Medical bills in excess of motorcycle injury settlement?

Asked over 4 years ago - Los Angeles, CA

Hit by a car while driving my motorcycle, car's driver 100% at fault; I was hospitalized for 3 weeks, medical bills = $320k.

My health insurance paid for it so far (pacificare HMO provided by my employer). My attorney suggests that we take a settlement in the amount of the car driver's insurance limit, $50k, since the driver has no assets. However, he also mentioned that if I take a settlement, then I become responsible (under CA law) for the medical bills

My attorney's firm's plan is to "try" to negotiate the med bills down to zero but he can't guarantee success. If that fails, do I become liable for medical bills in excess of the settlement amount that I may end up with after legal fees? If so, should I just NOT take the settlement, or is my HMO going after me anyway? I have assets...

Attorney answers (4)

  1. R. Sebastian Gibson

    Contributor Level 14

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    Answered . Your attorney should negotiate the bills down BEFORE you have to agree to accept the settlement. He or she just needs to call the medical providers and tell them the amount of the policy limits and what percentage he or she is asking them to accept. Then your attorney should get fax confirmations from each medical provider that they have agreed to accept whatever percentage of a reduction, e.g. 33 1/3 off or more if that's needed to pay for the attorneys fees and costs and still put a chunk of the settlement in your pocket. You can also ask your attorney to take a reduction in his or her fees so he or she is not getting any more than you are after your attorney is first reimbursed for his or her costs. Many attorneys will do that. But the key is that your attorney shouldn't be asking you to accept a settlement not knowing what you'll come out with in your pocket. He or she should do the negotiations with the medical providers FIRST.

  2. Thomas Gerad Lewellyn

    Contributor Level 13

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    Answered . You can negotiate the amount of the medical lien and bills now before you settle. Your leverage is much better and you will know exactly what you are getting before the case settles. Also, you should talk to your lawyer about reducing his fee since this was a simple, one letter, demand for the policy limits. Good luck in your recovery.

  3. Gary Philip DuFour

    Contributor Level 10

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    Answered . To answer the last part of your question. No, your HMO cannot seek to recover the amount in excess of the settlement directly from you. Subrogation in insurance is your HMO's right to seek recovery from 3rd partys. They have a duty to pay your medical bills in thier entirety but a right to recover from the party at fault.

    Disclaimer: The preceding is not intended as legal advice and does not create an attorney client relationship.

  4. Lars A. Lundeen

    Pro

    Contributor Level 20

    Answered . Since you are currently represented by legal counsel, it would not be appropriate for attorneys here on Avvo.com to offer you specific legal advice. I suggest that you arrange a face-to-face meeting with your current attorney and discuss with him the various options and defenses which may be available to you regarding the HMO lien claim. There are a number of possible defenses to subrogation lien claims, which your attorney should be familiar with and should be able to advise you.

    Legal Disclaimer:

    Mr. Lundeen is licensed to practice law in Florida and Vermont. The response herein is not legal advice and does not create an attorney/client relationship. The response is in the form of legal education and is intended to provide general information about the matter within the question. Oftentimes the question does not include significant and important facts and timelines that, if known, could significantly change the reply and make it unsuitable. Mr. Lundeen strongly advises the questioner to confer with an attorney in your state in order to insure proper advice is received.

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