Subrogation Claims: Here Comes Your Health Insurance Company
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- Опубликовано: 19 июл 2024
- Did you know that your health insurance company has a contractual right to reimbursement if you recover your medical bills in a personal injury settlement? The exercise of this right by your health insurance company is referred to as a subrogation claim and in this week's #WhiteboardWednesday, Matt addresses how to minimize their impact on your personal injury settlement.
AMAZING SERVICE!!! I called the office just to ask a few questions that weren't available through videos and let me tell you!!! They were all answered. Even better, they gave me additional advice to move foward with my claim! I'm am so blessed to have found these videos and to have had the chance to speak with them. It was also a pleasant conversation to have. No stress!!! I feel like a weight was lifted off my shoulders. Thank you, thank you, thank you!!!🙏♥️
How can I reach them?
@@Milo_thepoochon they are open 8am-8pm their number is 415-345-4282 hope this helps!❤
Hi Matt, this was a great overview of subrogation. However, I think you may be misinformed about a health insurance company sending a letter. The claims forms that are submitted by doctors have an area that requires them to list if the visit was related to an accident or not. If a claim comes in with that information filled out, it prompts the insurance company to investigate via the form of a letter. Random ER visits would not prompt a letter. Thanks!
Keeps me from double dipping? So we can’t settle with the other party’s State Farm because 95% of it will go to my BCBS subrogation after my son had a horrible motorcycle accident (not his fault). Our attorney dropped us because the girl only has $50K medical, and with his fee, and with subrogation, there is NOTHING left for my son. We’re looking at filing no claim or even killing ourselves at this point.
Hello Matt. Good information but disagree with tip about ignoring private ins letter(s). The diagnosis codes reported on the claim reveal whether treatment resulted from an accident or if from illness. I have been a Medical Claims Collector for over 25 years and it is common for the insurance to hold payment to the healthcare provider until they receive a reply from the claimant. As soon as a claim falls under "Additional Information Requested From Patient", as a claims collector I will need to contact the patient and/or insured to inform them to reply to the insurance as to whether or not there will be a Third Party involved. If the provider is contracted with the insurance and they close the case until the claimant responds, the provider will typically send the bill to the patient or guarantor and quite often the bill is sent to a collection agency. In other words, the ignoring the insurance request can invite more aggravation to all parties involved.
I have UIM INSURANCE. Am I going to have to fight my own insurance co to get payment?
1/3 of 100= 33.3 %...not 40%
What if the health insurance didn’t pay for my care ?
I live in the unprogressive state of South Carolina. I’m sure BCBS has very little limitations. They mentioned 2 prominent ambulance chasers, 35% a piece. It’s sad because my son has been out of work for months, his bike is totaled, he is deformed and he went through an astounding amount of pain. But only a $50K kitty to divide up so I’m starting to realize, like our previous attorney), there’s no reason to seek a settlement. BCBS will get it all. Absolutely depressing.
I recommend you look into this statute: S.C. St. § 38-71-190.
Law Offices of Matthew J. Quinlan Thank you - I’ll look it up.
Hi Mary, sorry to hear about your sons injuries. Unfortunately lawyers care about 1 thing $ If they can't make alot off your claim then you are disposable. You are nothing more than merchandise to them. There are some good ones, but they are very rare.
@@marydahm6851i hope it all worked out in your favor
Can you,explain double billing and promissory notes ? Set-offs, Article 9.
The only thing I would disagree with is that insurance companies won’t go after money recovered from a UIM claim. It is written in many insurance contracts that reimbursement can come from UIM settlements, but as I’m sure you are aware some states (such as TX and NE) that do prohibit health insurance firm recovering from UIM provided that the person who was injured (or an immediate family member) is the one paying the insurance premiums. Kaiser does not pursue first party insurance recoveries but that is a business decision rather than a legal one.
Where did you find that info regarding Texas please
@@kathysowards217 I work for a company that does subrogation/reimbursement for health insurance companies. The law is called Texas chapter 140 that prohibits subrogation by an insurance company against a persons 1st party coverage such as PIP, Medpay, UM/UIM provided that they are the ones paying the insurance premiums (or listed as a named insured on the policy). But note that this does not apply to plans with federal preemption such as ERISA self funded insurance plans (with appropriate contract language that clearly spells out that such recoveries can come from proceeds included in the previously mentioned insurance coverages) or Medicare.
Hi! Is your account still active? Would love to ask some questions!
And the girl who did this has absolutely no repercussions to her. She didn’t even show up to traffic court. We’ll be financially ruined.
Mary, I am not sure what state you are in, but most states place some limits on what an insurance company can recover through subrogation. For example, in CA California Civ. Code 3040 controls. Unless your plan is a tightly-written, self-insured ERISA plan, the result of the settlement should leave your son with something in his pocket, the subrogation lien satisfied and the attorney's fees paid.
Through the end of June, BCBS wants almost $15K back in subrogation before I learned of the $143K hospital bill. BCBS will not return my calls. I think my son will have to end his therapy because we can’t afford this.