In US Airways, Inc. v. McCutchen, 2011 WL 5557411 (3rd Cir. Nov. 16, 2011), an ERISA plan sought reimbursement of 100% of what it had paid for medical bills for a car crash victim even though the victim had not been fully reimbursed because of limited liability coverage. The lawyers for the car crash victim … Continue Reading
My client was severely injured in an automobile accident. He received medical treatment that was paid for by his employer’s group health insurance policy. The plan is a fully insured health insurance policy. I was able to settle the injury case for the policy limits of the person who caused the accident, plus the policy … Continue Reading
My client was severely injured in a motorcycle accident. In a bad faith lawsuit against the at-fault driver’s insurance company we recovered a confidential amount well in excess of 150 times the policy limits. My client’s health insurer paid around $200,000 for medical care related to the crash. After resolving the bad faith case, my client’s health insurer … Continue Reading
My client was injured at work. Her employer totally controverted the claim. Because the claim was denied, she sought medical care under her employer sponsored HMO policy. Eventually, she and her workers compensation lawyer settled the work comp case as a totally controverted claim. The HMO sought reimbursement of its alleged lien out of the work comp … Continue Reading
My client was injured in an automobile accident. My client was an HMO member through his employer. The HMO was issued by Blue Cross and Blue Shield of Florida. After the accident, Blue Cross and Blue Shield provided some medical services to my client that were accident related, and also provided some services that were not related … Continue Reading
Today, I filed suit against American National Life Insurance Company of Texas which is asserting a lien on a portion of my client’s settlement proceeds. My client lives in Florida, but was injured in New Mexico in an automobile accident. American National paid for a portion of the medical care related to the accident, and believes … Continue Reading
On January 10, I wrote about a case which I filed in order to eliminate an ERISA health benefits lien that was being asserted against my client’s personal injury and uninsured motorists settlement. The client’s personal injury attorney had made a good recovery for the client, but the ERISA plan wanted to be reimbursed 100% of … Continue Reading
I filed suit today in federal Court against a self-funded ERISA plan which was seeking recovery of a lien against my client’s personal injury recovery. My client was seriously injured in an automobile accident. The self-funded ERISA plan paid for his medical treatment. Unfortunately, there was limited bodily injury and uninsured motorists limits available. My … Continue Reading
On June 25, 2009, I wrote that I had been referred a client by a local personal injury firm in order to litigate an ERISA lien. At the time I received the case, ACS Recoveries was refusing to reduce at all. I am happy to announce that today, as a result of our Federal Court Dec Action, the lien … Continue Reading
Many insurers who are providing med pay coverage for automobile accident victims are now seeking reimbursement or subrogation out of the bodily injury settlements. In many of those cases, no such right of reimbursement exists. In the remainder of cases, the med pay insurer will be required to take a substantial reduction in what it … Continue Reading
My client settled her UM case for the available uninsured motorists limits. Her HMO had paid for some of the medical care incurred as a result as the motor vehicle accident. At the time of settlement, the HMO asserted a lien against the recovery for the full amount of all benefits it paid which were related … Continue Reading
A prominent personal injury firm has referred me their client in order to deal with an ERISA lien which is being asserted against a personal injury settlement. The lien recovery firm is seeking 100% of the amount paid in medical benefits after an automobile accident, and is refusing to budge. However, I believe I will be able … Continue Reading
On June 1, I wrote about a declaratory judgment action I filed in order to reduce a $200,000 ERISA health insurance lien. Prior to receiving the suit, the health insurer took an aggressive stance, and advised my client’s personal injury attorney that it would take $142,000 of the personal injury settlement. Other than that meager reduction, … Continue Reading
Our client was severely injured in a car accident and his parents’ health insurer paid over $200,000 for medical expenses incurred as a result of the crash. Our client’s personal injury attorney settled the case for the available BI and UM policy limits (plus some additional money from the UM carrier for alleged bad faith). However, even … Continue Reading
In Ward Mfg. v. Yeager, 2009 WL 1107891 (E.D. Pa. April 22, 2009), Yeager’s injury lawyers recovered money for personal injuries. Ward had paid medical expenses associated with the injuries, and claimed a right to be reimbursed from the personal injury proceeds. Ward filed an action under 29 USC Section 1132(a)(3) (2009) against Yeager and … Continue Reading
Avmed HMO asserted a lien, or right of reimbursement, against a portion our client’s uninsured motorists settlement. Although the amount of the alleged Lien – $9,749.51 – is relatively small, it is my position that HMO’s never have any lien on UM benefits. When Avmed refused to voluntarily withdraw its claim of lien, I filed a … Continue Reading
Federico A. was involved in a serious car accident and as a result suffered extensive physical injuries. He was transported to the hospital for several emergency surgeries. The hospital promptly submitted his medical bills to his PPO health insurance company, Blue Cross and Blue Shield of Florida, for payment. The treatment had been rendered by … Continue Reading
Recently, a prominent local personal injury law firm asked me to deal with a $192,000 ERISA health insurance lien on a case they had settled. That firm had attempted to negotiate with the lien-holder to reduce the lien, but as is often the case, the lien-holder would not budge. The personal injury victims retained me, … Continue Reading
Many times, when a lawyer for a personal injury victim settles his or her client’s personal injury case, the health insurer will ask for a significant portion of the settlement for reimbursement of expenses which it incurred in paying for health care. This is known as "subrogration" or a "right of reimbursement." Repeatedly, I have … Continue Reading
Many times, when a lawyer for a personal injury victim settles his or her client’s personal injury case, the health insurer will ask for a significant portion of the settlement for reimbursement of expenses which it incurred in paying for health care. This is known as "subrogation" or a "right of reimbursement." Repeatedly, I have … Continue Reading
