NOTE: This article is part of our ongoing series highlighting recent cases.
If you have medical liens from doctors, or other healthcare providers, or, more scary, claims of liens or rights of repayment/subrogation from a health insurer, the government, or anyone else who may have provided medical services to you and they are demanding back money from you, you need to speak with an attorney. Here are two very good examples of our clients, who we have recently worked with, who called us to resolve lien issues and, in both cases, we wound up enhancing the value of their settlement, significantly.
One case involved an older man, back at work after his accident caused when his motorcycle was hit by a privately owned intrastate contracting company. He was run off the road and suffered significant injuries, including a broken leg, pelvis, and other damages requiring significant hospitalization. Our client left the hospital with permanent disfigurement to his body and several hundred thousand dollars in medical bills. He was lucky that he had good health insurance that paid for the medical bills, so his out-of-pocket costs really were as low as they possibly could have been.
But his health insurance company had in its health insurance contract a provision, like every contract for health insurance in America, that requires him to repay them for the value of the medical services they provided to him if he was able to collect any money from the at‑fault third party who caused the accident. After he went home from the hospital, our client was able to settle his claim by himself with the at‑fault party's insurance company for its policy limits, and signed an appropriate release. Unaware he might need to repay his health insurance carrier, he began to use the money how he needed to given his financial condition resulting from his lost wages following the accident. About nine months later he was contacted by the health insurance company who demanded repayment for the monies it had paid for his medical services. By this time the funds he had recovered from the available insurance monies had dwindled significantly and he was unable to pay the claimed lien amount. By the time he called us he was having difficulty negotiating with the health insurance company.
When we reviewed his file with him we reviewed this not only to see if we could help him in minimizing the amount of monies he would have to repay for the healthcare lien, but also to determine whether he had already received full value for his claim. When we looked at this case we discovered that there were two other insurance policies he did not know of that were available to provide an additional $200,000.00 in coverage to him for his injuries. We don't think that he ever would have discovered the existence of these policies or known that they had legal obligations to make a payment for his injuries, and we believe that our evaluation increased his value of his case by that $200,000.00 that we were able to recover on his behalf.
In the meantime we were also able to negotiate the liens for repayment. Our lawyers know that just because some health insurance companies claim that they have a right to be repaid means that legally they can force you to pay them back. Using our knowledge of these laws we were able to negotiate a settlement of this gentleman's health insurance lien and agreed to pay only 25 percent of the amount that the health insurance company claimed was owed to them. By the time we collected the additional $200,000.00 for our client and paid off the health insurance lien, we were able to put in excess of $100,000.00 into our client's pocket that he did not know existed prior to meeting with us, which initially was only supposed to be so we could help him resolve a lien.