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Can my health insurance company take part of my settlement?

Sun City, CA |

I recently received a settlement from a motorcycle accident I was badly injured in. Although my injuries were well over 100,000 that I received because that was the max the driver was insured for. Can my health insurance provider take my settlement? My personal pain and suffering was way more then the amount paid to me do they still have rights to take that money from me?

Attorney Answers 5

Posted

The only thing you can do is to tell your health insurance company that you have not been what is called "made whole" by the settlement. That means that you will not have received a fair share of the settlement amount if you are forced to re-pay the insurance company. Ask them to reduce your repayment amount so that you are "made whole" by the settlement. They may then say that your health insurance policy has a clause that says they are not required that you be made whole.
If you already have the settlement money they may be afraid that you will just keep the money. In that case they may be willing to negotiate with you. If you do not reach a settlement with your insurance company they may drop your insurance or sue you for the amount owed.
Good luck, John Burns

Persons reading this advice do not yet have an attorney client relationship with attorney John P. Burns and shall be solely and individually responsible for their own actions in this regard.

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Donald Steven Sjaarda

Donald Steven Sjaarda

Posted

This is an excellent answer. Your attorney will need to read the health insurance policy and determine if it is governed by ERISA.

Posted

The answer depends on the type of health insurance you have as well as the language of the health insurance plan which addresses its right of reimbursement/right of subrogation. The answer also depends on whether federal or state law applies. If you have an attorney the attorney can address this issue. If you do not have an attorney you may wish to retain one.

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Posted

What does your attorney say? In NY Tks to former Gov Patterson often no. Good luck

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Posted

I am one of the top biker lawyers in the State of California. You can read about this issue at www.bikerlawyer.net.

I am disappointed that other attorneys have chimed in here and not given you a straight answer, some of whom are not even licensed to practice law in California; probably to increase their Avvo answer level. What a shame.

The California Insurance Code allows insurance companies to be reimbursed for the money they pay out, when their insured is injured due to the negligence of another. Had you not gone after the defendant for a settlement or judgment, the insurance company could have under subrogation.

The short answer to your question is that they can seek reimbursement, or submit a direct lien to the defendant insurance company.

You need to negotiate with them to attempt to reduce what they will take. Your attorney should be doing this for you.

No attorney/client relationship is or shall be created by this response on Avvo to non-clients of The Law Offices of Norman Gregory Fernandez.

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Posted

if you recover from a third party as you did here your health insurance company can recover for medical bills they paid. your lawyer should have dealt with the negotiation of this lien.

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