QUESTION
Why would I have to pay my insurance money back for a medpay?
Asked on Mar 13th, 2012 on Personal Injury - Michigan
More details to this question:
I am getting ready to settle a auto accident. I'm not going to sign the final papers because my lawyer says in this settlement that he has to pay my medical bills back. Is that right? When it was the other guys fault i thought his insurance would pay. I'm not happy with the results anyway. I'm getting a low amount back.
33 ANSWERS
Small Businesses Attorney serving Livonia, MI
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Klisz Law Office, PLLC
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Maybe.
Answered on May 30th, 2013 at 8:20 PM
Assault Attorney serving Richardson, TX
2 Awards
He does if he issued a letter of protection to the medical providers.
Answered on Mar 21st, 2012 at 5:17 PM
Personal Injury (Plaintiff) Law Attorney serving Wheaton, MD
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The Law Offices of Paul A. Samakow, P.C.
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I assume your lawyer handled all of this correctly. Your "settlement" includes the medical bills. They get paid from the settlement funds that the other guy's insurance gives you as a total settlement.
Answered on Mar 19th, 2012 at 11:12 AM
You have to pay it back if your policy had a subrogation clause. If it did then the law requires you to repay a portion, not all but a portion and only if you were fully compensated. See a personal injury attorney.
Answered on Mar 18th, 2012 at 7:49 AM
Criminal Defense Attorney serving Anderson, SC
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The David F. Stoddard Law Firm
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His insurance is paying. The settlement comes from his insurance. The insurance settlement includes your medical bills, lost wages, and in some cases pain and suffering. If you do not have health insurance, most doctors have a clause in the papers you sign to get treatment saying that you assign to them any insurance proceeds you get for personal injury to pay their bill. If health insurance paid your medical bills, most health insurance policies have a clause that you assign any insurance proceeds from an insurance claim that is for medical bills to them. Either way, it is the other driver's insurance that is paying these bills.
Answered on Mar 16th, 2012 at 12:19 AM
The settlement included money for the medical bills to reimburse your insurance company. If your insurance policy has a requirement that they be reimbursed for payment of your medical bills, your lawyer is correct.
Answered on Mar 15th, 2012 at 8:19 PM
You have a contractual obligation in your insurance policy to reimburse your insurance company for medpay. Your lawyer should explain this to you. The amount you settle for is up to you. If the amount you receive, after paying medpay, is unacceptable, then tell your lawyer that you do not want to settle for that amount.
Answered on Mar 15th, 2012 at 7:27 PM
Criminal Defense Attorney serving Montrose, NY
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Law Office of Jared Altman
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Yes. Sometimes you have to reimburse others for initially covering your medical bills. If you don't want the settlement then don't sign.
Answered on Mar 14th, 2012 at 9:55 PM
1 Award
When an attorney makes an offer to settle a personal injury claim, the offer is a lump sum amount which includes special damages (i.e. lost wages, medical bills) and general damages commonly referred to as "pain and suffering." From the settlement amount received, medical expenses have to be paid as the medical provider will have a lien on the settlement proceeds. The attorney is obligated to pay such. The insurance company for the guy at fault does NOT send payment directly to the medical provider who rendered treatment to you. Instead, an amount to pay such is included in the settlement.
Answered on Mar 14th, 2012 at 9:01 PM
Criminal Defense Attorney serving Alexandria, VA
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Michael J. Sgarlat
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Sometime medical bills have to be reimbursed to healthcare providers when a third party causes the injuries and damages. Look at the subrogation portion of your policy.
Answered on Mar 14th, 2012 at 7:32 PM
Sam Louis Levine
Oh boy...this is not a good consumer situation. You need to talk with an attorney about your options whether it is me or someone else, I would urge you to speak to an attorney re: your medpay issue related to your car accident in Atlanta, Georgia. Take care & good luck.
Answered on Mar 14th, 2012 at 5:45 PM
Most automobile soft tissue injury cases do not result in very high or good settlements from the plaintiff's standpoint. Juries do not award much in these cases so insurance companies do not pay much. If you received medical treatment that your own insurance company paid for then under your policy with that insurance company there probably is a provision that they have to be paid back if your recover anything from the other side [subrogation].? Normally they will reduce the total amount by a percentage because you have an attorney representing you [up to a third reduction]. If your Dr'.s were not paid, then they are paid from the settlement amount. The only amount you get to keep, no matter who paid, generally is a portion of the medical insurance reduction.
