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 to the crash.
I advised the HMO that it had no lien at all, and even if it did, it would only be a small percentage of the amount it was seeking. The HMO refused to budge and I filed a dec action seeking a declaration that the lien did not exist.
On cross motions for summary judgment, the trial court ruled that an HMO has no right of recovery or lien with regard to UM benefits. This is because, an HMO’s right of reimbursement is a creature of statute, and the applicable statute only allows an HMO to be reimbursed if the victim is reimbursed "by a tortfeasor." Obviously, (or maybe not so obviously, given the fact that we had to litigate this issue to summary judgment) a UM carrier is not a "tortfeasor." We are now seeking our attorneys fees from the HMO for all fees incurred in the dec action.
Repeatedly, I have seen cases where good attorneys pay back liens that do not even exist, or they pay back way too much. Paying back liens that don’t exist, or paying back too much is a disservice to our clients, and can be considered malpractice. The law on health insurance liens is complicated and one should not dabble in it unless experienced.
Although this case was brought on behalf of one of our own personal injury clients, frequently, personal injury attorneys will recommend their clients to hire The Nation Law Firm to negotiate those liens. This referral removes any potential liability from the personal injury attorney, and provides a much needed service to their clients.