Many people are surprised to learn that in certain situations, the state and federal government, health insurance companies and hospitals can assert a claim against your personal injury settlement. When you have been the victim of an accident and have filed a personal injury lawsuit to recover the cost of medical bills, the people who paid for these medical costs may be able to file a medical lien against your settlement proceeds. A lien is a demand for repayment that may be placed against your personal injury case.
Your health insurance provider may also issue a lien to recover any money it spends on your personal injury accident treatment. You may be required to pay back these medical expenses. This is a process known as subrogation, whereby insurance providers can seek repayment from your settlement. The extent and strength of the subrogation claim depends upon the language used in the policy. Some states strictly prohibit an insurance company from placing a subrogation clause into a health insurance policy, so you should check the laws in your state.
In certain states, hospitals are entitled to file a lien for repayment of any monies spent on treating or caring for someone injured in an accident. Some medical providers may ask you to sign a lien letter, stating that you submit to a lien against your settlement to pay for services. Medical provider liens must follow a strict protocol in order to be valid. The hospital must follow the requirements of the Hospital lien statutes. Some of those requirements include:
If the hospital does not comply with the statutes, their lien is not enforceable. This does not mean you are not responsible for the bill. It only means that the hospital does not have a lien against your settlement. If the hospital has an opportunity to bill your health insurance, then it must do so and it cannot file a lien for the balance of the bill.
If you are injured in a work-related accident, a worker's compensation lien may be issued if your medical bills or lost wages have been paid through your state's workers' comp fund. This lien amount is typically whatever worker's compensation has paid for your case. Worker's compensation laws vary significantly between states; therefore it's important to check if the carrier can assert a workers comp lien on your personal injury settlement.
The general rule is that if the government paid for any portion of your medical care, they have a right to get paid back if you later recover money for your injuries from another party. Depending on the specific type of government program, some government agencies, (Medicare and Medicaid Liens, Veteran's Administration) have different rights when it comes to placing a lien against your settlement. Some have the right to recover a portion of the proceeds from your personal injury lawsuit.
It's entirely possible to get the lien holder to accept less than the amount they paid. Your attorney may be able to get the claim reduced from the medical providers who hold a lien against your case. Under the "fund doctrine", attorneys who create a "fund" for the benefit of a third-party are entitled for reimbursement from the fund in the form of attorney's fees.
Worker's compensation carriers are aware that a lien may be so large that is creates a disincentive to litigate. If the lien exceeds the total amount a plaintiff is likely to receive from a lawsuit, the plaintiff may choose not to sue. The plaintiff's attorney can negotiate with the carrier in order to resolve the lien for substantially less that the face value of their claim.
See How to Deal With a Personal Injury Lien for more on resolving medical and other liens.
If an entity requests reimbursement, it's important to ascertain what language in the insurance policy or public statute gives them the right to demand this. Lien law is extremely complicated and an experienced attorney may find ways to reduce or even eliminate the lien.