Question about personal injury claim

[SPROUTLADY123]

Medical insurance plans often have a provision that allows the insurance company to be reimbursed out of a claim settlement or award for any treatment that the insurance company pays for.



"I was told" is one of the most dangerous phrases in the English language. People who "tell" you things are often clueless.

While it's quite possible that your HMO plan doesn't cover treatment necessitated after an auto accident I wouldn't take anybody's word for without reading it personally in the plan policy or contract.

I suggest you do that.

Since I had absolutely no idea that my insurance company would pay (because from the beginning I was told this, that I was completely covered for my medical bills under the no fault, and now I come to hear that my insurance company paid the nursing home because, as they put it, "I am entitled to medical care and so they paid", good lord. I just wrote to my lawyer and told him all of this.

I only know that I was operated on, given paid meds, retained an attorney, was told I would be compensated for my pain and suffering..... and during my stay at the nursing home, I was contacted by the billing department of the nursing home and told them I was hit by a car, covered under no fault, and gave them my attorney's name. I sent every bill I received from anybody, well I sent them directly to my attorney. I have absolutely no family.

Please tell me I"m not screwed.

sproutlady

 

[adjusterjack]

I apologize. I seem to be piling one confusing concept on top of another so I suggest you rely on your attorney for any additional explanations.

 

[SPROUTLADY123]

I apologize. I seem to be piling one confusing concept on top of another so I suggest you rely on your attorney for any additional explanations.

Please don't give up on me now. I did email my attorney. Haven't heard back yet. It's been a short time.

I really don't understand all of this. What I do understand (at least I think I do) is that my insurance plan was not supposed to pay any of my medical expenses nor were they supposed to be billed.

I just want to know one fact. Will this impact my settlement and if so ....how?

Thanks,

Sproutlady

 

[Zigner]

Please don't give up on me now. I did email my attorney. Haven't heard back yet. It's been a short time.

I really don't understand all of this. What I do understand (at least I think I do) is that my insurance plan was not supposed to pay any of my medical expenses nor were they supposed to be billed.

I just want to know one fact. Will this impact my settlement and if so ....how?

Thanks,

Sproutlady

You REALLY need to be discussing this with your attorney, as he will know all of the intricacies involved. Relying on an internet forum in your situation does absolutely no good.

 

[SPROUTLADY123]

You REALLY need to be discussing this with your attorney, as he will know all of the intricacies involved. Relying on an internet forum in your situation does absolutely no good.

I have sent him an email. It's after business hours. I'm 70 years old. I just wanted a bit of information.

To anyone else who has a clue what I"m talking about, please help me.

Thanks much

sproutlady

 

[HighwayMan]

To anyone else who has a clue what I"m talking about, please help me.

No. You can wait a few days and speak with your attorney. No one here can give you any more information. You are foolish if you think a bunch of strangers on an Internet forum can help you more than your attorney can.

If you're not happy with your attorney you should consider getting another one.

 

[ecmst12]

If you've been sending everything to your attorney, he will handle anything that your medical insurance covered and will need to be paid back out of your settlement as well. You're worrying about things that you're paying your lawyer to worry about for you.

 

[SPROUTLADY123]

Just wanted to update you all on my situation. I had my deposition, told the truth, left the building and the guy who hit me had his turn to be deposed. He denied everything. Said he never hit me, that I panicked when I saw his car coming at me, threw myself on the ground and broke my own hip. My attorney said "he was the worst witness we ever deposed". He was not a credible witness, etc. I was mailed a piece of paper indicating I had to be examined by HIS choice of physicians. Which I was. We are now going to trial. Oh well.

 

[Taxing Matters]

Keep in mind that, on a contingency, all your lawyer has to do is get you an offer of settlement. If the offer is the policy limit, he's done. If you want him to pursue the at fault driver any further than that, you will have to go to trial and be awarded an additional amount. My guess is that your lawyer will refuse to do that if he has obtained the policy limit for you unless, of course, you pay him by the hour.

No Jack, that is not right. You are not familiar with law practice. The attorney is NOT done in the case with an offer for the policy limit. He or she cannot simply stop working the case at that point if the client declines the offer. The attorney is done when either a settlement is concluded or the case is resolved in court one way or the other, either with a judgment for his/her client, a dismissal of the case or summary judgment for the defendant, or whatever. The lawyer may strongly urge the client to take the settlement if he/she really thinks that’s the best deal they’ll get, but if the client doesn’t do that the fee arrangement does not suddenly flip over to an hourly fee agreement. Contingent fee agreements sometimes do increase the percentage of the award that the attorney gets if the case proceeds to trial rather than settling early to account for the extra time, effort, and risk that trial involves. In the case of firms in my area that would usually mean going from 33⅓% to 40%. But it is still a contingent fee deal, so the client still is not plunking down money for a lawyer’s fee in advance of getting any recovery.

The usual fee agreement does not typically cover appeals, though; the client may need to enter into a new agreement to cover the appeal portion of the litigation, and that might be done by the hour.

In a situation where policy limits are offered and the defendant has few easily attachable assets often taking that offer is a good deal even if a judgment might be obtained for more. A judgment you cannot collect is not really worth much.