Your Injury Case is Settled! Now, Who Do You Have to Reimburse?

After an accident, your medical bills can stack up quickly.  Emergency responders, hospitals, doctors, imaging, physical therapy and rehab, and the list goes on.  In Georgia, once you settle your personal injury case, you may be required to reimburse out of your settlement check the entities who paid for your medical treatment. It is important for you to know exactly who is entitled to a portion of your settlement before agreeing to a settlement amount so that there are no surprises when you get your final settlement check.

Here are a few of the common entities that may be entitled to reimbursement in Georgia:

Health Insurance

Most people are surprised when they find out that they actually have to reimburse their health insurance for money spent on your medical treatment for injuries suffered in an accident.  If your health insurance makes any payments for treatment related to your accident, then they will likely make a claim for reimbursement upon the close of your injury case.  However, your obligation to reimburse your health insurance hinges on whether or not the plan is governed by Federal Law of Georgia Law. If your plan is governed by Georgia Law, then your health insurer is only entitled to reimbursement if you are “made whole” under Georgia Law, per O.C.G.A. §33-24-56, by your settlement.  An experienced personal injury attorney like Bethany Schneider can work with your health insurance company to reduce or resolve their claim for reimbursement.

If your plan is governed by Federal Law (in the case of ERISA plans), then Georgia law will not apply, and you will be obligated to reimburse your health insurer regardless of the amount of your settlement. That is why it is important to figure out whether your employer’s health insurance plan is an ERISA plan.  It is usually much more difficult to negotiate a reduction if your health insurance is an ERISA plan, but Bethany will work hard on your behalf to get you the maximum reduction possible.

Government Health Benefits: Medicare & Medicaid

Because Medicare and Medicaid are funded by the U.S. government for the purposes of providing health benefits, they are  known as a “secondary payers,” meaning that they are second in line for paying your health claims and that other sources of payment, such as personal injury settlements, must be exhausted first.  Most times they will go ahead and make payments known as “conditional payments,” meaning that, if the patient receives a settlement, they are legally obligated to reimburse Medicare and Medicaid.

Contrary to reductions with other payers, Medicare and Medicaid reductions and negotiations can be very complex and may require an experienced attorney to protect your interests.

If You Do Not Have Health Insurance: Liens from Medical Providers

If you have no health insurance and have outstanding medical bills from the hospital or other doctors who have treated you for your injuries, many medical providers are allowed under Georgia Law to put a lien on your case for those outstanding bills.  Per O.C.G.A. §§ 44-14-470-476, any practice that employs a certified medical doctor (M.D.) can put a lien on your injury case if you had treatment there for injuries from your accident.  These liens are NOT against you, but instead are against your injury claim, meaning that you only have to pay them back if you recover a settlement.  A valid medical lien is simply a way for providers to ensure they are paid in the event of a settlement.  A lot of times these liens can be reduced substantially through negotiation by an experienced personal injury attorney like Bethany Schneider, putting more money in your pocket.

Even if the medical provider has not actually filed a lien, most times they must also be paid from your settlement amount to protect your interests and if you do not want them to go to collections. But again, the amount of these bills can sometimes be greatly reduced by an experienced personal injury attorney like Bethany Schneider.

If You Do Not Have Health Insurance: Third-Party Funding Companies

A personal injury settlement can take quite some time from start to finish, especially if litigation is required. During this time though, your expenses continue to add up and your debts continue to come due. You are faced with the dilemma of settling your case for less than it is worth or going bankrupt. This is where third-party funding comes in.  There are companies that can step in and act like health insurance by paying for your medical treatment.  Just like health insurance, they are entitled to reimbursement when you settle your claim.

Automobile Medical Payments Insurance Reimbursement

After an accident, many drivers carry insurance on their vehicles called “Medical Payments” coverage, or “Med Pay” for short.  In essence, med pay coverage is an amount allotted in your, or the other driver’s policy, that is solely for the purpose of paying medical bills in the event of an accident. Most med pay policies include language in the contract that will entitle them to reimbursement for these payments upon settlement of your case. However, Georgia law protects drivers that have not been “Completely Compensated,” as defined in O.C.G.A. §33-24-56.

This statute only requires Med Pay coverage to be reimbursed if the injured party is fully compensated for all of their economic (medical bills, lost wages, etc.) and non-economic losses (pain and suffering).  Furthermore, you are only required to reimburse Med Pay coverage up to the amount that the settlement documents, or judgment, allocates to those specific categories of damages.

In short, you may or may not be required to reimburse Med Pay coverage after your settlement, depending on the nature of your injury, the amount of the settlement, and the allocation of amounts to specific categories of damages.

An experience personal injury attorney like Bethany Schneider can help navigate all of these types of reimbursement and negotiate them down so that you can put the most money in your pocket.

Contact Bethany Schneider with Schneider Injury Law today if you or your loved ones have been hurt in an accident that was another party’s fault.