When making a claim for personal injuries, the amount of money recovered from the responsible party and his insurer is important. Obviously, the more you get in settlement or judgment, the better your result. However, almost as important is the amount you have to repay out of your settlement or judgment to your health insurer or Medi-Cal or Medicare.
What? I have to repay my health insurer or Medi-Cal or Medicare? Yes, you do! Many people don’t realize that most medical insurance, including government provided benefits, require repayment of a portion of benefits paid for you care out of any personal injury recovery. At the Law Offices of Kevin McConnell, P.C., we are experts at maximizing the amount of your settlement or judgment and minimizing the amount that needs to be repaid and deducted from your case result.
Reimbursement of Private Health Care Insurance
Health care insurance companies, including Blue Shield, Sutter Health, Kaiser Permanente, and most other large and small private health insurers include in their coverage a provision that requires repayment of a portion of their payments out of any settlement or judgment.
Typically, we are able to negotiate for a reduced repayment out of the proceeds of your case. At a minimum, most health insurers will accept a reduction equal to the proportionate share of attorney fees costs necessary to prosecute your case. In other words, if you have to pay a personal injury attorney one-third of your recovery plus costs, Kaiser or Blue Shield can be made to reduce their recovery by one-third plus their share of costs.
Medicare and Medi-Cal liens
Many folks who do not private medical insurance may be covered by Medicare (provided by the federal government) or Medi-Cal, provided by the State of California. Like private health insurance payments, government payments for medical care must be reimbursed at the time of settlement or judgment.
California’s Medi-Cal pays a very low rate for medical care and is entitled under statute to recovery 75% of their payments at the end of the case (Cal. Welf. & Inst. Code § 14124.72). Medicare also pays a fairly low amount for any medical care and will usually negotiate with your attorney for the repayment at the end of the case. Under California law, Medi-Cal cannot recover more from a case than the injured party (Cal. Welf. & Inst. Code § 14124.78).
Hospital Lien Act
If you are not insured and not eligible for Medi-Cal or Medicare, the hospital where you received initial treatment may file a Hospital Lien Act lien which entitles the hospital to payment out of your settlement or judgment of the full amount of their bill. If the result in your case is not a large amount, the hospital is limited to recovery of half of what you net in the case — in other words, you and the hospital would split the proceed of the case and thereby guarantee that you get something and the hospital does not take the entire settlement or judgment (Cal. Civ. Code § 3045.4).
What if I have no medical insurance at all? How do I get medical care?
Don’t worry, at the Law Offices of Kevin McConnell, P.C., we can arrange for top quality medical or chiropractic care with local Santa Rosa medical providers who will agree to defer payment until the end of the case and get paid out of your recovery.
Payment of medical liens is complicated!
You should be represented by an experience personal injury attorney in any case that involves a health care reimbursement claim or a government or hospital lien. Please contact your local Santa Rosa Personal Injury attorney at the Law Offices of Kevin McConnell, P.C., for a free consultation about your situation. Let us maximize your recovery against the responsible party and insurer and minimize the amount you pay out of your settlement or judgment to your medical creditors.
For a free, confidential, no-obligation consultation about your personal injury case, contact the Law Offices of Kevin McConnell, P.C., today.