Is Your Personal Injury Compensation Enough?

Is Your Personal Injury Compensation Enough? (The Insurance Company and the Hospital Get a Slice)

BY CHRIS TOBIAS

If you're injured in an accident and receive compensation from the defendant or their insurance company, it's important to understand that the compensation isn't all yours to keep. Certainly, your personal injury lawyer's fees come out of it, but there are other interested parties, as well. When you consider a settlement or other offer by the defendants and think about whether it's adequate, you need to take into account what these other interested parties might take out of it.

Your health insurance company may want some If your health insurance company paid for your medical bills while you were injured, and then the defendant pays you compensation that includes money for your medical bills, it will be like you received money for your medical care twice over. The health insurance company, then, is entitled to be reimbursed for what it spent on you -- out of your compensation payout. This is governed by the laws of subrogation. The laws of your state of residence can place restrictions on the money that the health insurance company can take. The fine print on your health insurance policy also determines how much of your personal injury payout the provider can claim. It's important to have a personal injury lawyer on your side to make sense of these laws and make sure that the health insurance company doesn't take too big a slice out of your compensation.

The hospital may take some of it Depending on who's paying, hospitals charge differently for the same kind of treatment. If you go and pay out-of-pocket for a chest X-ray, they might charge you $200. If a PPO health insurance provider pays for it, the hospital might charge them $100; and if a hard-bargaining HMO pays, the hospital might charge them $75. They have you contribute something, as well -- perhaps $50. Putting together what the insurance pays and what you pay, however, still doesn't make $200; the hospital is supposed to write off the loss. Sometimes, however, the hospital comes after you for the remaining sum. It's a practice called balance billing and it's illegal in some states: The hospital agrees to the discounted pricing contract with the health insurance company because they get a greater volume of business in return; the volume makes up for the cut-rate pricing. The hospital can't suddenly ask for volume, and more money, on top. Balance billing is illegal in states, including California, Connecticut, Florida, Illinois, Maryland, New Hampshire, Oregon, and New York, among others. Nevertheless, hospitals often ignore the law and illegally balance-bill their patients anyway. If the defendant is paying you compensation in a personal injury lawsuit, the hospital is especially motivated to come after you for the money they've lost, in view of the large sum of money you now sit on. Unfortunately, it's up to you to study your medical bills and determine if you've been balance-billed. You also need to determine what the law has to say about it in your state. If balance billing is against state laws, you'll have to contact a lawyer to sue the hospital and remove any lien or holds that they may have placed on your personal injury compensation. There are a number of challenges that you need to get past to ensure that you lose as little of your personal injury compensation as possible. It usually takes an experienced lawyer to help you find fair treatment. Finally, if you were involved in any type of accident, know your rights. Ask the Lawyer. Call 855-768-8845.l

Speeding ruins lives. Slow down.

Brian Figeroux, Esq.