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Is it ok not to reimburse my health insurance company from the settlement amount?

Santa Ana, CA |

I met with an auto accident on Jan 8, 2011. My lawyer settled the case without contacting me or letting me know. I am still taking treatment whose bills are not included in the file that was submitted to the insurance company. The case is settled for $13,700, my lawyer is forcing me to sign off the case, and offering me a very small amount from this settlement, where my out of pocket expenses are much more. The statute of limitations is upto Jan 8, 2013. Also, the lawyer says its ok to not to reimburse my health insurance company, as the settlement is for so less money, so that the lawyer gets more money as his fees. Is this really ok to not to reimburse my health insurance company?

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Attorney answers 9


Maybe you should get a second opinion from another attorney. Do not sign the release until you have got the second opinion.

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Get a second opinion. As for reimbursement - almost 100% of all insurance policies say that if you obtain a settlement or judgment from a third party claim, you are obligated to reimburse your insurance company. It depends on what your insurance policy says - you need a second opinion on this issue by showing another attorney your policy. Generally though, it is not a 1:1 reimbursement, your attorney should be negotiating with your insurance company on the amount of reimbursement based on the amount of settlement, and insurance companies generally understand and work with the attorney....

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You need to get your second opinion quickly if suit has not been filed yet, since the SOL is right around the corner based upon your post. I do warn you that it will be difficult for another attorney to really have an opinion on your case without all of the information about the accident and access to your medical records. Best of luck to you!

I will evaluate your case for free. I can also refer you to an attorney to help you if I cannot help you. Joyce J. Sweinberg, Esquire 215-752-3732 Disclaimer: Please note that this answer does not constitute legal advice. It is merely intended to provide general information to aid the poster in finding answers to the problem posed. This answer does not create an attorney-client relationship. In most cases, it is best to contact an attorney directly to find answers to your problems.


You are not required to accept the settlement. If you are still treating for the injuries, you should be very careful before settling the case. I agree with the other answers. Get a second opinion from a qualified personal injury attorney before signing the release. Make sure you are being treated by reputable doctors. If the insurance company knows the doctors are reputable, they likely will offer more in settlement. Make sure your lawsuit is filed timely if you decide not to accept the settlement offer.

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Typically you have a contract with your health insurance company requiring reimbursement when collecting from a third party. I generally like to get an agreement in writing from health insurance that they are waiving their reimbursement rights. If you stick your head in the sand and avoid them, and they later find out that you settled your case without paying them, they could potentially come after you.


This is complicated. Reimbursement for bills sometimes is mandatory. A local California attorney may be able to advise you. Good luck



I would respectfully suggest that you consult with another personal injury attorney and get a 2nd opinion about your current situation with your current lawyer. Your lawyer cannot settle the claim without your agreement, despite what he says. You are not obligated to sign a release document if you are not in agreement with the amount. Ignoring your medical insurance company's lien may prove disastrous in the future. Be mindful of your statute of limitations in this instance. If you decide to change attorneys, you must be sure that suit is filed to protect the statute from running.

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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 ensure proper advice is received.

This ans. does not create an attorney/client relationship.


Don't let a lawyer force you to sign anything.

You are the master of your own destiny. True?

Switch lawyers if this lawyer isn't representing you appropriately. Not all lawyers are created equal.

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You should receive a second opinion from a experienced California personal injury attorney to evaluate your case. I have represented and fought for my clients' rights to compensation for over 20 years and have the experience necessary to review the most complicated of cases. I hope that I can help you with your case.

Scott J Corwin
(310) 207-4030

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