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VIDEO TRANSCRIPT:
Hello everyone. This is Robert Mansour. In today's video I want talk about your health insurance company's right to reimbursement. Now I'm not going to get into all the different nuisances and details of this particular subject but here's the short thing I want you to remember. If your health insurance company pays for medical bills related to a car accident, they are probably entitled to reimbursement if you recover money from the responsible party. Let's say this fellow Bob hits me and causes an accident. My health insurance company pays for my medical bills, my hospital bill, my ambulance bill, et cetera. Let's say my health insurance company paid out $5,000 for that. Well, in most cases your health insurance company has a right to reimbursement of that $5,000 if I recover any money from Bob and Bob's insurance company. Let's say I call Bob and I say "Hey, Bob. You caused an accident. I want you to pay me." He says okay or his insurance companies pays me $5,000 or whatever, I have to make sure that from that settlement I pay back my health insurance company. This is a big mistake that people are not aware of and they don't realize that they have that reimbursement issue to deal with in many cases. If your health insurance company is involved in your personal injury case, find out how much they paid not how much they were billed but how much they actually paid. Find out if they have a right to reimbursement and if so what their lean amount is. Then you want to make sure that that lean is satisfied and taken care of as part of the settlement of your personal injury case. Thank you very much for watching this video. I hope you found it helpful. After a car accident, you have to be careful not to dig yourself into a financial hole by racking up all kinds for medical bills - and you have no idea how they are going to be paid. Even if you have an idea how they are going to be paid, you still must proceed with caution. You are not suddenly at a medical "buffet" where you can get unlimited medical care without question. Do not automatically assume the other party is going to pay all your bills.
Therefore, when clients contact my office, I always ask them if the other party has accepted liability. In other words, has the other party accepted fault for the accident? If they have not accepted liability or are "thinking about it," that is a warning sign. You can easily rack up medical bills, rental car bills, and other expenses simply hoping the other party is going to see things your way. In fact, I generally approach cases differently - I assume the responsible party is NOT going to pay anything unless I get a firm admission from the responsible party's insurance company that they are accepting fault. Reasonable minds might differ about how an accident occurred. If the police report is in your favor, you need to make sure and obtain a copy of the police report so that you could use it when arguing your position to the insurance company. If you don't have the police report, you cannot assume that it is in your favor even if you're 100% sure. I have seen too many cases where my clients are confident the police report is in their favor and then we find that it's not in their favor after reading the actual report. Even if the responsible party accepts fault for the accident, their insurance company may have a differing opinion. The insurance company might take an opposite position from their own client - either because they have a legitimate argument or, in some cases, simply to avoid paying you and force the matter into litigation. So what's the point of this blog post? Simply put, do not place yourself at financial risk after an auto accident. Do not got to countless doctors and health care providers, simply assuming the other party is going to pick up the tab! If you are going to incur bills, make sure there is a resource to pay for those bills. Then make sure there is a backup resource in case the first resource refuses to pay for some reason. Such resources might be your own auto insurance, your health care insurance, or some other resource. Do not simply assume the other party will accept fault and pay those bill. If you need help with your personal injury matter, consider calling our office at (661) 414-7100 for more information. |
Attorney Robert MansourRobert Mansour is an attorney in Santa Clarita, California who has been practicing law since 1993. After working for 13 years for the insurance companies, he now counsels victims of personal injury. Click here to learn more about Robert Mansour. Categories
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