Gain Insight Into Settlement Related Health Insurance Claims

If the victim of an accident were to get injured, and if that same victim had purchased health insurance, then that health insurance provider might cover a majority of the medical expenses. Consequently, following agreement on a settlement, the health insurance company would expect to be reimbursed for its payments to those that had treated the injured victim.

Procedure followed by health insurance providers

The health insurance company sends a subrogation letter to the claimant.
In that letter, the health insurance provider asks whether or not the accident had taken place at work. The same letter contains a few other questions.

The health insurance provider asks for the name of the company that had furnished the defendant with auto insurance. In addition, it seeks to obtain the name of the policyholder’s lawyer, if he or she has hired one.

Actions to be taken by the claimant

Claimants that have paid for a health insurance policy have the right to request a copy of that same policy. Smart claimants set aside time for studying that particular policy. In addition, the same claimants need to read the state’s laws, with respect to subrogation.

Some state laws do not allow subrogation. Still, a federal law always carries more weight than a state law. Federal law allows subrogation whenever an employer has a self-insured plan for the company’s employees. If a claimant were employed at a company, then that claimant would need to learn whether or not the employer at the same company had financed a self-insured plan.

Armed with all of that information, the client-lawyer team should know whether or not it would need to reimburse the client’s health insurance provider. If that provider did need to get paid, then the client’s lawyer should handle that particular transaction.

Where does the Personal Injury Lawyer North Bay obtain the money for the provider? Personal injury lawyers take those funds out of their clients’ compensation checks, which the insurance company has sent to the lawyer’s office. The same check is the source of the lawyer’s contingency fee. After the funds for the health insurance company and those for the contingency fee have been removed, the remaining funds get sent to the lawyer’s client, the claimant.

That usually brings an end to the process, unless the claimant’s check did not carry the name that is used on the claimant’s/client’s bank account. If that were to be the case, then the attorney’s office would have to be contacted. That situation would only arise if the attorney and the client had enjoyed a close and friendly relationship. Sometime such a relationship has existed prior to the time when a certain injured victim has found it necessary to seek legal assistance.