Why would I have to pay my insurance money back for a medpay? 44 Answers as of May 30, 2013I am getting ready to settle a auto accident. I'm not going to sign the final papers because my lawyer says in this settlement that he has to pay my medical bills back. Is that right? When it was the other guys fault i thought his insurance would pay. I'm not happy with the results anyway. I'm getting a low amount back.
The Law Offices of Paul A. Samakow, P.C. | Paul A. Samakow
I assume your lawyer handled all of this correctly. Your "settlement" includes the medical bills. They get paid from the settlement funds that the other guy's insurance gives you as a total settlement.
Answer Applies to: Virginia
David F. Stoddard | David F. Stoddard
His insurance is paying. The settlement comes from his insurance. The insurance settlement includes your medical bills, lost wages, and in some cases pain and suffering. If you do not have health insurance, most doctors have a clause in the papers you sign to get treatment saying that you assign to them any insurance proceeds you get for personal injury to pay their bill. If health insurance paid your medical bills, most health insurance policies have a clause that you assign any insurance proceeds from an insurance claim that is for medical bills to them. Either way, it is the other driver's insurance that is paying these bills.
Answer Applies to: South Carolina
EJ Leizerman & Associates | Michael Leizerman
You have a contractual obligation in your insurance policy to reimburse your insurance company for medpay. Your lawyer should explain this to you. The amount you settle for is up to you. If the amount you receive, after paying medpay, is unacceptable, then tell your lawyer that you do not want to settle for that amount.
Answer Applies to: Ohio
The Murphy Law Firm | Candace M Murphy
If you received any sort of medical treatment for your accident, you will have to pay for the treatment received whether the money comes from your or any proceeds that you receive as a result of the accident. If your attorney is settling your case, that means any proceeds will have to be used to cover the costs of handling your lawsuit. Your doctors and those who assisted you with no-out-of pocket expenses on your part, have to be compensated for treating you.
Answer Applies to: Texas
Ezim Law Firm | Dean Esposito
When an attorney makes an offer to settle a personal injury claim, the offer is a lump sum amount which includes special damages (i.e. lost wages, medical bills) and general damages commonly referred to as "pain and suffering." From the settlement amount received, medical expenses have to be paid as the medical provider will have a lien on the settlement proceeds. The attorney is obligated to pay such. The insurance company for the guy at fault does NOT send payment directly to the medical provider who rendered treatment to you. Instead, an amount to pay such is included in the settlement.
Answer Applies to: Louisiana
The Law Office of Harry E. Hudson, Jr. | Harry E. Hudson, Jr.
Why should you enjoy a windfall? 10 -1 the insurance contract provides for it to recover its expenses. The settlement includes your obligation that you owe to the insurance company. If you do not like the settlement, go to trial. At trial you run the risk of a jury deciding you get an amount that is less than Meds. Especially if you are in the southern central valley, Orange San Mateo, Santa Cruz or San Diego counties.
Answer Applies to: California
Parks Law Group | Melinda J. Parks
Yes, you generally have to pay back the amount covered by insurance for your medical bills. That is what the settlement covers. In other words, the liable party is actually paying for your medical bills; they are just doing it by way of giving the money to you in a settlement rather than paying it directly to your medical providers. Once you get the money, though, you have to pay it to the medical providers. Typically, lawyers can negotiate with the medical providers (or insurance company) to decrease the amount you owe but that varies on a case by case basis.
Answer Applies to: Alabama
DEAN T. JENNINGS, P.C. | Dean T Jennings
Yes, you have to pay back your own insurance company until the terms of your contract and the common law doctrine of subrogation. Your attorney should try to get a percentage discount for his fee and recovery costs from your insurance company so that you can payback less than the full amount and you can keep the difference.
