Your insurance company has a right to seek subrogation. That means that your insurer has a right to be reimbursed for paying on your medical bills when your were subsequently paid by the other party. If you have an attorney, he/she should have negotiated the subrogation down.
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Pursuant to the California Insurance Code, insurance companies are allowed to recover the amounts they expend on an insured, if the amounts expended were the result of negligence by a 3rd party.
Had you retained an attorney like me I could have negotiated the lien down to a level which would have allowed you to keep a significant amount of money in most cases.
This is another example of why you should never handle these types of cases on your own, in the end you flat out will not get as much money as you would with an attorney.
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Most insurance plans provide for subrogation if you recover against a third party. Your health insurance company can explain it to you. You should be using an attorney.
The response given is not intended to create, nor does it create an ongoing duty to respond to questions. The response does not form an attorney-client relationship, nor is it intended to be anything other than the educated opinion of the author. It should not be relied upon as legal advice. The response given is based upon the limited facts provided by the person asking the question. To the extent additional or different facts exist, the response might possibly change. Attorney is licensed to practice law only in the State of Alabama. Responses are based solely on Alabama law unless stated otherwise.
Kaiser, like every health insurance provider, has a clause in the health insurance contract that allows it to seek reimbursement from a settlement with a 3rd party because that settlement, at least in theory, includes reimbursement of the medical cost. You should be able to negotiate a reduction of the amount with Healthare Recoveries, and under no circumstances can Kaiser take more than 50% of your settlement under Civil Code §3040.
It may be a good idea to talk to an attorney about the situation. Many lawyers will even give you information over the phone.
It all depends on the language in your health plan contract. This is complicated stuff-- sometimes if the plan is not well-drafted, you can wind up paying nothing back to the carrier. If the $$ in issue are >$10K, you should get a lawyer.
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