Most people have filed some kind of insurance claim at one point in time. An insurance claim is simply a claim made by someone injured or who suffers property damage, like a wrecked car after a car accident or truck accident, to the insurance company. It is clear who owes what. The insurance company owes the injured claimant money to recover for their injuries and damages.
But there are situations where the injured claimant owes others money. This obligation to pay can be called an assignment, medical lien, right of reimbursement or subrogation right.
Negotiate Medical Lien Amounts
Medical care providers, private insurance companies and government agencies at the state or federal level may pay for an injured claimant’s medical treatment. Sometimes, these doctors, hospitals and other medical providers take an “assignment” of the policy benefits from the insured and/or the claimant. This means that the medical provider will cover payment of medical bill for now, but then the insurance company must pay that medical provider directly later.
These medical providers can bring their right to make a claim against the injured claimant once he or she gets paid or a settlement from the at-fault driver’s insurance company.
Each state has its own laws. How the lien works depends on which state’s laws apply. The right to a medical provider’s payment depends on the unique laws of the state that applies. For example, some states put a statutory cap on lien claims which means that the state made laws that limit how much money can be claimed as part of a medical lien. Some states say that the medical lien can only be a percentage of the total medical bills.
Certain exceptions apply. State laws may not apply to medical liens under certain government institutions and programs like Social Security, Medicare, Medicaid and the Veterans Administration. For example, state Medicare agencies’ right to recover on a lien cannot go beyond the amount of money the injured claimant actually spent on his or her medical treatment and care.
In one California lawsuit, the court considered the evidence of medical bills and decided that the hospital’s medical lien is limited to the amount of money that the insurance company actually paid for medical treatment. If medical treatment had nothing to do with the accident, then medical treatment for unrelated injuries should not be a part of the medical lien.
With the help of a skilled personal injury lawyer, an injured claimant can actually negotiate to get his or her medical lien amount, the amount of money owed for medical treatment after a car accident or truck accident, lowered. This may mean more money in the injured claimant’s hands. It is important to contact a lawyer as soon as possible, because you may not be aware of all the legal deadlines that apply to your specific case.
One of the first thing your lawyer needs to do is make sure that the medical the insurance policy contract and any other legally binding contractual agreements rules and procedures are followed. If you signed a paper agreeing to meet certain deadlines and follow certain steps as part of your contract with the insurance company or any other entity, then your lawyer can help make sure that you did not miss anything and risk your claim and damages award amount because of a technicality. Similarly, your lawyer can check any applicable legal deadlines under your state’s laws or the laws under a government program like Medicare or Medicaid. When an injured claimant is focused on recovering, it may be difficult to understand and keep track of all of the deadlines that apply to a specific case. But failing to follow each step, like filing a claim too late, can result in denial or rejection of a claim if not a delay that takes time.
If the injured claimant has a medical lien and owes money to a medical provider, then he or she may be able to negotiate to decrease the amount owed for medical treatment. Specifically, if the medical treatment ends up costing more than expected, the injured claimant’s lawyer can argue that the injured claimant needs to fully recover their health first. On the other hand, if the medical provider holding the lien and right of payment over the injured client is getting greedy, the lawyer can argue that the injured claimant will abandon his or her claim completely if the medical provider does not work with the injured claimant.
Car Repair Liens
Another type of lien is when the auto body repair shop for a car takes an assignment, or right to get a payment, to the insurance claims representative for direct payment. If the insurance company does not follow through on the assignment or lien, then the insurance company risk paying out twice, first to the injured claimant, and then again to the auto body shop.
Worker’s Compensation Liens
If an injured claimant is hurt in a car accident during work, and the employer offered worker’s compensation, then he can be covered by two insurance policies: the at-fault driver’s insurance policy and the employer’s worker’s compensation policy. The employer’s policy pays for medical bills and lost wages, which is the money the claimant would have made if he was able to work and not hurt in the car accident. Because of this, the employer’s worker’s compensation may have a lien or right to get money from the injured claimant after the claimant gets a settlement.
Bank and Mortgage Company
Generally, there are two types of damage claims after a car accident or truck accident: a bodily injury claim and a property damage claim. The damage to the vehicle is a part of the property damage claim. After a big accident, some vehicles are so damaged that they are considered a total loss. In other words, there is so much damage that the vehicle cannot be used. Some people take out car loans to buy their vehicle, and pay the bank or another lender for the car until they pay off the entire vehicle. Until the vehicle is completely paid off, the bank is usually the legal owner of the car. In these cases, the bank may be listed on the pink slip and vehicle registration. The lender may have a lien on the injured claimant’s vehicle, and because of this, the right to some of the money from the insurance company if there is a claim payment or settlement.
One things insurance companies consider is whether they will have to make two payments, first to the lender and then again to the injured claimant. Because of this, some lenders will not pay the entire fair market value of the vehicle. In other words, insurance companies may hold off on paying this kind of property damage right away if they think there is a chance they will be asked to pay twice for the same damage.
Mitigate (Reduce) Your Damages
A common mistake a lot of injured claimants make is that they do not need to do anything to help themselves out of the bad situation. This is not the case. Injured claimants need to do their part in trying to recover from their injuries. This is a legal obligation they have to do.
For example, this can mean that an injured claimant allows his or her injuries to continue to get worse by not going to all of their doctor appointments or getting all of the medical treatment they were told to get in order to heal.
The insurance company will argue that the injured claimant let his or her injuries get worse on purpose to get more money from the insurance company. This is why it is important to get the medical treatment you need. An injured claimant that cannot afford to get all of the treatment, like in cases where the claimant does not have health insurance, may be able to find a medical provider that is willing to work with them through a medical lien.
There are also several other myths about insurance claims and settlements that can do more to hurt than help a claim’s progress.
Hiring a personal injury attorney can help you understand the legal mechanisms that are at play in a particular insurance claim. Find the right attorney who understands all of the moving parts to complex personal injury cases and can help put more money in your pocket so that you can focus on recovering.
Contact an experienced personal injury lawyer
Without experience in the insurance industry or legal experience, understanding which factors or evidence can help or hurt your case can be difficult to understand.
Are you trying to secure your financial recovery with the help of experienced attorneys? If so, we can help.
The Pusch & Nguyen Law Firm has helped countless Texans handle their insurance disputes. Our experienced trial lawyers have gone up against some of the biggest names in the insurance industry while successfully bringing home payouts for clients. Our successful reputation speaks for itself, and with offices in both Houston and San Antonio, we are well equipped to assist Texans who are in dire need of our services. Register online for a free case evaluation or call us today at 713-524-8139 (Houston) or 210-702-3000 to schedule an appointment with a member of our team.