Some health insurance plans have liens on personal injury claims. A lien is a legal right to repayment, and some liens are stronger than others. Publicly-funded health insurance plans typically have automatic liens: Medicare, Medicaid, and Tricare have automatic liens, as to plans for employees of the Federal, state, and local governments. 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 paid back something. Each plan has different requirements.
Some corporate insurance plans have a right of repayment. If your company provides you with health insurance, that plan may get a repayment. The only way to know for sure is to examine the plan documents and items the company files with state and Federal governments. There is a Federal statute, known as ERISA, which gives some plans these rights in very limited circumstances. These plans do NOT have a lien, even though they’ll tell you they do, but they MAY have what’s called a “contractual right of reimbursement”, which is similar to a lien. You have to be careful, because many plans that do NOT qualify for reimbursement will still try to get it. The only way to know for sure is to consult an attorney who has experience in reviewing these plans and interpreting them.
However, if you have health insurance you pay for yourself, including if you buy it through ObamaCare (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. If you have a personal injury claim, contact the award-winning lawyers at the Miller Law Group for a free consultation. We’ve got your back.