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Medicare Settlement -anyone familiar with this?

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Nibot62

Junior Member
What is the name of your state (only U.S. law)? Nebraska
My father was hit head on in an auto accident 2 years ago. The other car had 2 people in the vehicle. Everyone died, although Dad did hang on for 10 days in the ICU. He was 79 years old. My mother, 75, was in the final stages of pancreatic cancer when Dad died. Luckily she was not in the car, however, she passed away one year ago today.

Eventually, we received $100,000 from Dad's insurance company, and $100,000 from the other families insurance. This money, $200,000 , went in to a special account at their bank. We then waited to see what our final bills would be. Eventually, Medicare settled with the hospitals. I only know that the total hospital bill was around $450,000. I have no idea what they accepted from the insurance companies and Medicare. An insurance rep (subrogation specialist) told me that we just needed to wait and see what Medicare would charge us. Expect it to take months. They may NEVER come back with a claim....and in that case, the proceeds from the settlement would be available to us.

Someone in my family decided that their friend, a personal injury lawyer, should in fact represent us. He assured us he would be very fair. For over a year, he dinked around with this case. Whenever we asked for an update (because we rarely if ever for a voluntary update from him) he said, "It's just a waiting game, waiting for Medicare to come back with their claim." Medicare finally came back with a claim of $58,000. The attorney got them to lower the amount to $38,000, because we would have attorneys fees to cover. Then the attorney charged us $38,000. So we ended up paying MORE THAN WHAT MEDICARE originally billed us. RIDICULOUS. This attorney did nothing. He did not negotiate the medicare bill at all, he simply waited to see what they would bill.

WOULD WE HAVE EVEN NEEDED AN ATTORNEY, or could we have just waited to see what Medicare would charge us, and then hire an attorney if we thought the fee was exhorbitant? We (the family) feel like we've been taken. BTW, the attorney quickly lowered his fee to $20,000 when we questioned it. I don't think he even deserved that.
We asked for copies of correspondence that he sent on our behalf, and the response was, "This does not have to be provided unless the case goe before a judge."

THOUGHTS?What is the name of your state (only U.S. law)? NE
 


Dandy Don

Senior Member
Did anyone in the family SIGN AN AGREEMENT OR CONTRACT with this attorney that explained his fees? If you didn't then a serious mistake was made. Did he ever send a final bill with itemized listings of his billable hours accumulated?

File a complaint with the Nebraska State Bar Association about this unethical behavior--it was wrong for him to take the entire settlement. But first talk with an attorney who has experience with wrongful death settlements to see if you have grounds for a legal case against him. You all were shafted and you can't let him get away with this.

DANDY DON IN OKLAHOMA ([email protected])
 

Nibot62

Junior Member
Medicare Claim - anyone familiar

Dandy Don - We did NOT sign a contract. He verbally told my mom, "I won't handle this like I would a normal case, where our fee would be 33%, because the money is already in your account. I will just help you negotiate with Medicare." But he DID charge 33% ($38,000) and when we balked at that, he immediately lowered his fee to $20,000. But again, I cannot see what he even did. We were told all along, that it was a "wait and see" with Medicare, to find out what they would in fact bill us. And from I can see, they only came back with one amount, which was $58,000. It wasn't like they came back with a claim of $150,000 and this attorney neogiated it down to $58,000. Plain and simple, once the atty got the bill for $58k, he went back to Medicare and said, "Oh, but this family has incurred atty fees, pls reduce your claim" and they reduced to $38k. So after we balked at the $38k atty fee, and he lowered the fee to $20k, we are supposed to believe that he did us such a favor. He "obtained quite a nice settlement" for our family, in the words of my brother in law, who by the way, is a friend of the attys.

So you really think we should protest? We would have had to pay $58k to Medicare had we not had the atty. My thoughts were, if the atty had not notified Medicare that he was representing us, blah blah blah, would MEdicare have EVER come back and filed a claim? The subrogation guy at the ins company said that often times, Medicare comes back to the family.

The $100,000 from both ins companies was for liability. I'm not even sure what that means. I mean, does that mean that that was supposed to be compensation for us for the sudden and trajic loss of our father? And is it typical that Medicare would come back and take some of that? It's all okay, we still have ample funds, and more that what we thought we would have, but I can't quit thinking about the fact that this atty took us for a $20k ride.
 

ecmst12

Senior Member
If you are sure that no one ever signed a contract with this shyster, then there is no reason for you to pay him anything.
 

Nibot62

Junior Member
Medicare Claim - anyone familiar

Regarding the lack of a signed agreement, we were told - now that we are questioning this - that we didn't HAVE to sign anything. The standard fee in these cases is 33%, plain and simple. No agreement needed to be signed. (Just reiterating what I was told.)

Where should I go for additional legal advice? Our estate attorney tells us that this settlement is probably fair. We live in a small town, and I get the feeling he doesn't want to rock the boat. The Personal Injury attorney is in Omaha. AND, my family all thinks that we should just go ahead and pay this guy his $20,000 and be done with it. But I feel like we should have just paid Medicare the $58,000 and him nothing. I would rather reimburse my gov't than pad his pockets anymore. Again, I wouldn't object to compensating him if I thought he had done something. But I can't see what he has done.
 

ecmst12

Senior Member
Medicare reduced their fees by 20k. You owe him 33% of the 20k that he got you. If you want to pay him something.

You WOULD have had to pay medicare back no matter what. The government always wants its money back.
 

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