When someone is injured because of another person’s negligence, medical bills can quickly become overwhelming. Emergency room visits, diagnostic testing, surgeries, hospital stays, rehabilitation, and ongoing medical care can cost thousands of dollars, or more, depending on the severity of the injury.
Health insurance can provide critical financial support after an accident by helping cover medical expenses while a person focuses on recovery. However, many injury victims are surprised to learn that using health insurance does not necessarily mean those payments disappear from a future personal injury settlement.
If you pursue compensation from the person or party responsible for your injuries, your health insurance provider or other benefit provider may have the right to seek repayment from your settlement through a process called subrogation.
Subrogation is the legal process that allows an insurance company or benefit provider to recover money it paid toward accident-related medical expenses from a settlement or judgment.
For example, if your health insurance company pays $50,000 in medical bills after a car accident, and you later receive a personal injury settlement from the at-fault driver, your insurer may seek reimbursement from that settlement.
This does not mean you should avoid using your health insurance after an injury. In many cases, using available medical coverage allows you to receive necessary treatment without waiting for a personal injury claim to resolve.
When a health insurer pays medical expenses related to an injury, it may place a lien against the personal injury claim. This lien alerts all parties involved that the insurer may be entitled to repayment from any settlement proceeds.
Before a settlement can be finalized, your attorney typically must identify and address any outstanding liens to ensure they are handled properly.
Subrogation does not only apply to private health insurance companies.
Government programs and other benefit providers may also have repayment rights, including:
For example, if Medicare or Medicaid pays medical expenses related to an accident injury, those programs may require repayment from a personal injury settlement.
In workplace injury cases, workers’ compensation benefits may also involve reimbursement issues if a third party contributed to causing the injury. These situations can become complicated and require careful legal review.
In many cases, yes. The amount requested by insurance companies, government programs, or other providers may not always be the final amount that must be repaid.
An experienced personal injury attorney can review medical liens, verify that charges are accurate, and negotiate with lienholders when appropriate. Reducing these repayment obligations may allow an injured person to keep more of their settlement while still satisfying legal requirements.
Some injury victims wonder why they should pursue a personal injury claim if part of their settlement may go toward repaying medical expenses.
The answer is that health insurance only pays medical bills—it does not compensate you for the full impact of an injury.
A personal injury settlement may provide compensation for damages such as:
While medical liens are an important consideration, they are only one part of the overall settlement process.
“After an accident, many people are focused on getting medical treatment and recovering, not worrying about insurance liens. These issues can have a significant impact on the amount of compensation an injured person ultimately receives. Our goal is to handle these complexities so our clients can focus on moving forward while we protect their financial interests.” — Caleb Fleschner
Navigating medical liens and subrogation claims can be confusing, especially while you are recovering from a serious injury. The personal injury attorneys at Fleschner, Stark, Tanoos & Newlin understand how these issues can affect accident settlements and work to ensure clients are not paying more than they should.
If you were injured because of someone else’s negligence, contact Fleschner, Stark, Tanoos & Newlin today for a free consultation. Our team can help you understand your legal options and fight to protect the compensation you deserve.
Fleschner, Stark, Tanoos & Newlin
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The financial burden that often comes with a serious injury can be too much for many people to bear. Unexpected medical debt, damaged personal property, and the sudden loss of income can impact the budgets of most families. The good news is that a successful injury claim could help reduce that financial strain after a serious accident. Get in touch with a Terre Haute personal injury lawyer with Fleschner, Stark, Tanoos & Newlin to learn more.
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