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Medical Liens and Subrogation


At the Anderson Law Firm in Fort Worth, many of our clients are surprised to learn that in certain situations, the state, federal government, health insurance companies and hospitals assert a claim against your personal injury settlement. If you have received a letter from the hospital or from your health insurance company asking about your accident and if you are pursuing a claim, then you probably know what we mean. If you haven't yet received a letter, you probably will get one if you went to the hospital right after the accident or if any of your medical bills were paid by an insurance company.

If you are trying to resolve the claim on your own, you must be aware that ignoring any of these liens can expose you to a lot of long-lasting trouble. The following is a summary of the different liens and subrogation interests we see most often:

Worker's Compensation Liens

If you were injured on the job and covered by worker's compensation insurance, then your claim against a negligent third party is subject to a "lien." This essentially means that the worker's comp carrier has a right to be paid back for all money spent on your claim, both for medical payments and for lost wages. Is this fair? Of course not! But it is the law in Texas and it cannot be avoided. Does this lien extend to all types of claims? Just about. However, if you are asserting a claim against your uninsured/underinsured motorists policy (UM/UIM), and you are the one who bought the policy, not your employer, then the law currently allows you to avoid "paying back" the worker's comp carrier. Simply stated, you will net more in your settlement.

Hospital Liens

Texas State law also allows for hospitals to file a lien on settlement proceeds as long as the injured party was admitted to the hospital within 72 hours after the accident. For this lien to be valid, the hospital must file the lien with the County Clerk anytime before the payment of the settlement is made. The lien also extends to physicians who provided emergency services. The hospital lien does not extend to UM/UIM benefits. Also, if the hospital has an opportunity to bill your health insurance, then it must do so and it cannot file a lien for the balance of the bill.

Government Liens (V.A., Medicare, Medicaid)

The general rule is that if the government paid for any portion of your medical care, then the government has a right to get paid back if you later recover money for your injuries from another party. Depending on the specific type of government program which is being used, the way the lien works is different. Great care must be taken to get the correct lien amount and any applicable reductions prior to settlement. Failure to pay the government lien can expose those involved to liability later on.

Health Insurance Subrogation Claims

All health insurance plans have a contractual right of subrogation. That means that all covered persons have agreed to pay back the health insurance carrier from settlement proceeds if the injuries were initially covered by health insurance. The extent and strength of the subrogation claim depends on whether the health plan is an ERISA-based plan and it is determined by the language of the policy. Usually, clients receive a subrogation letter soon after the accident, when the insurance company starts receiving the medical bills. At that point, it is a good idea to turn the letters over to an injury attorney so that the matter can be properly handled.

Free Consultation

If you have a question about medical liens, subrogation claims or your injury case, please call the Anderson Law Firm at 817-294-1900 or Contact Us Online.

 

Other Articles You Might Be Interested In:
Seeking Medical Attention After the Accident
No Health Insurance: How to Obtain the Necessary Medical Treatment After an Accident
Medical Treatment in Your Personal Injury Case

What are Pre-Existing Medical Conditions?

Will a gap in medical treatment hurt my claim?


Mark A. Anderson
Board Certified Personal Injury Lawyer in Fort Worth, Texas