Individuals call my office frequently after receiving a letter from their health insurance provider asking for more information regarding the cause of their injuries. Few people know why they are receiving this letter or how they should respond. The letter could come from Aetna, Blue Cross Blue Shield (BCBS), United Healthcare, Kaiser, Humana, Cigna, Coventry, or one of many others. Allow us to explain why your health insurance company is contacting you, and why you need an experienced personal injury lawyer to help you respond properly to the health insurance car accident letter and prevent the loss of your health insurance coverage.
When the insurance company sends you a letter asking about the cause of your injuries after an accident, they are seeking to collect information to enforce their right of reimbursement or subrogation rights under the terms of your insurance contract. You might not remember signing an insurance contract, but you likely agreed to the terms when you applied for the health insurance coverage. One of those terms you accepted likely requires that you pay back your health insurance provider from a settlement if you are ever injured because of someone’s negligence. Health insurance car accident negotiations are almost always best left for an attorney.
Most insurance contracts contain a health insurance car accident right of reimbursement. This means that any time your health insurance company pays for your medical treatment related to a car accident, slip and fall, dog bite, or some other injury, you are responsible for reimbursing them from any settlement or jury verdict for the amount they paid. This applies even when the settlement is minimal. Failure to pay back the health insurance company means that they could have sufficient grounds under the law to drop your coverage!
Do not think you can just hide the information from the insurance company and they will not find out. The negligent party’s insurance company will likely report any settlement. Plus, the terms of your health insurance contract likely also require that you cooperate by providing injury and settlement information. Failure, by you, to provide the information as required could cause you to lose your coverage.
Having an attorney guide you through the health insurance car accident process critical. These health insurance car accident subrogation rights are extremely complicated. For example, if you receive health benefits through your employer or the employer of your spouse, you might be violating federal law by not cooperating and reimbursing the health insurance plan. Federal law is very strict on which employer funded plans are legally entitled to be reimbursed. Only an experienced attorney can tell you which employer’s plans have that right.
Certain government health plans have even stricter and more complicated requirements. Medicare, Medicaid, the V.A., and others all have their own specific requirements. Medicare’s processes are the most complicated. Failure to follow all of the federal requirement with Medicare could cause you to experience a denial of Medicare claims.
You need an attorney that will not just settle your case, but will also ensure that all health insurance car accident rights of reimbursement are handled so that you do not face a future loss of health insurance coverage. You might think that you can save some legal fees by handling your own case, but failing to comply exactly as the law prescribes for your specific health plan could have devastating consequences.
Our firm routinely handles cases with health insurance car accident reimbursement implications. We take all of our personal injury cases on a contingency fee basis, which means that you do not have to worry about paying any legal fees from your pocket. We simply take a percentage of the settlement. Unlike some other lawyers, we do not take any additional amount for resolving any potential health plan or government right of reimbursement or subrogation issue. We consider this an added benefit for our clients as a thank you for hiring our firm. We will fight to ensure that the amount you are required to pay back is as low as possible and give you peace of mind knowing you don’t run the risk of losing your coverage.
If we can help you with a personal injury matter and the potential complications associated with health plan rights of reimbursement, call us at (678) 537-1209 or contact us on our webpage. We would be happy to answer your questions.