In situations where there really just isn’t enough coverage to properly pay for everything, the attorney will negotiate with the medical providers. They’re usually able to accomplish a result even if the medical bills far exceed what they’re able to obtain from the defendant.
If the defendant is someone with a limited insurance policy or doesn’t have a lot of assets, they then negotiate with the lien providers or the lien holders to make sure that the client receives some money. However, it may surely not be what the client is entitled to if there was ample insurance coverage.
In the case where there is limited insurance coverage and enormous medical bills have been paid by the health carrier, and if there is health insurance to work with, but no PIP, a motion can be filed in court to clarify that it is not an ERISA plan. Unless they can prove it is an ERISA plan, they are not entitled to repayment.
Therefore, instead of sending the large amount of money to an insurance company, it can be properly sent to the client and protect him from any future inquiry from that insurance company.
They should get their bills paid as soon as possible. It will set their mind at ease. Otherwise they will continue to get bills every month from these providers saying, “Where’s our money?”
If they’ve properly submitted those bills and are paid by the appropriate company, they won’t get calls from collection agencies. They won’t start getting harassed by providers claiming they want their bills paid. That’s very, very important and one can’t emphasize enough that that has to be attended to first. Never sit back and think that the defendant or the responsible party will come in at some point and pay the bills.
Once in 30 years, you may see unique situations where an insurance company for the defendant pays medical bills upfront. Those are situations where they were trying to get goodwill but that’s a very unusual circumstance.
Get answers to questions about Personal Injury Settlements, or call the law office of Attorney David Maran for a free initial consultation at (973) 622-5303 and get the information and legal answers you’re seeking.