personal injury case has finally settled or had a verdict, but you are not going to receive
your money that same day. What is going on? The time after a settlement
or verdict is called the disbursement stage and the type of case you had
and the type(s) of insurance coverage you had directly influences exactly
what happens during that process. The responsible party – through
their insurance company or lawyer – will send your lawyer a release
and settlement check.
Sometimes they will send both at once; sometimes they will send the release
and only send the check once the release is signed by you – sometimes
before a notary – and returned to them. If the responsible party
is a governmental entity, they can be very slow in providing the release
and settlement funds. Also, if the plaintiff is a minor or the case is
a wrongful death case, court approval of the settlement may be necessary
after a settlement is reached.
In addition to obtaining the release and settlement funds, there may be
balances still outstanding with medical providers after insurance payments
and adjustments, so you or your attorneys will have to confirm any outstanding
balances and pay anyone with a lien on your case (which is a legal right
to be paid out of your settlement).
Finally, if you had health insurance, Medicaid, Medicare or workers’
compensation, that can significantly delay things because each may have
a mandatory process by which you have to give them notice of your settlement
and an opportunity to assert a lien for any treatment they paid.
Why Do I Have to Pay My Health Insurance Company Back?
A recovery from a negligent party is intended to reimburse you for medical
bills, lost wages, and any other out of pocket expenses, in addition to
compensating you for your pain and suffering. Most health insurance policies
– as well as the laws regarding Medicare, Medicaid, and workers’
compensation – provide that if you receive compensation in your
case for medical care that they paid, they get paid back and you cannot
double recover by having both health insurance and the negligent party
pay you for your treatment.
That being said, not all health insurance companies are legally permitted
to assert a lien. Therefore, as your attorneys, we confirm whether anyone
asserting a lien legally can and, even if so, we confirm that the lien
is accurate. Dealing with liens properly is important because, if not
paid, your health insurance company could seek recovery from you and/or
terminate your coverage.
What is a Lien?
A lien is a legal right to be paid out of your recovery. Both a medical
provider and an insurance company may have a lien on your case. Your health
insurance company will contact you to assert their lien for reimbursement.
With Medicaid and Medicare, they have what is called a “Super Lien.”
They do not need to contact you or your attorney; instead, we are obligated
to contact them if you are Medicare or Medicaid eligible.
Even if you were not enrolled in either program at the time of your accident,
but become eligible while your case is pending, they require the opportunity
to search through their system to see if they paid for any care for which
you obtained a recovery. It can be time-consuming, but is legally mandatory.
How Can I Maximize My Recovery?
In addition to obtaining the highest possible settlement or verdict, we
also try to get reductions from medical providers and lienholders whenever
we can. This can take more time, but is well worth it because every reduction
obtained directly increases your recovery.
In the end, our goal is that we obtain the highest possible recovery for
you and also that we maximize your recovery by paying as little as possible
to only those parties who must be paid from your recovery. When we provide
you with the check for your recovery that is your money to keep knowing
that everything has been done properly. It is far better to take the time
to do it right, than to cut corners and open yourself up to later claims
from doctors or possibly lose your insurance coverage.
You have been through a lot – our job as your Washington, DC injury
attorneys is not just to obtain a recovery for you, but to help you keep
as much as possible.