Q. My health insurance paid for medical treatment after my San Diego auto accident. I have now received a settlement, do I have to reimburse them?
A. Yes in most cases, your medical insurance will be reimbursed from the proceeds of any settlement or jury award from a 3rd party. Since they paid for the care, they should be paid back. If not, it would be a windfall for you, as part of any settlement is for medical care you actually received.
If you paid out of your pocket, you would receive that amount. If you received care without any payment (where the doctor receives a lien on any future settlement/award) then the doctor would be paid at time of settlement.
So how much do you have to pay them back? Is it 100%? In California, the insurance company is entitled to a proportionate share if the proceeds are not enough to fully compensate the victim. For example, if you suffered $100,000 in damages (medical bills, lost wages, pain and suffering) but only recovered $50,000, then the health insurance company would be entitled to 50% of the amount they paid.
As a practical matter, the companies can be negotiated with. They may reduce their demands to compensate for future medical costs, hardships, additional damages paid, and attorney’s fees. Before you settle any accident claim you may want to consult with a San Diego Car Accident Lawyer to determine whether or not reimbursement of your health insurance company will wipe out any settlement and leave you with no compensation for your injuries.
If you would like more information on dealing with your personal injury claim, car accident, or paying for your medical bills, click on this link for a free copy of Joseph’s book, The 7 Mistakes The Insurance Company Wants You to Make.