The fact that some health insurance carriers have a right to reimbursement (i.e. subrogation) for medical bill expenses paid relating to your motor vehicle accident comes as a shock to many clients, and even some attorneys who are not familiar with the complexities of personal injury law. Why, would your health insurer expect or be allowed reimbursement when they pay personal injury claim related medical bills? Clearly, they don’t expect repayment if you accidently fall and break your arm, so why is it different for car wrecks, slip and falls, dog bites, etc.?
The answer is that nearly all health insurance providers have a reimbursement provision buried in the health insurance contract that you or your employer signed. Health insurance companies feel they have a right to some or all of the money from your case because they would not have had to pay medical bills if there was not a negligent party that caused the accident. Of course, all of this “logic” regarding the merits of reimbursement / subrogation does not change the fact that you were the one injured, you have been paying health insurance premiums all along, and you might be relying on the money from your claim to achieve some sort of financial stability following a devastating and expensive injury.
Thankfully, the Georgia Supreme Court understands this and has adopted a legal standard known as “made whole”, whereby private insurance companies are usually barred from collecting medical bill reimbursement from a personal injury claim settlement. This position has also been codified by the Georgia Legislature (O.C.G.A. § 33-24-56.1). Unfortunately, this rule does not apply to health insurance plans governed by federal law including ERISA, Medicaid, Medicare and Tricare. Regardless of the type of insurance coverage you have, different and complex rules govern the timing and amount of reimbursements paid to health insurance carriers following a personal injury claim. A mistake in this area can lead to substantial financial penalty or even loss of health insurance coverage.
Under Georgia Law (O.C.G.A. 19-16-16), the Department of Human Resources Office of Child Support Enforcement can rightfully file a lien against your case for unpaid child support. Upon notification of such a lien, we will contact you directly to discuss your payment options.
Federal law limits how much you may receive from your case while under bankruptcy protection. A large portion of your settlement may be claimed by creditors, so it is very important to discuss options with your attorney prior to making decisions about bankruptcy.
Owner-operator truck drivers often carry Occupational & Accident insurance rather than worker’s comp. Unfortunately, these policies will usually seek reimbursement for medical expenses following an injury claim. Early consultation with an attorney is advisable.