auto settlement and health care ins. ?

Question

I was involed in an auto accident a couple of months ago. My medical bills total about $ 3000.00 so far. Now I have only had to pay about $ 300.00 out of pocket and my health ins. has covered the rest. Okay for the question. In my auto settlement will I recover the 3000 or the 300 ?

I am in Texas.
P.S. My health ins. is not asking for the money back from me .. at least not yet.

.. I don't think my claim is worth 50k .. but I wish it was .

Answer 1

$300 to you...$2,700 back to your health insurer in subrogation. Your health insurance company won't ask you for the money in reimbursement, but the insurance companies will work behind the scenes and pay each other back.

Pain and suffering can be added to the amount you are paid as well. Amounts for that vary widely based on the extent of your injuries and the permanency of them.

Answer 2

If you spent those $300.00 for essential services, medicine, and/or transportation costs, you can get reimbursed from your own insurance company. However, you must provide proof that you paid what you paid. You can't just say this is what you've paid and not provide any receipts.

If you spent $300.00 on your medical bills, they will not reimburse you. Your insurance company is there to pay your bills. So if you picked up a tab before they could, then technically that's your problem.

I'm assuming you have an attorney representing you. Your health insurance should not be paying any of your medical bills which resulted from your accident. The only time your health insurance should be used is to clean up your copay and deductible, if applicable. If your health insurance feels like it, they will send you a bill that must be paid to them from your settlement for any and all money laid out, that were not your copay/deductible. And you will be responsible to pay them from your proceeds.

The only amount you will recover from the other party is your settlement with them.

Answer 3

More than likely you should seek pain and suffering and get about twice the charge of your medical bills plus any future medical bills your doctor says will be incurred because of the wreck.

Your insurance has what is called a subrogation claim though. This means they have a right to recover from you for any monies paid to you for medical bills caused by a third party. You can ask them if they will waive this or reduce the amount - though they usually don't and only in cases where like a kid is on lifesupport and the other party only had $25k. Basically it means if your charges were 3,000.00 - your insurance probably only paid about 1,200.00 because they have contractual deductions with care providers. They would want the $1,200.00 or whatever amount they acutally paid on your behalf. So if you settled for $6,000.00 then you would net $4,800.00 after paying the subrogation claim.

You may want to talk to a personal injury attorney. Most offer free consultations - bring your medical records, and all medical inovices. Your claim may actually be worth more.
Lawyers typically charge 33% of the recovery, but it can be worth iit if the claims adjuster is giving you the run around. However, most lawyers won't take a case unless it is worth about $50,000.00.

Also even though your insurance company isn't asking for the money back yet, that doesn't mean they aren't entitled to it back. It is like your land lord doesn't ask you for February's rent in January - but only after you are late. However, like I said they may reduce the amount that they want back if you ask.

If you try to be sly and settle without paying them. They can and will sue you. It is like cheating on your taxes - you will end up paying what you should have eventually and more in legal fees (and jail time in the case of taxes).

Answer 4

It depends on what Texas law says. If it's a state where you only can get pain and suffering then you will only get that and any out of pockets if your bills were paid by another source like health insurance. You have to ask the adjuster if you can claim the expenses or not. I don't know Texas, but let me ask you a question- do you really think it's fair to put your expenses up there like you incurred them when you didn't?

Answer 5

You will recover the $3000 i do believe & actually, im not sure if it varies by state, but here in Ohio the double what your medical expenses are, so if thats the case then you should get $6000. I would contact an attorney, I see all the commercials on tv, your auto insurance isnt going to get the amount you deserve. Usually consultations are free.

Answer 6

Your health insurance company will be entitled to get back the money they paid on your behalf. You should get your $300.00 back.