Which Providers Or Resources Are Entitled And Will Recoup Reimbursement Once The Settlement Is Achieved?
Settlements occur more than 90 % of the time. In a settlement, we are required to pay government liens, which would be Medicare and Medicaid. We are also required to pay ERISA liens, workers’ compensation liens and all letters of protection, which includes medical providers who’ve agreed to wait for their payment.
Clients are encouraged to assist attorneys at negotiating and paying all remaining bills. There is a broad list of everything that must be considered. Some are absolute requirements by law and some are more at the choice of the client but in all situations, an attorney can negotiate the amount of those bills based upon the recovery.
For example, if the recovery is full and the attorney has achieved everything the client is entitled to, the medical providers who hold the lien are not going to be willing to negotiate. They want their full payment. In situations where the recovery is limited for a variety of reasons, usually because there is not enough insurance coverage available, then the attorney can successfully negotiate. If the client is going to take less, very often the medical providers will also take less and there is a good reason for that.
What Is ERISA?
ERISA is a federal program where usually larger companies or unions provide medical coverage to their employees or members of the union which is funded by the pension plan. It is not really an insurance company. Sometimes insurance companies administer the plans and make the payments but the source of the funds come from the pension fund. Based upon federal statute, that has to be paid back when the case resolves.
When referring to health insurance in New Jersey, we are not required to pay that back based upon a Supreme Court case. In other states, health insurance companies are allowed to assert a lien for recovery of those funds. New Jersey is unique to that position.
Are People Surprised When It Comes To This Portion Of The Case?
No, they are not surprised because a good attorney will tell them beforehand. They may not remember at times, but clients at David Maran’s office are advised right upfront where the different liens might be so they understand how everything works.
The office of David Maran will also encourage you to find a way to have medical bills paid. They will tell you what the outcome will be and that yes, you get your bills paid by Medicare but they will want to be repaid. We have that discussion upfront and even if you’re working with another attorney, you should have that discussion to find out if there will be liens at the end of the day.
If you have questions about Paying Back After Winning A Personal Injury Case, 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.