My injury claim is small, I will be collecting only a tiny settlement from 3rd party to cover pain and suffering. My HI has paid the medical bills. So I am not collecting any money for medical
I am concerned My HI will someday decide they want my "tiny settlement "to reimburse themselves for medical paid.
I feel I deserve to keep the settlement because I am not being fully compensated and I pay insurance premiums to cover medical, I was the one that suffered and am the one that worked like the dickens to negotiate a tiny settlement. Also, because I am accepting a"tiny settlement" there would be no settlement at all , 3rd party would fight in court If i demanded more $ and too tiny case for lawyer.Thank you. There are NO liens. NOR notice of subrogation, Actually my claim is for "lack of care", hence, virtually almost no medical bills. A case were medical bills do not reflect the damages . The EOB shows less than $100 was actually paid by insurance company( Preferred Provider amount). I already paid deductible & copay. ( Insurance should Not be reimbursed what I paid myself out of pocket ) Maybe why they are not going to bother with sending me a subrogation notice. If they do I will negotiate a 1/3 discount for recovery cost. i don't think they can request my entire settlement if reimburse them.
The right of subrogation exists if there has been a payment, and only to the extent of payment. If there has been no payment, there is no right. If there has been a payment, you have to deal with it. That means proper statutory notice followed either by the assertion of a lien and negotiation, or followed by the failure to assert a lien pursuant to Florida Statutes.
There are exceptions to the rule that subrogation exists only for past paid medicals. The two major exceptions include Medicare and if your insurance policy EXPLICITLY says that your future benefits are reduced if you settle (or something like that). In those cases you will want to set up a set-aside trust.
This is a summary based on incomplete facts. You should not rely on it as legal advise. No attorney-client relationship is intended to be formed.
I hope you don't get caught by your insurance company. They have the right to be reimbursed. I would be very careful before proceeding without an attorney. If you hire an experienced personal injury attorney, they would be able to negotiate all of your medical bills down, the health insurance lien down, and would probably also be able to increase the amount of your settlement. I highly advise you to hire an attorney before you act as your own.
Do you have notice of a lien claim by your health insurer.? They are not stupid and if you have notice there is no such thing as not collecting for medicals and only for pain and suffering. If you do not like the way the laws are written take some action to change them. What you are doing is risky and ill advised. You need to discuss your proposed actions with an attorney
Your tiny claim may not be tiny if you hire an experienced lawyer. They will be able to negotiate any subro claim as part of the process at no additional cost to you..
Although it does not seem fair, your insurance carrier likely has a subrogation clause in their policy and the have to be paid back. They will not agree with you that your settlement is for pain and suffering only. There really is no such thing as a tiny injury claim. A lawyer can always help and usually adds value to the case. Insurance companies take advantage of unrepresented parties. That may be the reason the offer is so low. If you did not yet accept the offer you should at least have a free consultation with an attorney. Your claim could be worth more than you realize. Regardless of whether you hire an attorney, you do need to deal with the health insurance lien from your settlement proceeds. A lawyer would handle that if you hired one and may be able to get the amount owed reduced. Hopefully you didn't accept the offer yet!
Although I am happy to give my opinion freely based on my knowledge, experience, and training as a personal injury attorney, the opinions I give in response to questions posed on AVVO should not be construed as legal advice and should not be relied on to make legal decisions.
There are several ways to handle a situation like yours. But simply ignoring your health insurance carrier's lien is not a good way to handle it. You should contact an attorney right away to review your situation and see if there's anything else that can be done for you.
The answer submitted by the above attorney is not intended to be, nor shall it be, deemed to be legal advice. The response is based solely on the information provided, which is insufficient to render proper legal advice. The answers shall not be construed as creating any attorney-client relationship. The questioner has the responsibility of obtaining legal advice from an attorney of their choosing and is encouraged to do so. You should consult an attorney who can further inquire on your legal matter and give you proper legal advice, according to the specific facts of your potential case.
You say your claim is too tiny for a lawyer to take. Have you tried retaining a lawyer? How tiny is tiny? If you have not consulted with a personal injury lawyer in your area I advise you to do so before doing anything else. If it is truly "too tiny" that no lawyer will touch your claim, you need to negotiate with your healthcare provider before agreeing to any settlement. BTW.. is yours a motor vehicle accident?
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Without a lawyer, you have a tiny nuisance claim, but with a lawyer, you will get the maximum possible compensation. Avvo has a great lawyer finder tool to locate an attorney close to your home. Good luck.
Tiny or no, your HI insurance has a lien on third party money. In fact, any settlement release will usually have you agreeing to indemnify the original insurance company that paid you against such liens or you swear under oath that none exist, kind of language. You should deal with this directly with you HI in advance, because your "tiny" case can become a big fat lawsuit very easily.
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