Answered on Mar 14th, 2012 at 5:23 PM
In that you have a lawyer, you should follow that lawyer's advice. If you're not pleased with the proposed settlement, tell your attorney why you can't accept the offer.
Answered on Mar 14th, 2012 at 5:16 PM
Personal Injury Attorney serving Charlotte, NC
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Paul Whitfield and Associates P.A.
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Your lawyer is probably talking about subrogation. If your policy contains such a provision then it will pay you, subject to being reimbursed if the claim is against a third party. It is a contract question and doesn't matter what you think about it. read your policy and ask your lawyer to explain it to you. Quit grousing. He is probably doing the best he can do.
Answered on Mar 14th, 2012 at 5:06 PM
Criminal Law Attorney serving Salem, NH
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Law Office of Patrick E. Donovan, PLLC
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If your auto insurance paid your medical bills pursuant to a medical payment (medpay) provision in your policy, the auto carrier is not entitled to subrogation or reimbursement. If your health care insurance paid your medical expenses, then that carrier is entitled to reimbursement, but only that amount that it actually paid to the provider. Ask your attorney if the reimbursements are going to your auto carrier or your health insurance carrier. If it is the former, then something is wrong.
Answered on Mar 14th, 2012 at 5:06 PM
2 Awards
Since you are currently represented by an attorney, you need to speak with him about this.
Answered on Mar 14th, 2012 at 5:04 PM
Because it was the other person's fault, more than likely, it is his insurance company that is paying your medical bills. For instance, your attorney has negotiated a settlement price, let's just say $25,000.00 (since you said it was a low amount, and let's say you have $5k worth of bills), of that $25K paid by the other person's insurance company, yours attorney will pay the $5,000.00 (or the at fault driver is paying the $5K medical bills) and you are left with $20K to be distributed accordingly. Put another way, using the same #s, $25K - atty fees = $16675 - $5K medical bills, you would walk away with a check for $11,675 (provided there's nothing else outstanding) and all of your bills are paid for in full.
Answered on Mar 14th, 2012 at 5:03 PM
Civil Practice Attorney serving Redmond, WA
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Magnuson Lowell P.S.
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Under Washington law, you normally do have an obligation to repay YOUR OWN auto insurance company for medical payments they made on your behalf. That's part of the contract between you and your own insurance company. When negotiating with the at-fault driver's insurer, your attorney should have known this and made sure that he included the anticipated repayment in any gross settlement amount. Moreover, normally you are entitled to a Mahler discount. In other words, you may not have to pay the full amount of the medical payments back to your insurer. Talk with your attorney about this.
Answered on Mar 14th, 2012 at 5:02 PM
Motor Vehicle Accidents Attorney serving Lincoln, NE
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Lapin Law Offices
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I would not be in a position to "second guess" either your lawyer's advice or the settlement total. Your lawyer should explain why you have to repay your insurance company back its "med pay" money and your medical bills. You should ask him/her why the settlement was not structured that these items would not be paid directly from the settlement rather than you/your attorney paying them.
Answered on Mar 14th, 2012 at 5:00 PM
Medical Malpractice Attorney serving Valparaiso, IN
Partner at
Langer & Langer Attorneys at Law
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Auto med pay coverage usually has a provision that the auto carrier is entitled to be reimbursed for payments from proceeds from the responsible party.
Answered on Mar 14th, 2012 at 5:00 PM
They are entitled to it.
Answered on Mar 14th, 2012 at 4:50 PM
It depends. If the I injury occurred in Michigan the. A no fault provider should have paid the medical bills. The answer to your question depends upon the specific facts and circumstances of your case.
Answered on Mar 14th, 2012 at 4:48 PM
Slander and Defamation Attorney serving Tucker, GA
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Law Offices of David W. Hibbert
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Reimbursemnt of medical payments may be a provision of your policy. This is a way insurance companies are fooling their customers into thinking that something they have paid for belongs to the customer. Your polcu is a contract which you may not have ever read in its entirety. Often an insurance company puts language in the policy saying that they will pay your medical expenses without regard to fault , however , if a third party is found to be responsible for your medical expenses, they claim a right to reimbursement. Your own state's laws may provide some relief if you have not "been made whole" or "completely compensated" by the settlement. This varies from state to state. Insurance companies spend millions on advertising but rarely explain what you are really buying from them.
