them reduced to.

Most personal injury cases end in payouts from settlement agreements or jury verdicts, where victims receive a certain amount in damages from the at-fault party. However, if there is a lien attached to your injury claim, then outside parties may have a legal claim to a portion of the final payout.

These third parties can include insurance carriers, hospitals, medical treatment providers, and other entities. Their claim to a portion of the recovery is usually court-ordered to secure payment for unpaid services like medical care.

Medical care liens are fairly common in personal injury lawsuits and most often get filed when third parties pay for a victim’s treatment in advance of the final settlement or judgment. In that way, liens are often considered as a sort of debt owed which will be repaid by a lienholder’s stake in the victim’s proceeds from the case.

What Is A Lien?

If you have a lien against your personal injury claim, it simply means a lienholder has placed a court-protected hold on a portion of your expected case proceeds. It also means that your compensation may be reduced by the amount that you owe them, most likely for services that they rendered you at some point during your case.

Your health insurance policy might have a section with language describing whether your carrier authorizes liens, and what terms they allow for them. This is a ‘Subrogation Lien.’ You may want to ask an attorney to look at your policy for these conditions.

Of course, the lienholder’s right to repayment is limited to care for injuries that are tied to your claim. That is, they will only be repaid for the medical treatment you received for your crash injuries. The lien should not include treatment that you got for anything outside of the accident.

A lien repayment can also be reduced by attorney’s fees and costs that come up throughout the case. Since most personal injury attorneys work for contingency fees, it’s common for the lawyer’s portion to be calculated as a percentage of a settlement or judgment. Under Florida law, the lienholder’s repayment is limited to the amount of recovery after the attorney’s fees and costs have been withdrawn.

Who Can Make A Lien On An Accident Injury Settlement?

Some liens are considered higher priority based on the lienholder that has it. There are many different types of financial interests that can cause a person or company to file for a lien. Some common lien holders that are involved in a personal injury case are:

Insurance Carriers

Lien terms can be written right into health or auto insurance policies. This is why it’s important to check yours and maybe have an attorney review it and explain your rights as a policyholder.

Government-Based Medical Benefit Programs

In a personal injury case where medical treatment for an accident was paid for with Medicaid, the state is required to create a lien to be repaid from the compensation you receive.

This can also apply to medicare, only in these cases, the lienholder on your settlement or judgment would be the federal, not the state, government.

Medical Treatment Facilities

One of the most common lienholders is the doctors, hospitals, and facilities that provide treatment for accident-related injuries. Depending on your amount of health insurance coverage, these care providers may get a lien for the full amount of your medical bills, or set up a partial lien for you to pay a portion. Especially in the case of partial payment, you may want to consult with a lawyer for advice.

You could also offer a voluntary lien, or a ‘Letter of Protection’ to your healthcare provider. This letter is usually given at the time you receive treatment.

It is essentially a signed agreement stating that you will pay that provider for the medical care from the proceeds of your case at a later time (either from your settlement or a favorable verdict).

Before giving a Letter of Protection, you may want to speak with an injury attorney for help. They can draft the Letter for you to protect your rights.

How Liens Are Affected By Negligence And Insurance Limits?

Under Florida’s comparative negligence system, juries determine who was liable in an accident by giving certain drivers a percentage of fault. Some of that percentage can even be assigned to the injured victim if the jury decides they caused the accident to some degree.

When a victim is found to be at least partially at fault for a crash, they still have a right to recover for their damages and losses. However, the amount of their compensation is reduced by the percentage of their negligence. For example, if you were hurt in an accident and later assigned a 30% fault, then your recovery would be reduced from 100% to 70%.

In the same way, a health insurance lienholder’s stake in your proceeds is typically also reduced if your compensation is smaller than a fault percentage. Using the example above, a lienholder’s claim on your award would be lowered to 70% of what it was as well.

This lien reduction can also happen if there are insurance policy limits that reduce your injury claim recovery. According to Florida Statute 768.76(5), if the at-fault party’s insurance coverage has limits that will cap off the amount you can get in compensation, then those limitations can also offset any liens that are attached to that compensation as well.

Protect Your Recovery From The Start

Speak with your attorney for strategies to negotiate any liens you have. They may be able to help you get them reduced or eliminated altogether.

These kinds of changes can save you a lot of money and trouble when there is a lot at stake in securing your recovery. Liens can have a big effect on the amount you walk away with, so hiring an experienced lawyer from the beginning can give you more protection from the get-go.

We know liens can be overwhelming when you are already facing an injury case, and we are ready to help you. Learn more about the services we offer by scheduling your free, one-on-one attorney consultation today. Call (813) 229-5353 or complete this online form to get started.

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