Identifying Health Insurance With Personal Injury Liens

Understanding what personal injury liens are and which healthcare plans permit reimbursement can help you prepare for potential impacts to your settlement. Some health insurance plans have liens on personal injury claims. A lien is a legal right to repayment, and some are stronger than others. Let’s look at how healthcare plans handle personal injury liens and how our insurance claim lawyers can help assert your rights after a collision—and protect your settlement.

Publicly funded health insurance plans typically have automatic liens. These include government programs, such as Medicare, Medicaid, and Tricare, and other plans for employees of the federal, state, and local governments, like clergy and teachers. If you have one of these plans, and it pays for some or all of your treatment for your injuries as part of a personal injury claim, then the plan will have to be reimbursed. Each plan has different requirements but many of these involve automatic repayment for personal injury liens.

Some corporate insurance plans have a right of repayment. Many of these plans are governed by Employee Retirement Income Security Act (ERISA) which allows employers to recoup healthcare expenses for plans they fund. These personal injury liens are not automatically applied and vary based on the type of plan and the language in the policy.

If you have health insurance through the Affordable Care Act, then you don’t have to repay the plan. North Carolina’s Administrative Code specifically prohibits personal health insurance plans from seeking any reimbursement.

The only way to confirm the lien policy of your health insurance plan is to examine the plan documents and items the company files with state and federal governments. We recommend consulting with an insurance claim lawyer, as this fine print and jargon can be difficult to decipher. Plans under ERISA have rights to reimbursement in very limited circumstances. These providers may tell you they have rights to personal injury liens, but what’s more likely is that they have what’s called a “contractual right of reimbursement.”

Our lawyers who handle car accident claims see providers try to recoup expenses even though the plan does not qualify. An insurance claim attorney experienced in reviewing and interpreting healthcare policies can help clear up any confusion about what liens exist and which must be paid.

Don’t wait until it’s too late to discuss subrogation and liens against your claim. If you have a personal injury claim with potential liens, contact Miller Law Group’s award-winning lawyers for a free consultation. We’ve got your back.