Answered on Mar 14th, 2012 at 4:45 PM
Personal Injury Attorney serving Palm Springs, CA
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Gilbert & Bourke
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Most insurance policies carry a subrogation clause which allows the insurance company to recover the medpay back after you settle with a third party. Your lawyer can negotiate the amount down for you, and if the circumstances are that the settlement with the third party does not "make you whole", the reduction in the subrogation amount can be substantial. Speak to your attorney and negotiate the reimbursement before your settle.
Answered on Mar 14th, 2012 at 4:45 PM
Chapter 7 Bankruptcy Attorney serving Syracuse, NY
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Andrew T. Velonis, P.C.
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No-fault is not lienable in New York.
Answered on Mar 14th, 2012 at 4:44 PM
Typically, in Massachusetts the first $2000 in medical bills are paid for by your own car insurance (we are a no fault state which means it doesn't matter who caused the accident). This money does not have to be paid back from any settlement. If your bills are over $2000, then all remaining bills should be submitted to your health insurance. Whatever your health insurance pays, they are entitled to be paid back from any settlement you receive from an at fault party. When your lawyer negotiated your case, he or she should have taken into account the money owed to your health insurer and asked for additional money to cover this (above and beyond your money for pain and suffering). If you have medpay, then medpay should continue to pay bills above $2000 based on the amount of medpay you purchased. You do not have to pay back medpay either. I understand this may be a little confusing.
Answered on Mar 14th, 2012 at 4:44 PM
General Practice Attorney serving Indianapolis, IN
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Broad Law Firm, LLC
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Generally, whenever you receive benefits from your insurance company when it is someone else's fault (like Med Pay benefits or Uninsured/Underinsured Motorist benefits), the insurance company has the right to get their money back from the person who was at fault, either through a lien on any settlement/judgment or through subrogation. It sounds as if in your case that you received Med Pay benefits from your insurance company, and you are now settling with the person at fault. If that is the case, then your insurance company does have the right to get money from that settlement. You can negotiate with them, and they will generally accept less than the full amount, but they do have the right to seek reimbursement.
Answered on Mar 14th, 2012 at 4:43 PM
Plaintiff's Personal Injury Attorney serving Seattle, WA
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Shaw Legal Solutions
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Yes, whoever paid for your medical bills gets reimbursed from your settlement. If that's an insurance company (health, PIP, medpay), then that company gets paid back. If it was you paying out of pocket, then the money goes to you. This is standard. Keep in mind that by having an attorney, the reimbursement is reduced by a pro rata share of fees and costs, which means that you pay back less.
Answered on Mar 14th, 2012 at 4:43 PM
Bruce Arthur Plesser
If there are medical expenses over med pay and pip, you pay from your award. That should have been in retainer and explained.
Answered on Mar 14th, 2012 at 4:41 PM
Personal Injury — Plaintiff Attorney serving Taylor, MI
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Downriver Injury & Auto Law
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It depends on the situation. An out of State accident permits your PIP carrier to request repayment of the medicals paid from the tort settlement. You should discuss this with your lawyer.
Answered on Mar 14th, 2012 at 4:41 PM
Personal Injury Attorney serving Portland, OR
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Kaplan Law, LLC
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Yes, that can be correct. It really depends on how the case is negotiated and what the types of insurance policies involved say.
Answered on Mar 14th, 2012 at 4:41 PM
Plaintiff Animal Bites Attorney serving Missoula, MT
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Bulman Law Associates PLLC
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Your lawyer should dispute the subrogation claim for your medpay.
Answered on Mar 14th, 2012 at 4:41 PM
Personal Injury Attorney serving Richmond, VA
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Blank & Marcus, LLC
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You do not have to pay medpay benefits back. You do, however, have to pay back health insurance benefits or medicare/medicade, or workers' comp benefits if the health care policy is a self funded ERISA policy. This has nothing to do with your settlement it is based on a separate contractual obligation contained in your health insurance policy.
Answered on Mar 14th, 2012 at 4:41 PM