Answer Applies to: Iowa
Adler Law Group, LLC | Lawrence Adler
Generally if you have medical insurance there is no payback for m medical bills unless it is an ERISA policy (usually subsidized by employee trust funds). If you had no medical insurance the bills must be paid out of the settlement only if there is a lien by the doctor. If there is no lien you still may owe it, but the atty need not take it out of the settlement unless you give him permission to do so. The amount of the settlement should include extra money t pay these bills.
Answer Applies to: Connecticut
Law Offices of George H. Shers | George H. Shers
Most automobile soft tissue injury cases do not result in very high or good settlements from the plaintiff's standpoint. Juries do not award much in these cases so insurance companies do not pay much. If you received medical treatment that your own insurance company paid for then under your policy with that insurance company there probably is a provision that they have to be paid back if your recover anything from the other side [subrogation].? Normally they will reduce the total amount by a percentage because you have an attorney representing you [up to a third reduction]. If your Dr'.s were not paid, then they are paid from the settlement amount. The only amount you get to keep, no matter who paid, generally is a portion of the medical insurance reduction.
Answer Applies to: California
Law Office of Sam Levine, LLC | Sam L. Levine
Oh boy...this is not a good consumer situation. You need to talk with an attorney about your options whether it is me or someone else, I would urge you to speak to an attorney re: your medpay issue related to your car accident in Atlanta, Georgia. Take care & good luck.
Answer Applies to: Georgia
The Law Office of Stephen R. Chesley, LLC | Stephen R. Chesley
If it is an automobile case most of your medical bills are paid by your insurance company under No Fault provisions. However, in many cases you went to a no fault physical examination and the your insurance company determined that you were fine and denied further treatment even though you continued to receive treatment. In that case the doctors may have taken the further medical treatment under a lien arrangement. That is they get paid for the outstanding treatment from your share of the settlement.
Answer Applies to: New York
Law Office of Patrick E. Donovan, PLLC | Patrick E. Donovan
If your auto insurance paid your medical bills pursuant to a medical payment (medpay) provision in your policy, the auto carrier is not entitled to subrogation or reimbursement. If your health care insurance paid your medical expenses, then that carrier is entitled to reimbursement, but only that amount that it actually paid to the provider. Ask your attorney if the reimbursements are going to your auto carrier or your health insurance carrier. If it is the former, then something is wrong.
Answer Applies to: New Hampshire
Paul Whitfield and Associates P.A. | Paul L. Whitfield
Your lawyer is probably talking about subrogation. If your policy contains such a provision then it will pay you, subject to being reimbursed if the claim is against a third party. It is a contract question and doesn't matter what you think about it. read your policy and ask your lawyer to explain it to you. Quit grousing. He is probably doing the best he can do.
Answer Applies to: North Carolina
Fox Law Firm LLC | Tina Fox
Because it was the other person's fault, more than likely, it is his insurance company that is paying your medical bills. For instance, your attorney has negotiated a settlement price, let's just say $25,000.00 (since you said it was a low amount, and let's say you have $5k worth of bills), of that $25K paid by the other person's insurance company, yours attorney will pay the $5,000.00 (or the at fault driver is paying the $5K medical bills) and you are left with $20K to be distributed accordingly. Put another way, using the same #s, $25K - atty fees = $16675 - $5K medical bills, you would walk away with a check for $11,675 (provided there's nothing else outstanding) and all of your bills are paid for in full.
Answer Applies to: Illinois
Magnuson Lowell P.S. | Richard S. Lowell
Under Washington law, you normally do have an obligation to repay YOUR OWN auto insurance company for medical payments they made on your behalf. That's part of the contract between you and your own insurance company. When negotiating with the at-fault driver's insurer, your attorney should have known this and made sure that he included the anticipated repayment in any gross settlement amount. Moreover, normally you are entitled to a Mahler discount. In other words, you may not have to pay the full amount of the medical payments back to your insurer. Talk with your attorney about this.
