Repayment And Lien Matters In Personal Injury Cases

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You may not realize that if you received certain types of medical insurance benefits for your accident injuries, you may need to repay some of it. The law allows many insurers to recover a portion of what they paid on your behalf if you subsequently receive a personal injury settlement or recovery. Unfortunately, even some novice attorneys fail to anticipate repayment requirements. Nevertheless, these matters are surmountable and an effective attorney can work with insurance companies and agencies to negotiate resolutions that allow you to keep more of your recovery.

If any of the following programs paid medical benefits on your behalf and you subsequently receive a personal injury award or settlement, an insurance company may have a lien on the proceeds:

  • Medicare
  • Medicaid
  • Workers’ compensation
  • Employer health insurance plans under ERISA

In a recent case before the United States Supreme Court, a personal injury victim recovered a settlement for his injuries only to have his ERISA health plan reclaim the entire proceeds in repayment of the medical bills it paid on his behalf. The Supreme Court ruled that this action was proper.

This type of result can be avoided, however, if your attorney knows about liens in advance and can work with those insurance companies and government agencies to negotiate reduced repayment figures. Although you probably must pay back something, with proper attention the final repayment can be a fraction of the actual lien amount. Therefore, always inform your attorney as soon as possible if you receive any of these types of benefits and provide the details of any employer-sponsored health plan in which you participate.