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My father was involved in an auto accident,which was not his fault.He sustained injuries [two broken ribs]

Hawkinsville, GA |

He is 84 years old and in bad health ,so i have been trying to handle this for him with the insurance company.I have provided them with the medical records and a written diagnosis from the doctor.The insurance company claims that they cannot compensate him for his injuries because since he is on Medicare that they have an automatic lien and that must be addressed prior to settlement.Is this true?This seems like two separate issues to me.It seems as though that would be between the insurance company and Medicare as to whether they wanted to be reimbursed by the insurance company.They're telling me that we have to handle dealing with Medicare.


Attorney Answers 11

  1. Unfortunately, you are doing your father a disservice by handling this yourself. Your motives may be altruistic or even responsible, but you are well over your head. Your questions crosses over to legal advise. My advise is to retain a qualified and local attorney.

    Personal injury cases only; I'm good at it; you be the Judge! All information provided is for informational and educational purposes only. No attorney client relationship has been formed or should be inferred. Please speak with a local and qualified attorney. I truly wish you and those close to you all the best. Jeff

  2. As you can see from your experience, without a lawyer representing your father he facing an uphill battle with the insurance company, and besides you, he has no one advocating on his behalf. Please feel free to call my partner Peter Ross at 404-812-4300 to discuss this situation.

  3. You have likely really messed things up by being his lawyer. Talking to the insurer almost always guarantees a far lower settlement than he should get (on average 70% lower). And where Medicare reimbursement is at issue, a lawyer also may help by negotiating the amount.

    STOP talking to the insurer and stop sending them records and see a lawyer before the case is damaged further.

    If you find this answer helpful, please mark it here on AVVO as helpful. In answering you, I am attempting to communicate general legal information and am not representing you (and am not your lawyer). Do feel free to call me at 404-768-3509 if you wish to discuss actual representation (the phone call also does not retain counsel; that requires an office visit and appropriate paperwork). In that a forum such as this provides me with limited details and doesn't allow me to review details and documents, it is possible that answers here, while meant to be helpful, may in some cases not be complete or accurate, and I highly recommend that you retain legal counsel rather than rely on the answers here. (You can also email my office at . An email also does not retain my office, but can help you get an appointment set if you prefer not to call). I am happy to discuss possible representation with you. Any information in this communication is for discussion purposes only, and is not offered as legal advice. There is no right to rely on the information contained in this communication and no attorney-client relationship is formed. Nothing in my answer should be considered as tax-advice. To ensure compliance with IRS Circular 230, any U.S. federal tax advice provided in this communication is not intended or written to be used, and it cannot be used by the recipient or any other taxpayer (i) for the purpose of avoiding tax penalties that may be imposed on the recipient or any other taxpayer, or (ii) in promoting, marketing or recommending to another party a partnership or other entity, investment plan, arrangement or other transaction addressed herein. I am also required to advise you, if your question concerns bankruptcy, that the U.S. Congress has designated Ashman Law Office as a debt relief agency that can help people file bankruptcy.

  4. As the other attorneys have stated you should contact an attorney immediately, so they can attempt to determine the damage that is done on this claim.

    Good luck.


    This response is for general information only, no attorney client privilege has been established by this communication.

  5. If you really want to help your father hire an attorney. Insurance companies make their money by denying claims and delaying the process as long as possible. Good luck NY.

    -Michael R. Juarez Law Office of Juarez and Schaeffer PO Box 16216 San Diego, CA 92105 (619) 804-4327 This posting is provided for “information purposes” only and should not be relied upon as "legal advice." Nothing transmitted from this posting constitutes the establishment of an attorney-client relationship. Applicability of the legal principles discussed here may differ substantially in individual situations or in different jurisdictions.

  6. In addition to what the others have said, yes medicare must be dealt with. The injured party (usually thru thier atty) contacts medicare and has to go thru the red tape of getting the detail of what bills mcare paid. Medicare has to be reimbursed, subject to certain reductions. If future care is reqd, it can get even more complicated. If the ins co pays your dad, and medicare doesnt get paid by you, mcare can sue the ins co. That is why they wont pay now.

  7. Hello, that's terrible about what happened to your father, particularly since it appears that you live some distance from him. You did the right thing trying to help him. Now you have hit a brick wall with the insurance company & dealing with medicare is a major headache. This is somewhat complicated. The best thing to do is to communicate with an attorney experienced not only in personal injury, but also in health law, which I am & of course there are other attorneys as well. If you would like to talk about this matter, I would be happy to. I can relate to what you are going through as my own father suffered a rib injury as well from an accident years ago. I can be reached most anytime directly at (404) 468-4689. I hope you father feels better.

    Sam Levine, Esq.
    (404) 468-4689

  8. Trying to handle an accident case without a lawyer will either get you #1. no money or #2. a tiny nuisance settlement. A good personal injury lawyer will get the compensation to which he is entitled, as well as negotiate down any medical liens to 10-20 cents on the dollar.

    Only 29% Contingency Fee! Phone: 215-510-6755

  9. I would strongly recommend that you hire a local attorney to help your father in his situation. Best of luck.

  10. The lien cannot be addresses until settlement numbers are know so in a sense you are correct; there are two separate steps. Real issue is with broken ribs, there is notice medical care; it just hurts. Settlement should be about 8 to 10 k on 2500 in medicals. Medicare will have paid about 1500 on 2500 so reimbursement is workable.

  11. We understand this is a very scary time for you and your father. You need to hire an attorney for many reasons: so you don't have to talk to the insurance companies (you need to focus on getting better), the attorney will speak with the at fault insurance company, medicare, and the medical providers to sort out payment stuff, you also need someone on your side to fight to try and get him compensated for: pain and suffering and any future medical bills. Yes, there will be a lien from medicare (an experienced attorney will go over that bill by bill and get it reduced before it is paid). Let an attorney handle this for you so that you can just focus on getting your father better. You should call a couple attorney's to find one that you trust and treats you with the respect. Just a note: Because you hire an attorney does not mean that you have to sue anyone and our goal is to keep you OUT of court! I hope this helps.

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