At BenGlassLaw, we have handled countless personal injury claims over the years. One thing that most clients are surprised to learn is that their health insurance company (whether it be BlueCross, Aetna, Kaiser, etc.) may have a right to be re-paid for the medical bills for which they paid out of their personal injury case. They always say, “Well, if I have to pay them back, why did I get health insurance in the first place?!” The purpose of this article is to clear up a lot of confusion.
- In many instances, health insurers do have a right to be reimbursed if you can win your personal injury claim. Their right to reimbursement, if it exists, comes from the health insurance contract that you signed. If you receive a letter from your health insurer asking for reimbursement, ask them to point out the language in your policy that gives them that right. If it’s there, it’s simple contract law.
- Not all health insurers ask for reimbursement. Many don’t require reimbursement in their contracts. However, the reimbursement requirement is becoming more and more frequent.
- Even if you end up having to reimburse your health insurer, it’s still very important to get health insurance. Many times when you need health care, it’s not due to the negligence of another. Therefore, you need to protect yourself from life’s unforeseen issues.
- The personal injury claims process is very long. The statute of limitations for a personal injury case is two years in Virginia. In many instances, two years is how long it takes to pursue your claim (if not more). During that time, your doctors, hospitals, therapists, etc., want to be paid for the work they performed. If you didn’t buy insurance, often those providers WILL NOT WAIT for your personal injury claim. And just like any other debt, they will send you to collections. That means your credit would be destroyed, and you have pressure to settle your PI claim (at a discounted amount) because of money issues.
- Health insurers get discounts on medical bills. If you’ve received treatment from a hospital and had insurance, you know what I’m talking about. You have an MRI for $3,500, but you see that your health insurer only had to pay $1,000.00 for it. If that MRI was due to an accident, and you’re required to reimburse the health insurer, you only have to reimburse it for how much was paid out. So here, only $1,000. If you were uninsured, you’d owe your MRI provider the full $3,500.00.
If you’re hurt in an accident, and your health insurer is seeking reimbursement, keep things in perspective. Yes, it may not be fair. But if you didn’t have that health insurance, you’d be in a lot more difficult position.