Attorney’s Role in Seeking Reductions of Medical Bills for Injuries in a Motor Vehicle Accident
In personal injury cases, your attorney can negotiate with your health insurance provider to reduce the amount deducted from your settlement, especially when legal fees are high. Health insurance companies often have a right to subrogation, allowing them to recover funds they paid for your medical treatment if you win a settlement or judgment. Here’s how it works:
What is Subrogation?
Subrogation allows an insurance company to “step into your shoes” to recover the costs it paid for your medical care from the party responsible for your injuries. This process prevents double compensation for the same expenses—from both the insurer and the liable party.
How Subrogation Works in Personal Injury Cases
- Medical Bills Paid by Insurance: If your health insurance covers medical expenses from a personal injury (like a car accident), it may seek reimbursement if you receive a settlement.
- Insurance Company’s Claim on Settlement: The insurance provider will often claim a portion of the settlement to cover what it paid for your care, potentially reducing your net recovery.
- ERISA vs. Non-ERISA Plans: Subrogation rules depend on whether your health insurance is regulated under ERISA (Employee Retirement Income Security Act) or state law. ERISA plans often have stricter subrogation rights, demanding full reimbursement without considering attorney fees or other costs. Non-ERISA plans are typically governed by state laws, which may limit the insurer’s recovery to a fair portion.
- Made-Whole Doctrine: In some states, such as South Carolina, the “made-whole doctrine” may apply. This means the insurer can only recover if you’ve been fully compensated for all damages. However, this may not apply to ERISA plans, which supersede state laws.
How Your Attorney Can Help
Your attorney can often negotiate with the insurance company to reduce the amount it takes from your settlement. This negotiation can significantly impact your final recovery.
What You Should Do
To protect your compensation:
- Review Your Health Insurance Policy: Understand its subrogation rights.
- Discuss Subrogation with Your Attorney: Your attorney can work to reduce the amount owed to the insurer.
The experienced attorneys at Bannister, Wyatt & Stalvey in Greenville, SC, are ready to advocate for you. Call us at (864) 781-0228 or schedule a consultation online.
