Settlement payment

[Amgibbie]

My husband was in a motorcycle accident and the auto insurance company paid a settlement to us . Our lawyers told us that they can't release the check till the first hospital he was at gives us a zero balance for the time he was there. The medical insurance denied payment because the claim was not billed in a timely manner and under their contract with the hospital it says they have a right to deny payment and that we are not responsible for that bill. Shouldn't that be enough for them to release the check?

 

[quincy]

What is the name of your state, Amgibbie?

 

[Amgibbie]

California

 

[latigo]

My husband was in a motorcycle accident and the auto insurance company paid a settlement to us . Our lawyers told us that they can't release the check till the first hospital he was at gives us a zero balance for the time he was there. The medical insurance denied payment because the claim was not billed in a timely manner and under their contract with the hospital it says they have a right to deny payment and that we are not responsible for that bill. Shouldn't that be enough for them to release the check?

NO, that is not enough to permit the attorneys to "release the check"! And your big mistake is in the mistaken premise that "we" are not responsible for that bill. Moreover I'm much disinclined to believe that your "medical insurance" carrier would be so foolish as to tell you that "we are not responsible."

The patient's liability for the medical care is totally independent of available insurance coverage. The only question here might be whether or not the hospital perfected its statutory lien upon the settlement as provided in Sections 3045 et seq. of the California Civil Code.

Circumstances here would indicate that the hospital lien has been perfected. If so, the attorneys are bound to honor it in making distribution of the settlement, or pay it out of their own pockets. (See: Section 3054.4)

If I were in your shoes, I would be looking into the issue of whether or not the hospital's claim was properly denied by the insurance company. This business of the carrier getting off of the hook because of its "contract with the hospital" smells of week old fish. If you haven't addressed this specific issue with the attorneys, then do so.

 

[Amgibbie]

Wow

You seem a little rude? We're not trying to screw anyone out of their fair share. Since the settlement was paid from our auto insurance company from the uninsured motorist policy. Plus the man that hit my husband didn't have a license and was just trying to avoid traffic by jumping into the carpool lane (without a passenger). Also since the medical insurance told us and sent legal documents saying we are not responsible but i could submit the claim myself if it was within the year from the billing date and they would pay .Unfortunately the hospital didn't submit the bill till 2 days before the year deadline for us which is past the contract date with the insurance company which is 180 days i couldn't even ask for them to pay which they would have,if I'd have asked. All i was asking for was advice not a rude comment. I have forwarded your comment to our attorney to double check your comment and thank you for your input but next time maybe try not to be such a douce bag!

 

[Indiana Filer]

You seem a little rude? We're not trying to screw anyone out of their fair share. Since the settlement was paid from our auto insurance company from the uninsured motorist policy. Plus the man that hit my husband didn't have a license and was just trying to avoid traffic by jumping into the carpool lane (without a passenger). Also since the medical insurance told us and sent legal documents saying we are not responsible but i could submit the claim myself if it was within the year from the billing date and they would pay .Unfortunately the hospital didn't submit the bill till 2 days before the year deadline for us which is past the contract date with the insurance company which is 180 days i couldn't even ask for them to pay which they would have,if I'd have asked. All i was asking for was advice not a rude comment. I have forwarded your comment to our attorney to double check your comment and thank you for your input but next time maybe try not to be such a douce bag!

You are the only one being rude in this thread, calling names and using rude language.

 

[AdoptADog]

If it was a participating hospital in your insurance plan, they had your proper insurance information, and they failed to bill it in time, you are not liable for the fees. It should be explained in your plan's information and your explanation of benefits. But beware that depending on your insurance plan, some of the doctors might not have been participating physicians even if the hospital was.