At Foley & Small, our attorneys and staff work together with you to resolve these medical liens and to achieve a complete resolution of your case. We want to share with you information about medical bills and insurance liens, what they are and how they are resolved as part of a personal injury claim.
WHAT IS A LIEN?
Let’s say you’re in an accident and you’re injured and have to get medical care. Your medical bills are then paid by your insurance. This insurance can be in various forms. It can be medical pay coverage which is provided for under an auto or homeowners policy. You could have your medical bills paid through your health insurance or you could have your medical bills paid through Medicare or Medicaid. If you’re injured at work, your medical bills would be paid by workers compensation insurance.
Then let’s say you retain Foley & Small to represent you on your case. For a personal injury claim, a client is able to recover for four different types of losses: (1) for the medical expenses incurred; (2) for any loss of pay suffered due to your injuries and being unable to work; (3) for the pain and suffering that results from your injuries, and, finally, (4) for the value of any permanent injuries that are suffered. When Foley & Small obtains a recovery on your case, either by a settlement or a trial, that recovery is going to be for a dollar amount that will cover all the various elements of your loss – the medical bills, pay loss, pain and suffering, and permanency. So let’s say hypothetically we resolve your case for $100,000.00 and your medical bills were $20,000.00 and you had a loss of pay claim of $6,000.00. That total recovery of $100,000.00 would include payment for your medical bills and your loss of pay. The remainder of the recovery would be to compensate you for your pain and suffering and for any permanent injury. And let’s also assume that you had health insurance coverage that paid for your medical bills.
At that point you would have had your medical bills paid twice. First, you would have had them paid through your health insurance. The second payment would be the recovery Foley & Small obtained on your case, the $100,000, which would include payment of your medical expenses of $20,000.00. At that point you’ve gotten your medical bills paid twice – once by your health insurance and then also from the other party to the case.
The law, usually by a statute, creates a lien or right of recovery or reimbursement by your health insurance from the monies you recovered in resolving your claim against the other party. What that means is, from that $100,000.00 recovery, by law you are obligated to pay back your health insurance for the medical bills they already paid. So in our hypothetical you would need to pay back part of the money – the $20,000.00 to your health insurer.
If you don’t pay the money owing on the insurance lien, you can then be sued by a private insurance company for payment of the lien amount and denied future coverage. If it is a Medicare or Medicaid situation and you don’t pay them back, they will refuse to pay any further benefits on your behalf under the Medicare or Medicaid and will seek reimbursement through the courts. Foley & Small will take care of these lien issues for you as part of our handling of your case.
FOLEY & SMALL RESOLUTION OF LIEN CLAIMS
At Foley & Small, we will contact your various insurers, or if you are covered by Medicare or Medicaid we will contact them, to let them know we are representing you and that we will be in contact with them about resolving their lien. When it comes to the payment of liens, we can often obtain a reduction in the lien amount. We can obtain a reduction from your insurance company or Medicare and Medicaid so they pay their share of the attorney’s fees and expenses. Our attorney’s fees and expenses do not go up, its just that your health insurance company will have to help pay that cost. This results in a benefit to you, our client, because the lien reduction goes to you. In addition, Foley & Small can negotiate to reduce the lien amount if there is a problem getting a case resolved because of issues with liability or a dispute about the extent or cause of the injury. If the case is settled for a reduced amount in light of these risks, we can negotiate a similar reduction in the lien amount. So, in other words, we can negotiate your lien holders to obtain reductions, if the case warrants it, and if those reductions are obtained then the savings go to you giving you a greater net recovery.
Medical liens can be confusing. I hope this discussion sheds some light on what a lien is. At Foley & Small we will take care of your lien issues and obligations so that when you leave our office, after the successful resolution of your case, you will leave knowing that Foley & Small have taken steps to pay all of your known medical bills and liens arising from your accident and injuries.
CONTACT FOLEY & SMALL
If you or a family member have been injured in an accident or suffered some other wrong due to the fault of another, contact Foley & Small by email from our Contact page. You can also call us at 800-276-2525.
We have years of experience and extremely helpful staff and we truly care about our clients and their families. Thanks again for contacting us at Foley & Small.