My health ins. paid for surgery after I was in a car accident. Will they want to be reimbursed when I settle?

Question

My health insurance has forked out approximately $50,000 in the last few years. I'm just wondering if they can come after anything I get in a settlement. Need Help!!!

Answer 1

your insurance that covered it was from your auto policy. unless they don't file which they rarely don't. during the suit, they must contact the company to know the total costs and they apply a lien on the settlement through the attorney which will come out of the proceeds. but the settlements are based on your attorneys fees, medical costs and what you want out of it. if you settle or are awarded money, it comes out of it, but you will get a good amount of it.

Answer 2

Generally, your health insurance will not pay on a claim resulting from an auto accident unless your motor vehicle insurance has exhausted. However, sometimes things slip through the cracks and the health insurance will pay.

Normally, once they find out that your surgery was a direct result of an accident (( not sure how they find out but they always do! )) they will retract their payment and then the place you had the surgery will start billing your car insurance.

With an car accident, your car insurance is primarily responsible for payment and your medical insurance is the secondary. But sometimes your car insurance benefits may be exhausted by the time your hospital bill comes through and then your medical insurance will pay as long as they have a copy of the exhuastion letter.

In my experience, the facility will not come after you directly unless 1) the car insurance refuses to pay or 2) the medical insurance refused to pay.

As the patient, you are the last resort for payment. Just make sure that everything gets paid by the insurances and you'll be fine.

Answer 3

The theory behind insurance claims is "indemnification," or putting a person back the way they were before an accident. If your health insurance carrier paid for your medical bills and the settling company does the same, you would be unfairly enriched, which goes against that principle.

The health insurance company, in most states and under most policies, retains the right of "Subrogation," which allows them to collect any money they have paid out on your behalf from any responsible party. Those rights, as well as your policy provisions, also require you to protect them in any settlement.

Insurance companies have subrogation departments to go after people to collect their money. If you get the money they were supposed to have, they will come after you.

There are some rare instances where policies allow you to collect twice and do not retain subrogation rights.

Answer 4

Most insurance policies are a pay and pursue. They pay the claims and question if there is 3rd party liability or a lawsuit. Yes they will request money back. After any settlement, your Lawyer or the other Lawyer involved may call the Reimbursement Segregation area of your insurance company and tell them of the settlement. They may pay as secondary to what is not paid however, proof of this would be needed.

Answer 5

Most insurance policies have a subrogration clause in them, which means if you get money for the medical costs from anywhere else, you have to repay them. You need to make sure that your settlement is more than enough to pay the medical costs back, as well as all your out-of-pocket costs, and also $$ for pain and suffering. Don't forget that your attorney will take between 30-40% of the settlement for his fees.

Answer 6

Yeah usually Health Insurance Companies will want to be reimbursed. If you have an attorney, have them make sure your part of the settlement is separate from the medical bills part of the settlement.

Answer 7

They can get reimbursement from any medical payments you receive, but not from pain & suffering, lost wages, services you have to hire because you can't perform them, or modifications you need to make to your house (for permanent disability).

Answer 8

you really contact your insurance company as most of them want the money back