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My Health Insurance Sent Me a Letter Asking About My Car Accident Claim and They Want Part of My Settlement, Is This Correct? | Guy S. Di Martino Dc, Jd, Pa

June 6, 2013

A. Yes. Your health insurance may be entitled to reimbursement if it paid for accident related healthcare expenses. If you pull out your health insurance booklet, summary plan description, or plan description it will usually contain a clause that reads something like this: if we pay for medical expenses that a third party is responsible for, we are entitled to repayment of these medical expenses. In legal terms this is called a right of subrogation or contractual right of reimbursement.

Legally, the health insurance company will take this position. Look, we have paid for medical expenses because you were injured by a negligent party. If you receive compensation from the negligent party for these medical expenses, we want all the money we paid or a portion of the money we paid – otherwise you will have a windfall.

Health insurance liens can be complex. Many times health insurance companies hire third party vendors to collect this money and the liens contain charges that are not related to the accident related medical treatment. We spend a lot of time in our practice negotiating these medical liens for our clients.

If you have any questions about a health insurance subrogation lien or a Florida car accident case, give me a call at 352-267-9168 or fill out the Internet consultation form on the right hand side of the screen.