Answer Applies to: Washington
Lapin Law Offices | Jeffrey Lapin
I would not be in a position to "second guess" either your lawyer's advice or the settlement total. Your lawyer should explain why you have to repay your insurance company back its "med pay" money and your medical bills. You should ask him/her why the settlement was not structured that these items would not be paid directly from the settlement rather than you/your attorney paying them.
Answer Applies to: Nebraska
Ewusiak & Roberts, P.A. | Christopher J. Roberts
The only thing you do not need to pay back is PIP (your own personal injury protection insurance). Otherwise, most doctors and health insurance companies have valid liens on any medical bills that were related to the accident. When you settle a case, you should factor in that you will have to pay some of that back. Doctors/insurance companies usually will take a reduction on the amount you owe, because of the risk of litigation and the fact that you had to incur expenses and fees to get a recovery. Your lawyer should help you negotiate the amounts.
Answer Applies to: Florida
Joel H. Schwartz, P.C. | Steven A. Schwartz
Typically, in Massachusetts the first $2000 in medical bills are paid for by your own car insurance (we are a no fault state which means it doesn't matter who caused the accident). This money does not have to be paid back from any settlement. If your bills are over $2000, then all remaining bills should be submitted to your health insurance. Whatever your health insurance pays, they are entitled to be paid back from any settlement you receive from an at fault party. When your lawyer negotiated your case, he or she should have taken into account the money owed to your health insurer and asked for additional money to cover this (above and beyond your money for pain and suffering). If you have medpay, then medpay should continue to pay bills above $2000 based on the amount of medpay you purchased. You do not have to pay back medpay either. I understand this may be a little confusing.
Answer Applies to: Massachusetts
Law Offices of David W. Hibbert | David W. Hibbert
Reimbursemnt of medical payments may be a provision of your policy. This is a way insurance companies are fooling their customers into thinking that something they have paid for belongs to the customer. Your polcu is a contract which you may not have ever read in its entirety. Often an insurance company puts language in the policy saying that they will pay your medical expenses without regard to fault , however , if a third party is found to be responsible for your medical expenses, they claim a right to reimbursement. Your own state's laws may provide some relief if you have not "been made whole" or "completely compensated" by the settlement. This varies from state to state. Insurance companies spend millions on advertising but rarely explain what you are really buying from them.
Answer Applies to: Georgia
Gilbert & Bourke, LLP | Brian J. Bourke
Most insurance policies carry a subrogation clause which allows the insurance company to recover the medpay back after you settle with a third party. Your lawyer can negotiate the amount down for you, and if the circumstances are that the settlement with the third party does not "make you whole", the reduction in the subrogation amount can be substantial. Speak to your attorney and negotiate the reimbursement before your settle.
Answer Applies to: California
Broad Law Firm, LLC | Donald K. Broad
Generally, whenever you receive benefits from your insurance company when it is someone else's fault (like Med Pay benefits or Uninsured/Underinsured Motorist benefits), the insurance company has the right to get their money back from the person who was at fault, either through a lien on any settlement/judgment or through subrogation. It sounds as if in your case that you received Med Pay benefits from your insurance company, and you are now settling with the person at fault. If that is the case, then your insurance company does have the right to get money from that settlement. You can negotiate with them, and they will generally accept less than the full amount, but they do have the right to seek reimbursement.
Answer Applies to: Indiana
Shaw Law Firm | Steven L. Shaw
Yes, whoever paid for your medical bills gets reimbursed from your settlement. If that's an insurance company (health, PIP, medpay), then that company gets paid back. If it was you paying out of pocket, then the money goes to you. This is standard. Keep in mind that by having an attorney, the reimbursement is reduced by a pro rata share of fees and costs, which means that you pay back less.
Answer Applies to: Washington
Paris Blank LLP | Irving M Blank
You do not have to pay medpay benefits back. You do, however, have to pay back health insurance benefits or medicare/medicade, or workers' comp benefits if the health care policy is a self funded ERISA policy. This has nothing to do with your settlement it is based on a separate contractual obligation contained in your health insurance policy.
Answer Applies to: Virginia